Coa Rules In Redden-Clark Case

[bobandtorey]

so if they can't get you for this they will try that and if that don't work they will try some thing else and if not something else they can keep you in court for as long as they want

 

their are lots of MMJ haters out their judges are not Doctors the AD is solid

[Dr. Bob]

As promised, this is a copy of the follow up survey I will provide to all my future patients to help satisfy that aspect of the bona fide doctor patient relationship. Feel free to paste it to your word processor, fill it out and send it in to your certification physician. Request it be made a part of your chart, and keep a copy yourself as proof of 'follow up' with your doctor after your initial certification visit. Copies will remain on my website, www.drbobmmj.com , if you need more information it is available there.

 

Dr. Bob

 

Follow up for Certification Visit:

 

 

 

Name-

 

Date of birth/age-

 

Gender- M F

 

Date of Certification and location:

 

 

 

Today's date:

 

 

 

Qualifiying Conditions:

 

 

 

Type of Marijuana used

 

 

 

Indica Strain Sativa Strain Blend Does it have a street or common name? ________________________________

 

 

 

Approximate cost per gram (or oz):

 

 

 

Method of use circle all that apply:

 

 

 

vaporizer smoking edible oil tincture other_______________

 

does one method seem more effective?

 

 

 

Comments-

 

 

 

Do you have questions for Dr. Bob

 

 

 

 

 

How does your primary physican feel about MMJ?

 

supports opposes wants more info (give name and #)

 

 

 

 

 

Your contact telephone number:

 

 

 

Dr. Bob and the Certification Crew

 

513 Edgemoor Dr. Kalamazoo, MI 49008

[Eric L. VanDussen]

 

 

 

 

 

 

 

 

 

 

 

[TajMahal]

Wow!

 

Thank you Eric for your work on this.

Much respect.

 

Taj

[peanutbutter]

You go Eric!!

 

you bulldog you ..

 

Thank you very much. I, for one, am very interested in seeing these arguments that were presented.

 

Also .. nice touch about the actions of the judge gathering more information outside the arguments for his conclusion.

[Dr. Bob]

Hi Doc,

Thanks for all of the useful suggestions. I discussed MMJ with my doctor years ago and he was fine with it, but now that it's time to help me out with a recommendation he is too afraid of the powers that be to put his signature on the form. He doesn't want to have to go into court to explain his treatment protocol to some prosecutor. He has his hands full explaining his decisions to the insurance companies.

 

I often get referrals from him to see specialist for various reasons. These are almost always one visit scenarios. Do you think it would make our position more easily defensible if we had at least a referral to your clinic? That way my doc doesn't have to sign the form or appear in court and you have the same thing other specialists have for many of these one visit relationships.

 

Honestly I think that if more primary physicians would refer patients to a certification clinic for evaluation, the strong the case of a 'bona fide' doctor patient relations would be. Just like a referral to a surgeon, who in turn recommends surgery. No one questions that relationship is bona fide. In court, if one of my certifications was questioned, my defense would be as follows.

 

I am a skilled doctor, with no history of malpractice claims, discipline by the board and my DEA registration not only is clear, it has been upgraded to a higher level than most doctors (I am a suboxone physician)

 

I examined the patient and took a history to the degree of a level 2 medicare E/M code.

 

I reviewed and retained in a chart the medical records from the primary care doc, specialists, and other findings related to the condition.

 

I offered a means of follow up and referred the patient to a local organization.

 

That is pretty solid evidence of a quality cert and a bona fide doctor patient relationship. Add to that, 'and I did it all on the referral of the primary care physician', and the case is almost iron clad.

 

Dr. Bob

[jtgeme]

Honestly I think that if more primary physicians would refer patients to a certification clinic for evaluation, the strong the case of a 'bona fide' doctor patient relations would be. Just like a referral to a surgeon, who in turn recommends surgery. No one questions that relationship is bona fide.

 

Dr. Bob,

 

I want to preface my question with this: I am not attacking you, or your position. I read the Redden-Clark opinion, and I agree with your statement. But I am curious. I do not want to come across as argumentative but inquisitive.

 

But with a surgeon, isn't there generally more than one appointment? A meet, an examination, then schedule the surgery, and then follow up? I think the CoA was off base with trying to decide what is and is not a "bona fide" relationship. But I think the relationship between a surgeon and a patient is a little more developed than even the court would expect.

 

Thoughts?

[Southern Cross]

Honestly I think that if more primary physicians would refer patients to a certification clinic for evaluation, the strong the case of a 'bona fide' doctor patient relations would be. Just like a referral to a surgeon, who in turn recommends surgery. No one questions that relationship is bona fide. In court, if one of my certifications was questioned, my defense would be as follows.

