Patient Management Issues Specific to Rural Practices

Problem: Rural patients may have to travel long distances to get to my office and coming frequently presents an undue burden.

Solution: Refer patients to outpatient addiction treatment programs in their community that can verify counseling and perform urine testing. Get releases to speak with family to corroborate patient reports about treatment progress.

Problem: Acquiring buprenorphine may be more difficult at smaller local pharmacies.

Solution: Before you start prescribing buprenorphine, call at least one pharmacy to verify that they will keep the drug in stock.

Problem: Poverty rates are often higher in rural areas than larger suburban and metropolitan areas, and patients may be less likely to have medical insurance.

Solution: Make sure your practice is set up to accept Medicaid patients and consider adding a fee-for-service treatment program.

Problem: Maintaining confidentiality may be more difficult in small communities than in more populated areas.

Solution: Ask staff members to sign a special confidentiality agreement pertaining to buprenorphine patients and require that buprenorphine patients /issues are discussed only in private areas of the office.