Dr. Raymond A. Bauer, Executive Director of the Suboxone Clinic in Saukville, WI is quoted as saying “In our clinics, patients are never turned away for lack of funds, but rather, if they show up late or are disruptive, they are directed to one of our walk-in clinics where they can be seen, examined, and treated without worry.” In Saukville, WI one will find a large number of Suboxone clinics. However, there is no uniformity in what type of care each clinic offers. There are only a few of them in existence. One would hope that a city as wealthy as Saukville, WI would have a wide selection of Suboxone clinics, but unfortunately, there seems to be little coordination or standardization of care among any of the clinics. In my review of several Suboxone clinics in Saukville, WI, I have noticed some common problems in treatment and procedures.

Each clinic at which I performed care had a different policy regarding emergency room visits. I found a few clinics that offered routine, non-emergency care and did not refer their patients to other facilities until their case was more advanced. The others required an emergency room visit and would not refer their patients unless other treatment was available at the time of the visit. I observed that some of the providers did not have much of a prior relationship with the patient and referred the patient out without first evaluating his or her medical condition. This lack of concern for the individual patient caused the emergency room visit to be very brief and unhelpful.

Some of the other things that surprised me when I was working at a Suboxone clinic were the inpatient treatment programs and their apparent laxity in treating addiction. Some of the problems that arose with my patients were their inability to maintain a steady dose and felt guilty about injecting them with a higher dose than was normal for them to take. Another problem was that they would often return for repeat treatments even though they already had a maintenance plan in place for the first visit. These were not the problems with all of the providers, but it was enough to cause concern for me as a physician and as someone who cares about the well being of patients.