ratush

Twenty years of concierge recovery medicine. A practice limited to a small number of families each year.

A longitudinal physician-led engagement for a single patient and their family. Medical stabilization at home, followed by twelve months of direct continuity with the doctor who began the work.

Schedule a Consultation
By application. New families considered as openings allow.
The Practice

Recovery medicine is not a five-day event. It is a relationship.

Most addiction care is organized around episodes — a detox week, a residential month, an outpatient program — each delivered by a different team, each ending at the moment the work begins. The first ninety days after detox are when most families lose what they came for.

This practice is built differently. One physician. One family. One year. The medicine is the same medicine practiced everywhere; what is uncommon is the continuity of the person practicing it.

The work is intimate. It is meant to be transformative. It is offered to a small number of families at a time, not because the demand is small, but because the relationship is.

The Physician

Four credentials, accumulated over two decades.

i.
Twenty years of concierge recovery medicine.
A clinical career built inside private practice — patients seen one at a time, families known by name, treatment plans carried over years rather than weeks.
ii.
Twenty years of nonprofit leadership in the recovery field.
Board service and operational leadership at the institutions that shape American addiction care — a vantage point on the field, not a distance from it.
iii.
Founder of the first DTC telehealth recovery brand.
Built and led the first nationally-available direct-to-consumer telehealth recovery brand for insurance-based care, more than a decade before the category existed. The work that proved the model could exist — and the operational vantage point on what that model can and cannot deliver.
iv.
A practice trusted by patients with the resources to choose anyone.
For twenty years, Ratush has cared for patients with the resources, the relationships, and the discretion to choose any institution, any clinician, anywhere. They have chosen privately. The references are private as well. The standard of care is not.
Why Families Choose This Practice

The patients with the most options are usually the ones who have already tried everything else.

The patients who arrive at Ratush are sophisticated buyers of medical care. They have access to the best-credentialed specialists in the country and they use it. They have seen the inside of the most respected residential programs. They have run their own diligence on the medications, the modalities, and the clinicians. Most have spent years inside conventional treatment before they ever look at something private.

They do not arrive here first. They arrive after the brand-name residential program, after the second-opinion psychiatrist, after the credentialed addiction specialist their primary doctor recommended. They arrive having seen the inside of the field and remained dissatisfied with it.

Three things explain why they stay.

i.
An out-of-the-box clinical approach.
Recovery medicine has a small set of standard answers and a large variety of patients. This practice is built around the assumption that most patients have already received the standard answers and that those answers were insufficient. The clinical work begins where conventional treatment usually ends.
ii.
Evidence over orthodoxy.
Every recommendation is investigated against the data, not against the convention. Medications, modalities, lifestyle interventions, and emerging therapies are all evaluated on the merits for each individual patient. Nothing is added because it is fashionable; nothing is withheld because it is unfamiliar.
iii.
Technology used as a clinical instrument.
Continuous monitoring, structured outcomes data, telehealth continuity, and integrated assessment tools are part of the practice — not because technology is interesting, but because it allows a single physician to maintain the kind of clinical attention that used to require a team.
Writing

The substance of the practice, in long form.

Essay
Why the First Ninety Days After Detox Are When Most Families Lose What They Came For
A note on the medicine of the year that follows the week — what is happening neurobiologically in the post-acute window, why the standard model is poorly matched to it, and what a single-physician longitudinal practice looks like when designed to address it directly.
Approx. 12 minutes · Written by E.R., MD
Read the Essay →

Additional essays — on the family system, on outcomes, on what evidence-driven addiction medicine looks like in practice — are published quarterly. Inquire by text to be added to the practice's reading list.

Reported Themes

What families usually notice when care becomes continuous.

Continuity. Families often describe the difference as having one physician remain involved across stabilization, medication decisions, family conversations, and the long months after acute detox.

Individualization. The work is built around the patient’s actual physiology, history, sleep, family system, medication response, and recovery environment rather than a fixed program schedule.

Family integration. The family is treated as clinically relevant: not as an audience, not as an afterthought, and not as a separate administrative problem.

Access with boundaries. The engagement is designed for direct physician continuity and urgent clinical availability within the engagement terms. It is not an emergency medical service.

Longitudinal medicine. The central premise is that the year after detox requires medical continuity, not episodic handoffs.

Privacy. The practice is structured for families who need care handled quietly, personally, and with attention to confidentiality.

These are practice themes, not testimonials, guarantees, or outcome claims. Patient identities and identifying details are protected. No patient is identified or quoted without specific written authorization.

