The Detroit News - Fixing A Pot Law Problem - Doctors, Patients Stuck In Medical Marijuana Certification Limbo

[MI Compassion]

Fixing a pot law problem

Doctors, patients stuck in medical marijuana certification limbo

Jennifer Chambers / The Detroit News


Fighting brain cancer, Matthew Watkins was wasting away from the destructive effects of radiation and chemotherapy -- weight loss, headaches and anxiety.
His treating physicians were pumping the 17-year-old with all kinds of drugs to get his appetite back. Nothing was working. Then an oncologist mentioned medical marijuana.
"We weren't convinced it was going to help him. Being his mother, I was desperate for anything. I was angry they were putting him on addictive drugs," Kim Watkins said.
There was a catch: The mother and son would have to seek the help of a doctor unknown to the family for Matthew to be certified to use medical marijuana legally in Michigan.
Matthew's oncologist didn't offer to certify her son -- and the pair, unfamiliar with Michigan's Medical Marijuana Law -- said they didn't ask, even though the law allows any physician licensed in Michigan to certify a patient.

It's a conundrum widespread among Michigan physicians. Medical marijuana is a treatment option for qualified sick patients, yet most doctors won't certify patients to use it.
To fill the gap, some physicians are setting up clinics across Metro Detroit expressly for the purpose of patient certification.

Dr. William Gonte, founder of the Michigan Marijuana Certification Center in Southfield, did just that after realizing his peers across Metro Detroit were shying away from certification.
"The law is very confusing for patients and doctors. Physicians have a problem with it because they have the liability," said Gonte, an internal sports medicine doctor affiliated with Providence Hospital in Southfield. "We set them free -- both patients and physicians -- we qualify people here. Our main service is to certify them. We have lawyers on staff; we give them free advice."
Gonte and his 12-physician staff, which includes psychiatrists, general surgeons, family practitioners and internists, have certified more than 2,000 patients in the last 12 months. Patients come from across the entire state. On a recent afternoon, Gonte's waiting room was full of prospective patients.

Patients desperate

The process begins with a screening over the telephone and then an appointment. Three to five years of medical records must be reviewed before a physician spends a few hours with the patient, discussing current treatment and problems. Gonte said patients must have explored traditional options before turning to medical marijuana.
The charge for certification is $200 and includes legal advice on how to obtain a state ID card and a referral to an established and licensed caregiver who grows marijuana legally for up to five patients.

"These people are so desperate," he said. "You can see it. All these patients need an alternative therapy. Most medicines have side effects. There are so many medicines on the market because none of them work."

Gonte, a doctor for 20 years, is preparing to open a clinic in Grand Rapids next month with a third planned for northern Michigan.
He says he doubts treating physicians will ever be in the business of medical marijuana certification because they are uncomfortable with the law and they don't have the legal background.
"We are a safe haven for physicians," Gonte said. "Many prominent oncologists give me a hug when they see me because they can send people to me and I can help them."

Doctors uncomfortable

In April 2009, legal counsel for the Michigan State Medical Society published a two-page article in the society's journal as an advisory for physicians. It told them that marijuana possession, use and distribution remains illegal under federal law and that physicians are under no legal obligation to provide patients with a written certification.
Attorney Daniel Schulte also told physicians the law protects them from arrest, prosecution or penalty by Michigan law enforcement agencies and from disciplinary actions that may be taken by the Michigan Board of Medicine or any other licensing board or bureau in connection with a patient certification.

Dr. Daniel B. Michael, president-elect of the society that represents the state's 37,683 licensed physicians, said his organization does not track whether members are certifying patients. The unwritten policy at his neurosurgeon practice where 13 doctors see patients is that certification is not offered.

The reasons vary. Michael said most patients say they are satisfied with their treatment and aren't looking for alternatives. But the biggest reason doctors are not getting involved with providing a pathway to medical marijuana, he says, is they are simply not comfortable with having a patient use a drug for which they have no control over the dosage or a deep understanding of the pharmacology.
"It's just not something we are taught to do. We are not comfortable with that," Michael said. "It's not that we aren't being compassionate. It's just not our line."

Michael has had only two requests for certification. In one case, he referred the patient to a clinic that was in the business of certification. The patient came back to Michael and was not happy about his experience.

"He said it didn't seem they were interested in establishing a doctor-patient relationship or looking into a diagnosis. It was a pro forma -- here I am and give me a certification," Michael said.
Dr. Naveed Aslam, a Beaumont Hospital oncologist, said he has received less than a dozen requests for medical marijuana certification since the law passed, which amounts to less than 1 percent of the patients he sees in a year. Aslam has referred those patients to doctors outside the practice who are in the business of certification, including to Gonte's clinic.

"I think probably like most doctors I feel a little torn. I think there are patients who can really benefit from it, for a few patients where pain medication isn't working," Aslam said. "My main concern is other patients who can use medication and would use this inappropriately."

But it works for some.

Since beginning treatment with medical marijuana, Watkins has gained all of his weight back and the pot helps ease his frequent headaches.

"I didn't know it would work. I am convinced," Kim Watkins of Chesterfield Township, said of her son's treatment. "I'm so happy the state of Michigan legalized marijuana. Otherwise, I would do it illegally if it would help my son."

(734) 462-2289
jchambers@detnews.com


From The Detroit News: http://www.detroitnews.com/

*broken page link replaced w/ home page link*

[phaquetoo]

Good article, yea i had to find a diff dr than the one i see to give me a recomendation, but we are building a dr. patient relationship!

Thanks for the article!