Physician Patient

Archive for August, 2018

Follow the money: Why there’s a shortage of addiction-trained physicians in Minnesota

Monday, August 6th, 2018


Why aren’t there enough addiction-trained physicians in Minnesota?

Thanks to the StarTribune (above) for telling readers about the life-saving potential of physician-prescribed buprenorphine (Suboxone, Subutex) in preventing inadvertent opioid overdose deaths. Buprenorphine (Suboxone, Subutex, a number of generics now) is a proven effective clinical tool in the war against preventing inadvertent overdoses from opioid pain pills or street heroin, which is 100 times more lethal when laced with fentanyl.

So why is buprenorphine not more widely available to help Minnesota patients who are diagnosed as being opioid dependent? Yes, it’s hard for opioid dependent patients in Minnesota to get a prescription for buprenorphine medication. But this is due to much less to (past) restrictive managed care prior-authorization rules than because today there are few doctors in Minnesota who are certified to prescribe buprenorphine as a treatment option for patients who are diagnosed with opioid dependency. The physician training and certification requirements
are clearly reasonable and doable for primary care doctors in Minnesota. So, what’s the problem?

Follow the money. The shortage of certified buprenorphine prescribers is due to low third party payments to the physicians who engage their opioid dependent patients in doing evidence-based, individualized, person-centered addiction care.

Next Steps After Health Care Price Transparency in Minnesota

Thursday, August 2nd, 2018

Congratulations to Dr. Neil Shah for writing an excellent article titled Minnesota’s price transparency law in the July issue of Minnesota Physician magazine. See:

Health care price transparency is a good and necessary first step to empowering Minnesota consumers. And in 2018 most Minnesota legislators on a bi-partisan basis agreed. But, as Dr. Shah correctly concludes in his article, “Unfortunately, what’s good for patients and health care purchasers may not be good for some insurers or large health care systems.” That can change.

So, here are three “next steps” to improve Minnesota health care:
1. Voters in 2018 need to support and elect politicians who’ll expand consumer health care choices in Minnesota.
2. Minnesota “insurers” should offer consumers (employers and patients) a wide range of health care coverage options.
3. When health care “providers” as a normal business practice can tell patients what their care costs, this will improve and sharpen the quality of health care decisions as well as be a business opportunity for “providers.”