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 Post subject: Online Sub Doc?
PostPosted: Wed Jun 29, 2016 8:35 pm 
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My insurance allows Telemedicine and lists some providers who are licensed for bupe. Does anyone use an online doc?


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 Post subject: Re: Online Sub Doc?
PostPosted: Thu Jun 30, 2016 1:39 pm 
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While I have an actual suboxone doctor, we have a video chat every month for my prescriptions. 4 times a year I have to go into the office.

It's more likely that you might find a doctor who would prescribe for you that way after establishing a relationship first. I don't know of any specifically online sub doctors. Sorry.

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 Post subject: Re: Online Sub Doc?
PostPosted: Mon Sep 26, 2016 10:25 am 
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Having done telemedicine in an unrelated field (stroke treatment), couple of comments --

1. Establishing an empathetic therapeutic relationship is hard enough as it is. Anything other than a face to face visit (email, phone, video) sets up barriers to communication. Recognizing that in any exchange there is both verbal and non-verbal communication, and the non-verbal stuff doesn't come through at all in writing, and not very well even on video.
2. Agree video followup could be an option for some patients under some circumstances. Mainly, if the patient is stable, has a support system in place, and face-to-face adds burdens (expense, time off from work) that need avoiding. Sounds like it could be a valuable service; in fact if I get back into OTP I would consider offering it.
3. Anything other than a face-to-face eval for the first visit, in which controlled substances are prescribed, is a huge red flag. Pretty sure it's not legal in Florida and suspect it's probably illegal elsewhere. I think we should be able to make exceptions under some circumstances; for example some Western states are huge, sparsely populated, with docs concentrated in urban areas. Video treatment could be a solution where addiction is a significant public health issue (and it usually is). But when telemedicine is used to cut corners rather than to benefit the public, watch out.

From the consumer's viewpoint, if the telemedicine program is affiliated with a university, that's always a good sign. If it's some cowboy out to make $$$ -- well, you know.


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