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Brief ReportBrief Report

Practice Predictors of Buprenorphine Prescribing by Family Physicians

Lars E. Peterson, Zachary J. Morgan and Tyrone F. Borders
The Journal of the American Board of Family Medicine January 2020, 33 (1) 118-123; DOI: https://doi.org/10.3122/jabfm.2020.01.190235
Lars E. Peterson
the American Board of Family Medicine, Lexington, KY (LEP, ZJM); Department of Family and Community Medicine, University of Kentucky, Lexington, KY (LEP); Department of Health Management and Policy, University of Kentucky, Lexington, KY (TFB).
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Zachary J. Morgan
the American Board of Family Medicine, Lexington, KY (LEP, ZJM); Department of Family and Community Medicine, University of Kentucky, Lexington, KY (LEP); Department of Health Management and Policy, University of Kentucky, Lexington, KY (TFB).
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Tyrone F. Borders
the American Board of Family Medicine, Lexington, KY (LEP, ZJM); Department of Family and Community Medicine, University of Kentucky, Lexington, KY (LEP); Department of Health Management and Policy, University of Kentucky, Lexington, KY (TFB).
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  • Article
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Article Figures & Data

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    Table 1.

    Physician, Practice, and County Characteristics of Family Physicians Registering to Continue their American Board of Family Medicine Certification in 2017 and 2018 (n = 2726)

    N (%)
    Prescribes Buprenorphine161 (5.9)
    Physician characteristics
        Male gender1,556 (57.1)
        Age ≥50 years1,492 (54.7)
        White race1,972 (72.3)
        Hispanic ethnicity189 (6.9)
        MD degree vs. DO degree2,458 (90.2)
        International medical graduate600 (22.0)
    Practice characteristics
        Practice organization
            Academic health center186 (6.8)
            Federally qualified health center173 (6.3)
            Federal90 (3.3)
            Health maintenance organization173 (6.3)
            Hospital owned917 (33.6)
            Miscellaneous/other125 (4.6)
            Other public128 (4.7)
            Private practice934 (34.3)
        Site size
            Solo practice306 (11.2)
            2 to 5 providers938 (34.4)
            6 to 20 providers838 (30.7)
            >20 providers644 (23.6)
        Any mental health professional967 (35.5)
    County characteristics
        Whole county health professional shortage area—mental health519 (19.0)
        Rural county405 (14.9)
    • View popup
    Table 2.

    Physician, Practice, and County Characteristics of Family Physicians Registering to Continue their American Board of Family Medicine Certification in 2017 and 2018 by Whether they Prescribe Buprenorphine (n = 2726)

    Prescribes Buprenorphine, N (%)Does not Prescribe Buprenorphine, N (%)
    Physician characteristicsn = 161n = 2565
        Gender
            Male100 (6.4)1456 (93.6)
            Female61 (5.2)1109 (94.8)
        Age
            Under 5067 (5.4)1167 (94.6)
            50 or older94 (6.3)1398 (93.7)
        Race
            White113 (5.7)1859 (94.3)
            Non-White48 (6.4)706 (93.6)
        Ethnicity
            Hispanic or Latino13 (6.9)176 (93.1)
            Not Hispanic148 (5.8)2389 (94.2)
        Degree type
            DO13 (4.9)255 (95.1)
            MD148 (6.0)2310 (94.0)
        International medical graduate
            Yes35 (5.8)565 (94.2)
            No126 (5.9)1993 (94.1)
    Practice characteristics
        Practice Organization*
            Academic Health Center19 (10.2)167 (89.8)
            Federally qualified health center27 (15.6)146 (84.4)
            Federal2 (2.2)88 (97.8)
            Health maintenance organization5 (2.9)168 (97.1)
            Hospital owned31 (3.4)886 (96.6)
            Miscellaneous/other9 (7.2)116 (92.8)
            Other public8 (6.3)120 (93.8)
            Private practice60 (6.4)874 (93.6)
        Site size
            Solo practice28 (9.2)278 (90.8)
            2 to 5 providers51 (5.4)887 (94.6)
            6 to 20 providers42 (5.0)796 (95.0)
            >20 providers40 (6.2)604 (93.8)
        Any mental health professional*
            Yes84 (8.7)883 (91.3)
            No77 (4.4)1682 (95.6)
    County characteristics
        Whole county health professional shortage area—mental health
            Yes26 (5.0)493 (95.0)
            No135 (6.1)2072 (93.9)
        Rurality
            Rural26 (6.4)379 (93.6)
            Urban135 (5.8)2186 (94.2)
    • ↵* P value for χ2 test < .05.

    • View popup
    Table 3.

    Percent of Family Physicians Prescribing Buprenorphine by Primary Practice Site Size and Rural/Urban Status in 2017 and 2018

    Site sizeRural, N (%)Urban, N (%)Total, N (%)
    Solo practice (n = 306)7 (17.1)21 (7.9)28 (9.2)
    2 to 5 providers (n = 938)6 (3.3)45 (6.0)51 (5.4)
    6 to 20 providers (n = 838)9 (6.4)33 (4.7)42 (5.0)
    >20 providers (n = 644)4 (9.8)36 (6.0)40 (6.2)
    • Number and percent represent the percentage of family physicians in each size of practice who prescribe buprenorphine.

    • View popup
    Table 4.

    Adjusted Associations between Personal, Practice, and County Characteristics with Family Physicians Prescribing Buprenorphine in 2017 and 2018

    Odds Ratio (95% CI)
    Physician characteristics
        Male gender1.39 (0.97, 1.97)
        Age ≥50 years1.03 (0.73, 1.46)
        White race0.82 (0.55, 1.22)
        Hispanic ethnicity1.18 (0.63, 2.22)
        MD degree vs. DO degree1.01 (0.55, 1.84)
        International medical graduate1.08 (0.69, 1.68)
    Practice characteristics
        Practice organization
            Academic health center1.29 (0.67, 2.48)
            Federally qualified health center1.98 (1.08, 3.63)
            Federal0.24 (0.05, 1.03)
            Health maintenance organization0.37 (0.14, 0.99)
            Hospital owned0.53 (0.33, 0.87)
            Miscellaneous/other0.97 (0.45, 2.08)
            Private practiceReference
            Other public0.84 (0.36, 1.93)
        Site size
            Solo practice2.60 (1.38, 4.92)
            2 to 5 providers1.48 (0.89, 2.45)
            6 to 20 providers0.90 (0.56, 1.44)
            >20 providersReference
        Any mental health professional2.70 (1.73, 4.22)
    County characteristics
        Health professional shortage area—mental health0.72 (0.42, 1.23)
        Rural County1.28 (0.73, 2.23)
    • CI, confidence interval

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The Journal of the American Board of Family     Medicine: 33 (1)
The Journal of the American Board of Family Medicine
Vol. 33, Issue 1
January-February 2020
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Practice Predictors of Buprenorphine Prescribing by Family Physicians
Lars E. Peterson, Zachary J. Morgan, Tyrone F. Borders
The Journal of the American Board of Family Medicine Jan 2020, 33 (1) 118-123; DOI: 10.3122/jabfm.2020.01.190235

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Practice Predictors of Buprenorphine Prescribing by Family Physicians
Lars E. Peterson, Zachary J. Morgan, Tyrone F. Borders
The Journal of the American Board of Family Medicine Jan 2020, 33 (1) 118-123; DOI: 10.3122/jabfm.2020.01.190235
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