 

I am a skilled doctor, with no history of malpractice claims, discipline by the board and my DEA registration not only is clear, it has been upgraded to a higher level than most doctors (I am a suboxone physician)

 

I examined the patient and took a history to the degree of a level 2 medicare E/M code.

 

I reviewed and retained in a chart the medical records from the primary care doc, specialists, and other findings related to the condition.

 

I offered a means of follow up and referred the patient to a local organization.

 

That is pretty solid evidence of a quality cert and a bona fide doctor patient relationship. Add to that, 'and I did it all on the referral of the primary care physician', and the case is almost iron clad.

 

Dr. Bob

Thanks. This is what I will work toward with my primary care physician.

[Southern Cross]

Dr. Bob,

 

I want to preface my question with this: I am not attacking you, or your position. I read the Redden-Clark opinion, and I agree with your statement. But I am curious. I do not want to come across as argumentative but inquisitive.

 

But with a surgeon, isn't there generally more than one appointment? A meet, an examination, then schedule the surgery, and then follow up? I think the CoA was off base with trying to decide what is and is not a "bona fide" relationship. But I think the relationship between a surgeon and a patient is a little more developed than even the court would expect.

 

Thoughts?

Dr. Bob commented on this earlier in this thread. Here's part of one of his comments.

 

"1. I will continue to perform single visit certifications, just as Aviation Medical Examiners, Disability Examiners for the VA and other agencies, and many specialist consultations. This is both appropriate and legal and results in a defensible certification."

 

Hope this helps.

[jtgeme]

Dr. Bob commented on this earlier in this thread. Here's part of one of his comments.

 

"1. I will continue to perform single visit certifications, just as Aviation Medical Examiners, Disability Examiners for the VA and other agencies, and many specialist consultations. This is both appropriate and legal and results in a defensible certification."

 

Hope this helps.

 

I remember reading that post. And it is helpful. Thank you. But if the courts are going to focus on what is and what is not a doctor patient relationship I think the post you referenced is better than drawing a comparison to surgeon-patient relationship.

[bobandtorey]

Dr. Bob commented on this earlier in this thread. Here's part of one of his comments.

 

"1. I will continue to perform single visit certifications, just as Aviation Medical Examiners, Disability Examiners for the VA and other agencies, and many specialist consultations. This is both appropriate and legal and results in a defensible certification."

 

Hope this helps.

 

 

sounds right to me hes a Doctor we did get are renewal from the same Doc so if i get my next one from him it would be 3 renewals that should do it i guess they will just appeal it again

[MORE COWBELL]

so now what we go to jail because of the Doctor

it seems that doctors are going to be under scrutiny now -how are we supposed to know if our Doctor is a quack or not?????????????????????????????

more gray area they have created-do doctors now have to specially licensed to prescribe MM?

maybe i should stay underground and call the whole day off

[bobandtorey]

it seems that doctors are going to be under scrutiny now -how are we supposed to know if our Doctor is a quack or not?????????????????????????????

more gray area they have created-do doctors now have to specially licensed to prescribe MM?

maybe i should stay underground and call the whole day off

 

 

some times i wish i had but then were would we be more Gray

[peanutbutter]

I remember reading that post. And it is helpful. Thank you. But if the courts are going to focus on what is and what is not a doctor patient relationship I think the post you referenced is better than drawing a comparison to surgeon-patient relationship.

 

The courts can not legally explore the relationship between patient and doctor within this context.

 

It is a crime for a PA or judge to disclose the name of the doctor.

 

How would it be possible for a doctor to get called into court when it is a crime to identify the doctor?

[Southern Cross]

The courts can not legally explore the relationship between patient and doctor within this context.

 

It is a crime for a PA or judge to disclose the name of the doctor.

 

How would it be possible for a doctor to get called into court when it is a crime to identify the doctor?

Exactly!!

 

Once the MDCH has issued a card, that's it. End of story!

 

If the PA has an issue with the card that issue should be addressed to the MDCH not the patient. And the only response from MDCH is "Yes" the patient has a legitimate card or "No" we did not issue that card.

[bobandtorey]

The courts can not legally explore the relationship between patient and doctor within this context.

 

It is a crime for a PA or judge to disclose the name of the doctor.

 

How would it be possible for a doctor to get called into court when it is a crime to identify the doctor?

