In Reply While I appreciate the concern by Lund regarding balancing quantity and quality of buprenorphine-waivered practitioners,1 I will argue that increasing quantity may in fact secure several of the aims Lund outlines in his response. First, because trainees do not have their own license, prescribing buprenorphine can only be done under the auspices of an upper level clinician, something that incentivizes faculty to acquire their own certification. In my own institution, we have just one pediatrician licensed to prescribe buprenorphine. His own expertise evolved by aligning with family medicine and psychiatry colleagues under what is the suggested “train the trainer” model. Concordant with the didactic model of medicine, having a cohort of trainees will create and reinforce learning for faculty.
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Dwarakanath M. Increasing Capacity and Improving Quality in Substance Use Disorder Training—Reply. JAMA Pediatr. 2020;174(4):392–393. doi:10.1001/jamapediatrics.2019.6275
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