John William Dougherty, DO

What Category Provider type are you? Psychiatry
What board certifications do you hold? American Board of Psychiatry and Neurology, American College of Osteopathic Family Physicians
How many years have you been in ketamine practice? 3
What percentage of your work is clinical versus research? 95%
Please describe any connections you have to major universities, research institutions and pharmaceutical companies, both financial and advisory/board? Collaborate on some research papers with colleges in the TBI realm at Johns Hopkins but no formal associations currently
What are your views regarding desirability and appropriateness of including and fostering the variety of practitioners who presently administer ketamine for mood disorders? I believe it is important to foster many different perspectives regarding ketamine for mood disorders because each representative has views that may be overlooked by the other practitioners. These views may provide valuable insight into how we can do things better to improve patient outcomes. I believe in a team approach and that all of us have the same goals in mind for patients so whatever will help them is best.
What is your preferred route of administration of ketamine for mood disorders. What are your thoughts about the appropriateness or therapeutic value of other routes? I prefer IV administration due to having performed more than 2000 infusions over the course of the last few years. I had some experience with IM as well but most often patients did not like the quick impact and it often led to more nausea and unpleasant experiences for them. I have no experience with PO ketamine at this time and am open minded but wish he bioavailability was higher.
How do you approach the problem of integrating the transient altered state we induce into the patient’s overall psychic economy? What is the practitioner’s responsibility in this regard? For the previous clinic I worked at, we had always left individuals to themselves during the experience because it seemed that if that had certain dissociative symptoms they would often appear to respond better to the treatment itself and the subsequent treatments. I do believe having some symptoms are likely important although there are some patients who were the exception to the rule. I would look at the bottom line in terms of results of symptom reduction but if they were not improving, I would definitely push for a more transformative experience to give them the best chance to succeed. I have also now seen/heard some patients do better with some guidance during there experience with psychotherapy which I think can also help to a certain point in some individuals.
The practioner’s responsibility is to optimize results so if they do not appear to respond I think it is important to increase the dose to change the experience a bit as long as they can tolerate this change. I try to balance this with the overall pleasant nature of the experience because if they have a terrifying time we also do not want to scare them away from continuing this treatment.
Please describe your present clinical practice. How will it look different in 5 years? Currently I have transitioned away from an all ketamine practice in the past year and have started to get back into it again. Currently I am providing some ketamine services within an existing ketamine practice in New Jersey under the leadership of Dr. Patrick Sullivan. The goal is to increase volume and gradually expand the hours of the practice and to hopefully add a second location in PA in the near future. In the next five years, we hope to be able to have at least two successful practices offering a variety of services including traditional psychiatric services, TMS, ketamine and possibly even psilocybin if that is available at some point in the next few years.
How do you envision ASKP3 growing over the next 4 years? I envision ASKP3 growing to add more providers from a variety of disciplines and expanding access to ketamine across the country. I envision this organization advocating for the destigmatization of ketamine as a valuable treatment option and pushing for more ways to get ketamine to patients with better forms of oral supplements, easier ways to set up clinics using spravato and providing a great understanding to general practioners and other providers to consider referring for ketamine treatment sooner in treatment rather than waiting until a patient has tried practically every medication and has been struggling with severe depression for years. I hope they can advocate to the different states for ways to help access happen easier and encourage providers to offer ketamine.