'online' counseling

Buprenorphine Post
Posts: 2

Re: 'online' counseling

Postby sambrayfield » Fri Dec 07, 2018 5:08 pm

I have practiced in rural Missouri 34 years. 'Rural' general practice has it's unique challenges. Having a one on one with a another human is best but I fully agree with the practitioner from the UP that you often have to go with what you have to work with. Samuel 'Buddy' Brayfield, DO

Posts: 111

Postby fishdoc » Fri Oct 14, 2016 8:44 am

Be careful with Skype and other such services as they may not be HiPPA compliant. There are free HIPPA compliant video chat services available, though.

Posts: 104

Postby jmosby1469 » Fri Oct 14, 2016 8:44 am

One of my colleagues departed the practice and took with him a set of patients whom he manages via skype for clinical contact, then escribes or calls in their bupe prescriptions. Made a big gap in the clinic schedule here in LaGrange. Not sure that passes muster, either.

Jeremy K
Posts: 109

Postby Jeremy K » Fri Oct 14, 2016 8:44 am

Again, thanks all for the comments. Dr Passer: I appreciate your concern. In my case, I won't be doing any 'online' practice myself, I'm just wondering about my patients using it to access counseling. However, for a physician using 'online' to 'remotely' evaluate and treat patients, I would agree: check with your malprac insurance to make sure you're covered.

Posts: 1404

Postby drpasser » Fri Oct 14, 2016 8:44 am

Check with your malpractice insurance about anything like this.

Jeremy K
Posts: 109

Postby Jeremy K » Fri Oct 14, 2016 8:44 am

Thanks everyone for the input.

Posts: 32

Postby robertsonjon » Fri Oct 14, 2016 8:44 am

In my area (Michigan's Upper Peninsula) there aren't a lot of psychiatrists available, so many patients (addiction and other) see a psychiatrist by Skype (many through the VA) and it seems to work well. I'm sure there are sketchy drug counselors out there who do it, but plenty of good ones, too. If it works for the patient, and they feel they are making progress and getting their needs addressed, I don't see a problem.

Posts: 70

Postby mack86 » Fri Oct 14, 2016 8:44 am

I have been doing this for prescribing. I call or fax Rx to their pharmacy. North Carolina medical board accepts this as a way to reach people in rural, remote, or otherwise underserved areas.

There is also a format for online counseling, but I have not used it yet.

Posts: 111

Postby fishdoc » Fri Oct 14, 2016 8:44 am

Many of my patients will supplement local 12 step programs with online meetings. We have found no problems with these meetings, but we have no experience with counseling as you describe. Some of my colleagues are experimenting with telemedicine for well established patients.

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