Scope of Practice

A single longitudinal engagement, delivered as one continuous relationship.

Comprehensive Consultation
A clinical interview with the patient, a separate interview with the family, and a review of medical and treatment history. Required of every new family before any further engagement is discussed. The consultation produces a clinical impression and a recommendation; the conversation that follows determines whether the practice is the right setting for the work.
Medical Stabilization at Home
When clinically indicated, medically managed withdrawal in the patient's residence — five to fourteen days, depending on the substance, history, and risk profile. The nursing team is selected and overseen by the physician; the medicine, the assessment, and the longitudinal arc remain his. Home is rarely the right setting for this work; when it is, it is the only setting.
Twelve Months of Direct Physician Continuity
After stabilization, twelve months of direct contact between the patient, the family, and the physician. Weekly to monthly cadence by clinical need. Telehealth and in-person. Medication management, family integration, urgent clinical availability within the engagement terms. This is the work.
Family Inclusion
Addiction is a family condition. Spouses, parents, and adult children are part of the engagement from the first interview forward, and structured family work is embedded in the twelve-month arc — not added to it.
Engagement

Two ways to begin. Both begin with a paid consultation.

Geography

Considered for patients and families in eleven licensed states.

Edward Ratush, MD is independently licensed to practice medicine in eleven states. The practice considers patients and families in states where the physician is licensed and where the proposed clinical work is legally and clinically appropriate. Controlled-substance prescribing, telemedicine, in-person care, nursing services, and any local services are subject to federal and state requirements at the patient's location.

The eleven states are: New York, New Jersey, Connecticut, Massachusetts, Pennsylvania, Ohio, Florida, Colorado, California, Arizona, and Texas.

NY
New York
New York City, the Hamptons, Westchester, Hudson Valley
NJ
New Jersey
Bergen County, Princeton, the Jersey Shore
CT
Connecticut
Greenwich, New Canaan, Westport, Litchfield County
MA
Massachusetts
Boston, Cambridge, the Berkshires, Cape Cod, Nantucket
PA
Pennsylvania
Philadelphia, the Main Line, Pittsburgh
OH
Ohio
Cleveland, Columbus, Cincinnati
FL
Florida
Miami, Palm Beach, Naples, Boca Raton, Jupiter Island
CO
Colorado
Aspen, Vail, Telluride, Denver, Boulder
CA
California
San Francisco, Bay Area, Los Angeles, Malibu, Montecito
AZ
Arizona
Scottsdale, Paradise Valley, Sedona, Tucson
TX
Texas
Houston, Dallas, Austin, the Hill Country

For families residing outside these eleven states, any request is reviewed individually and depends on applicable law, licensure, and clinical appropriateness.

On the Practice

Questions families ask before applying.

Why is the consultation paid in advance?
Because it is a clinical service, not a conversation about a clinical service. The work of the consultation is real, and it begins immediately. Paying in advance is the standard for any specialist's time at this level.
Why is the engagement a year?
Because the medicine of the first week is well-understood, and the medicine of the first year is where most families fall through. Continuity is not a feature of this practice — it is the practice. A shorter engagement is available in unusual circumstances; the standard is twelve months.
Is this a treatment program?
No. It is a private medical practice. The physician is independently licensed in each of the eleven states listed; nursing and family-therapy services are delivered by independently licensed clinicians under their own credentials. The engagement is a longitudinal physician-patient relationship, structured to include the family.
Do you accept insurance?
No. The practice is private-pay. A superbill can be provided for the family's own out-of-network submission, where applicable.
What about confidentiality?
Patient confidentiality is the bedrock of the practice. Records are governed by HIPAA and 42 CFR Part 2, the federal protection specific to substance-use treatment records. The practice does not advertise or identify any patient, past or present, without specific written authorization. See the Notice of Privacy Practices for detail.
How do I begin?
By scheduling the consultation. There is no other entry point.

For the family who has
already decided to be private about this.

Inquiry is by text message only. The practice does not maintain a public phone line, a chat widget, or a contact form.

To Schedule
Text "year one" to
917 · 512 · 6082
A member of the practice will respond personally within one business day with available consultation times and a secure next step. Please do not include diagnoses, medication names, substance-use history, or other clinical details in the first text message.
By application. New families considered as openings allow.

This is not an emergency or crisis service. If you are in immediate danger or experiencing a medical emergency, call 911 or go to the nearest emergency department. For mental health or substance-use crisis support, call or text 988 or use the 988 Lifeline chat.