 

And it's a crime for us to be in court for so long also and it has to start all over again am not sure if we even have to go to court tomorrow i will post if i find out if any one knows how to check that would be nice to know

last time the court did not even send us anything and Matt said they are trying to railroad us

 

 

YOU THINK

[+RevThad]

Exactly!!

 

Once the MDCH has issued a card, that's it. End of story!

 

If the PA has an issue with the card that issue should be addressed to the MDCH not the patient. And the only response from MDCH is "Yes" the patient has a legitimate card or "No" we did not issue that card.

Exactly, after a card is issued the only thing a PA can attempt to rebut "The presumption may be rebutted by evidence that conduct related to marihuana was not for the purpose of alleviating the qualifying patient's debilitating medical condition or symptoms associated with the debilitating medical condition, in accordance with this act."

 

The type of conduct I would suspect that falls into that category would be a caregiver or patient running around with a pound and a half of medical marijuana, and/or having it divided up into much smaller quantities (intent to distribute). I would also suspect that the burden would be pretty high for the PA to prove the conduct was not related to the medical use of marijuana...

[bobandtorey]

Exactly!!

 

Once the MDCH has issued a card, that's it. End of story!

 

If the PA has an issue with the card that issue should be addressed to the MDCH not the patient. And the only response from MDCH is "Yes" the patient has a legitimate card or "No" we did not issue that card.

 

Maybe they will just dismiss are case they don't have a case we have tow cards by the same Doc in of Story

lets all move on the courts are not doing us Right

[+Silverblue]

 

Sb

[solabeirtan]

And it's a crime for us to be in court for so long also and it has to start all over again am not sure if we even have to go to court tomorrow i will post if i find out if any one knows how to check that would be nice to know

last time the court did not even send us anything and Matt said they are trying to railroad us

 

 

YOU THINK

 

There should be a way to check the Court Docket online. If you're not sure about a date call the Court Clerk immediatley, Bob.

 

They would have had me a couple times, when they changed a court date and I didn't here from my Lawyer, I checked in online to find that the date was that morning, once, another time it was postponed.

 

Best of Luck, Bro!

[Nameless_Hero]

I don't get the thing about a 'bona fide' relationship with the doctor. I thought a certification doctor is there for the purpose that the benefits of medical marijuana have finally come to light in our society but some doctors may be hesitant to recommend it. Don't all those type of clinic require medical records anyways prior to certifying? So are they saying that an actual licensed physician is not even able to determine if the people had a bona fide relationship with their regular doctor? That's pretty one-sided when you compare the ease of obtaining other prescriptions.

[+Green Cross]

Once the MDCH has issued a card, that's it. End of story!

 

Not end-of-story, sorry to say. Some examples where a card can be invalidated include:

-- if a patient used false pretenses to get a card (eg: bogus medical records).

-- if a patient or caregiver provides (in any form, not just selling) mj to a person not allowed to possess it under the MMMAct.

-- if a doctor signed a recommendation without sufficient, valid proof that a patient has a qualifying condition.

 

A concern I have is when a doctor charges one price for an encounter -with- records, but a higher price -without- records.

I fear that, in the latter case, -all- patients' cards will be invalidated who received a signed recommendation from that doctor

found by a court to have conducted bogus or unprofessional patient encounters. To prevent this from happening a group

of doctors and lawyers are working up a set of Standards of Care meant to withstand scrutiny from any Court in Michigan.

 

Here's another potential problem: a patient without records pays a higher fee to a doctor who signs the recommendation

at a dispensary infamous for being shady, and that dispensary allows said patient to walk right over to the bud-tender area

and purchase meds without waiting the requisite 20 days for the paperwork to mature. Wouldn't moo-poo ya.. it happens now.

[peanutbutter]

Green Cross ..

 

Do you favor every doctor that has signed a recommendation being drug into court?

 

The state issues licenses to the doctor.

The same department that issues the doctors license issues the medical marijuana ID card.

 

The same department verifies the letter has been signed by a licensed doctor. After that they issue the ID card.

 

That department can invalidate (revoke) the ID card under the circumstances you list.

 

None of those items are for review before courts.

 

Whatever takes place between the patient/doctor/MDCH is a confidential matter. Not a public record.

 

End of story. With the exception of fraud.

[bobandtorey]

We are not going to court tomorrow thats what the Lawyer said we are not going to court

we are going to the supreme court

and will be FREE soon

[+Green Cross]

[ Do you favor every doctor that has signed a recommendation being drug into court? ]

 

No, just the opposite. I'm leading efforts -to protect- doctors who sign medical marijuana recommendations from legal liability. A group of doctors and lawyers are working up medical Standards of Care that will withstand prosecutors' and Courts' scrutiny.