Like all doctors, Donald J. Kurth, MD, FASAM, treasures his day-to-day, one-on-one interactions with patients. But the Rancho Cucamonga-based addiction medicine specialist also sees medicine from 30,000 feet. To him, it's one of an entire kit of tools--along with local politics and public speaking--he can use to improve the world around him.

"Taking care of people at the Loma Linda University Behavioral Medicine Center is what I do every day," Dr. Kurth says. "I help them through detox in a compassionate way and provide education to help them build a foundation for their recovery."

However, Dr. Kurth works to make an impact well beyond individual patients. By advocating for state and national public policy changes, Dr. Kurth is trying to do no less than "build a movement within medicine that hasn't been here before." His overarching aim: Remove the veil of secrecy around addiction medicine and expose what he calls "the faces and voices of recovery."

There's a tradition of anonymity with addiction treatment, Dr. Kurth says, emphasizing that he respects some patients' unwillingness to speak openly. "But I think it hinders us sometimes," he says. "Talking about addiction medicine lets the public know that not everybody in recovery is there one weekend, but drunk the next."

Dr. Kurth's passion comes from his past experience with the demons he now treats. When asked why he made the switch from emergency medicine, the first specialty he was boarded in, to addiction medicine, he says simply that it happened "through my own recovery from drugs and alcohol."

To explain why changing public policy is essential, Dr. Kurth uses a metaphor of addiction as a treacherous waterfall. "[When I was in emergency medicine], I felt like I was running a trauma center at the base of a waterfall," he says. "Day after day, night after night, the paramedics pulled people from the water with head injuries and broken bones. We brought them into our trauma center and we brought to bear all the technology and expertise of modern medicine to try to save their lives."

He continues: "How can we be more successful? Should we be buying bigger and better CAT scanners? Should we hire more doctors and nurses and buy more plaster for casts? Or would it make more sense to put up a sign above the falls saying, 'Turn Back Now. Deadly Falls Ahead.' Perhaps boating safety lessons or even a barrier across the river upstream from the falls would be the answer. A problem like the waterfall has to be addressed proactively on a public policy level. Bigger and better CAT scanners are not going to be the answer."

To find answers, Dr. Kurth says, physicians must participate. He cites the German pathologist Rudolf Virchow as one of his heroes. "Virchow realized that, although physicians are often trained to understand disease on the basis of a single patient, the great strides in eliminating disease must occur on a public health or political basis. Were he alive today, I am certain he would be fighting for addiction treatment on request for every American in need of care."

Virchow also said that "if medicine is to fulfill her great task, then she must enter the political and social life." Dr. Kurth did so most recently through a two-year term on the Rancho Cucamonga City Council. "We voted to ensure that our new senior center was alcohol-free so our citizens would have a clean and sober place to gather with their families," he says. "On the chemical dependency front, we recognized September as Recovery Month and passed a proclamation in that regard. In addition, we strongly supported the city's Drug Court program, helping people receive treatment in lieu of incarceration."

To educate the public broadly, Dr. Kurth spoke out with programs titled "Chronic Pain and Addiction" and "Dealing With Addiction During the Holidays" on a variety of local radio shows and presented "Staying Sober Over the Holidays" for a cable channel.

Dr. Kurth's wife, Dee Frances Matreyek-Kurth, PhD, champions his causes as well. "I am fortunate to have a wife who supports my social commitment to creating healthy public policies," he says. "She has a PhD in political science and runs a nonprofit she created called the Restorative Justice Center of the Inland Empire." She also teaches classes at the Chino women's prison on nonviolent conflict resolution. Says Dr. Kurth: "I can't tell you how proud I am of all the things she does. We support each other's policy work."

Dr. Kurth carries his enthusiasm for positive change to the halls of organized medicine as well, working with the California Medical Association, the California Society of Addiction Medicine and the American Society of Addiction Medicine. Advocacy activity is necessary, he says, for medicine to reach its full potential.

"Is there any greater gift than being able to serve another human being as we do in our roles as physicians?" he asks. "Perhaps not. But if there is, it is being in a position to change public policies so that other human beings can live happier, healthier and more fulfilling lives. In Virchow's day, dysentery and typhus were rampant. Individual physicians could not cure them. Public policy had to be changed. Without physician input, politicians are simply not going to know what public health policies should be instituted to create a healthier world. As physicians, we have to be there. If we don't have a seat at the table, our views are going to be ignored."