So I just got done doing some shadowing in a rural area and I really enjoyed the Dr I shawdowed. He was really good with his patients and was really receptive to my questions. The thing that bothered me was the amount of “controlled substance” seekers I saw while there.
I have shadowed at other family practices in more urban areas and even volunteer at the “county” ER. I didn’t see as many of those folks there as I did at this rural practice. The Dr seemed pretty bummed that I was seeing this, but did say that there was a decnet portion of his practice spent dealing with these issues.
My question is for those who practice, shadow or volunteer in these areas is this realy common? Also woudl it be a good idea to bring this stuff up if it is ever asked about in a secondary or intreview? (ie what do you see as the most troubling aspect of rural medicine, or the like?)
If you continue to shadow, in different area/practice setting, you will notice that each area is unique and present a different set of problems. Unfortunately, drug seeking behavior seems to be prevalent with rural practice. This is a complicated issue, intertwined with other social problems. Be cognizance that in many instance, the patient does not always consume the prescription drug themself or alone.
It really depends on the community.
Some rural communities have a large unemployed population and very little to offer as distraction - thus a tendency to alcoholism and drug seeking. But in other communities with the same statistics you don’t see those behaviors very often.
Don’t let the experience turn you against the idea of rural medicine, but accept that in the US you will see seeking behavior in a lot of areas. One doctor I shadowed enjoyed it - said it was like being an investigator, and made the day to day routine more interesting. 
You think that’s bad. I volunteered with a rural health organization that does medical, dental, vision in under served areas. One of the dentists told me that about 50% of the cases that they treat at these clinics are drug related. I helped with patient registration the next day, and yes, it was bad. About a third of the people that came into the ER I shadowed at were seeking. Some of them were the worst actors too…
It’s such an epidemic in a lot of rural areas. I have no idea what we can do for these people.
I agree with all of the posters. During the decade or so that I volunteered at an urban free clinic, I noticed a steady increase in the number of substance abuse cases and those who were drug-seeking (medical marijuana, hydrocodone addictions, etc.) At a rural clinic where I did some short term volunteer volunteer work, there were some cases like these but I have not done significant rural work in the U.S. On the other hand, my long-term experience in rural Mexico has shown just the opposite: I cannot recall a single case of anyone coming with addiction-related requests. The only time we hand out possibly addictive drugs (Vicodin, morphine sulfate, etc.) is when the doctors order it for pain relief prior or after dental or surgical work.