Standards Of Care

[jon165]

What are the standards of care for medical marijuana recommendations? Some doctors require detailed medical records, some will take a journal, some take chiropractic records, and some glance at your records for about 2 minutes and ask if marijuana is helping without asking your name, checking your blood pressure, temperature or even doing the most basic physical examination! I think if we really care about protecting medical marijuana in this state, maybe we should start by maintaining proper standards of care for doctors...

[AKenewell]

What are the standards of care for medical marijuana recommendations? Some doctors require detailed medical records, some will take a journal, some take chiropractic records, and some glance at your records for about 2 minutes and ask if marijuana is helping without asking your name, checking your blood pressure, temperature or even doing the most basic physical examination! I think if we really care about protecting medical marijuana in this state, maybe we should start by maintaining proper standards of care for doctors...

 

The standards of care are what define a valid doctor patient relationship, and how they are followed varies quite a bit, depending on who you see. You should seek out someone who is not just providing you with paperwork, but who's looking out for your welfare in general. So I would argue that the ones who are just handing you paperwork without proper medical records, in some cases with no medical records, are not upholding the intent of the program and they are not looking out for the patient's best interest. So you are exactly right, maintaining standard of care is very important. This law was intended to help people in need, some doctors are qualifying people who under the guidelines of the law, should not be qualified. Those who argue that marijuana should be available for everyone may have their day, but handing out certification's to anyone and everyone is not going to help that cause and might very well damage it.

[sumguyngirl]

The standards of care are what define a valid doctor patient relationship, and how they are followed varies quite a bit, depending on who you see. You should seek out someone who is not just providing you with paperwork, but who's looking out for your welfare in general. So I would argue that the ones who are just handing you paperwork without proper medical records, in some cases with no medical records, are not upholding the intent of the program and they are not looking out for the patient's best interest. So you are exactly right, maintaining standard of care is very important. This law was intended to help people in need, some doctors are qualifying people who under the guidelines of the law, should not be qualified. Those who argue that marijuana should be available for everyone may have their day, but handing out certification's to anyone and everyone is not going to help that cause and might very well damage it.

 

 

Well said

[gonegreenbrb]

STANDARD OF CARE REPORTED BY THE WESTERN JOURNAL OF MEDICINE...

 

Before recommending marijuana to a patient, you as a physician should ask yourself the following:•Is there documentation that the patient has had failure of all other conventional medications to treat his or her ailment? Have you counseled the patient (documented by the patient's signed informed consent) regarding the medical risks of the use of marijuana—at a minimum to include infection, pulmonary complications, suppression of immunity, impairment of driving skills, and habituation?

•Has the patient misused marijuana or other psychoactive and addictive drugs?

•Do you periodically provide drug testing of the patient who has been prescribed marijuana, and have patients been excluded from being prescribed marijuana who are found to be using other illicit drugs? Who does the drug testing and by what means?

•Is the use of smoked marijuana part of a study and/or will the monitoring of that use be under the supervision of an investigational review board?

•Have you carefully reviewed exactly which patients should be allowed to use this drug medicinally and for how long?

•Do you carefully examine and consistently follow up patients who use smoked marijuana as a medical treatment, including pulmonary function testing, evaluation of immune status, and the presence of any superadded infection?

•Have you exercised due care in assuring the standardization of the tetrahydrocannabinol potency content of the marijuana to be considered for medicinal use and whether it is free of microbial contaminants?

•Because marijuana is a federally controlled substance, has a system been established in the state to track all patients and their source of marijuana, as with other controlled substances? Are you complying with such requirements?

•Will you be required to be licensed by the state or federal government?

•Have you shown knowledge, training, or certification in addiction medicine? Do you have demonstrable knowledge of the physiologic effects of marijuana, its side effects, and its interaction with other drugs before prescribing it?

NotesCompeting interests: None declaredReferences1. US v Oakland Cannabis Buyers' Cooperative, 2001. WL 501567 (US).

2. Voth EA, Schwartz RH. Medicinal applications of delta-9-tetrahydrocannabinol and marijuana. Ann Intern Med 1997;126: 791-798. [PubMed]

3. Joy JE, Watson SJ Jr, Benson JA Jr, Eds. Marijuana and Medicine: Assessing the Science Base. Washington, DC: National Academy Press; 1999. Available at www.books.nap.edu/catalog/6376.html.

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Articles from The Western Journal of Medicine are provided here courtesy of

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[xxsesimeseedxx]

Have you ever heard of anyone being put through extensive examination to be prescribed Xanax, vicoden, zoloft, darviset, asacol, prilosec, tylenol 3 or any other poisonous pharmaceutical? Most likely not. And if they WERE put through the extensive exams, two thumbs up to that dr that actually CARES enough about his/her patient. It's going to be the same thing with MJ. Some dr's are going to test you and some are just going to go off of what you tell them works for you. From what I've been reading on here and on other sites, MJ works for just about EVERYONE! No matter what we say or do, there are still going to be Dr's "handing" out MMJ certs. So we shouldnt be complaining about it. If you are a person with a condition that can be helped by MJ, then GO GET CERTIFIED. I'm pretty sure that YOU know what makes you feel better much better than the Dr. knows. And, I'm also sure that you wouldnt mind NOT going to the extensive exams that you say you should be put through. I walked into the cert center and waited for about an hour before I was able to see a Dr. She looked over my paper work, which in my opinion was barely legible due to typical dr. handwriting, asked me a few questions about my Crohns Disease and signed away! I was HAPPY to get out of there quick!

[lawyercaregiver]

What are the standards of care for medical marijuana recommendations? Some doctors require detailed medical records, some will take a journal, some take chiropractic records, and some glance at your records for about 2 minutes and ask if marijuana is helping without asking your name, checking your blood pressure, temperature or even doing the most basic physical examination! I think if we really care about protecting medical marijuana in this state, maybe we should start by maintaining proper standards of care for doctors...

 

 

This is perhaps the best question yet- thanks!

 

Hopefully Komorn can weigh in on this and correct whatever I get wrong.

 

Marijuana is NOT a prescription. You are NOT going to a marijuana clinic for a medical examination. There does NOT have to be a doctor-patient relationship (at least not a clinical relationship).

 

You visit the marijuana doctor for a RECOMMENDATION and CERTIFICATION that you have a serious medical condition with symptoms that can be relieved from the use of marijuana. It is a consultation, not a clinical examination.

 

A consultation without the doctor reviewing medical records or supporting documentation and spending some time with the patient is NOT a sufficient consultation and amounts to fraud and medical malpractice.

 

So... the "standard of care" in a medical marijuana consultation is a review of medical records and consultation with the patient sufficiently thorough to determine whether the patient has a debilitating medical condition to which marijuana could provide some palliative or therapeutic benefit.