A Good Dr. In Genesee County?

[mmma087]

Hello:

 

Could anyone recommend a physician in Genesee County that is medical marijuana friendly and is also accepting new patients? I am a non medicated ..... and a ....... that has chronic pain in the form of ...... in the .... I dont really like Dr's nor the medical establishment in general and dont have any insurance so I dont have alot of recent records. I could come up with some old medical records that state Im ....... but it doesnt detail the painful ........ I am willing to goto a Dr. now because its getting pretty painful and I would rather grow my own natural medicine rather than perpetuate a pharmaceutical system that I dont believe in.

 

 

Any help from you folks in the know would be greatly appreciated.

 

Thanks alot and god bless you all.

 

 

edited: key information redacted

[Guest Indica Jones]

Dr. Scott A. Graves

[whodathot]

Dr. Scott A. Graves

 

 

Ditto.

 

2337 W Mount Morris Rd

Mt Morris, MI 48458-8256

(810) 564-9524

 

Walk in basis, $100 per evaluation, Hours 1-5 for new patients, every day but Wednesday (call to confirm). Bring your application and Dr statement paperwork or he will provide for another $10. You do not need medical records. He may be accepting new patients in general but I have heard that he is not being paid by BCBS, just what I heard.

 

Get there early. If you get there after 1, you are likely not to be seen until 2 or 3 or later, depending on the number of people. Kind doctor, listens, seems very fair.

[FootFungus]

Yep. He's the man, you can get there before 1 to sign up on the sheet then leave and come back, if you get there after 1 plan on being there until 5 or 6 usually.

 

Not even 5 mins off I-75, Mt. Morris Rd. exit (126 I think), head east, just past the first light on the right.

[mmma087]

Thank you all, I will look into this.

[homeinmyhead]

Is he still doing it? I heard he stopped doing it. anyone know of any recent news on it?

[Guest Indica Jones]

My 5th patient got his certification from him last thursday...............

[homeinmyhead]

Cool cool man, I must of just heard rumors then. Is it still walk in basis?

[Dr. Bob]

Everyone nods when I talk about standards and bona fide doctor patient relationships, yet when a new member asks about a certification the first thing that comes to mind is a no record clinic that even charges for the forms. No one comes forward to talk about defensibility, or safety, or the need for records to document the condition is severe. I see now I have utterly wasted my time. When the state cracks down on these no record clinics by making it impossible to get a cert except from your family doc, you have no one to blame but yourselves. Recall that one of the main complaints in here is that primary docs won't write certs.

 

You think that no record clinics are a good idea? Look at this news report

 

http://www.wwmt.com/articles/smoke-1384128-michigan-newschannel.html

 

and see how the public and state view them. How they call for a crackdown. Then review the comments about how he does good work and shouldn't have to play by the rules of good practice because the ends justify the means. You want to go to a cancer specialist that doesn't require records and charges you $10 to use a chair in the waiting room? You willing to take a blood pressure med that can cause impotence/muscle spasm/kidney failure from a doc that didn't bother examining you, didn't check your pressure and doesn't need to follow up except when your 1 year script expires because you walked into his office with $100 and signed an affidavit stating you had high blood pressure? Think your family would win a malpractice suit when you took the pill, passed out and drove into the side of a school bus?

 

I am not active in this area, so it is no skin off my nose. But how about instead of recommending an easy, no records clinic, we instead suggests ways this man could get the necessary records. He clearly states he is a cancer survivor, cancer is a pretty much slam dunk certification. Neuropathy? Clearly he has some records, and a pain log brought to a single visit to an urgent care and noted in the visit record could easily qualify him. No need to go to a no record clinic. Get that together and bring it to a doc that will review them, follow up, and give you a certification that will stand up in court.

 

It is about time folks in here figure out a couple of things. The recommendation for records, an exam and follow up recommended in the O'Connell concurring decision may not be law, but the ARE common sense and good medical practice. Personally, if I was defending a patient, I would rather disagree with the decision but show I complied with it, than try and convince a court that a higher court 'got it wrong' and that I, a non-attorney, would 'set them straight about the law....'. If they come up with a ruling that I have to stand on my left foot when I sign a cert, I'll call it BS, but produce a photo of me doing just that if it will protect my patient.

 

And by the way, I don't charge for the forms.

[homeinmyhead]

Yes, I get your point Doc, The Michigan Wellness center is more on the lines on what your talking about. They require medical records, and stuff like that.

[Dr. Bob]

Yes, I get your point Doc, The Michigan Wellness center is more on the lines on what your talking about. They require medical records, and stuff like that.

 

Never go to a no record clinic of any kind, unless you are taken on as a regular patient for a period long enough to document your dx (office visits x3, imaging, labs, etc) and to generate a medical record over time, the cert will not stand up in court if the prosecutor wants it. Affidavit clinics only protect the clinic (well the patient signed his name saying he had the condition, therefore I felt comfortable signing the cert). The patient is NOT protected. If the procedure sounds strange if you substitute high blood pressure medicine or heart surgery for MMJ, it is not a legit clinic. Another red flag is if you have to pay one price for a records based cert, and another for a no records cert. That is basically selling a signature for the extra cost.

 

When you talk about dozens of folks going through a 'clinic' in a couple of hours, what kind of understanding can about a patient when you see a dozen an hour? Even with a great deal of experience, an excellent support staff, and everything in place 4-6 an hour is a max unless you are just signing papers. That is a very mentally taxing pace for any doctor.

 

Doc. Bob

[Highlander]

Never go to a no record clinic of any kind, unless you are taken on as a regular patient for a period long enough to document your dx (office visits x3, imaging, labs, etc) and to generate a medical record over time, the cert will not stand up in court if the prosecutor wants it. Affidavit clinics only protect the clinic (well the patient signed his name saying he had the condition, therefore I felt comfortable signing the cert). The patient is NOT protected. If the procedure sounds strange if you substitute high blood pressure medicine or heart surgery for MMJ, it is not a legit clinic. Another red flag is if you have to pay one price for a records based cert, and another for a no records cert. That is basically selling a signature for the extra cost.

 

When you talk about dozens of folks going through a 'clinic' in a couple of hours, what kind of understanding can about a patient when you see a dozen an hour? Even with a great deal of experience, an excellent support staff, and everything in place 4-6 an hour is a max unless you are just signing papers. That is a very mentally taxing pace for any doctor.

 

Doc. Bob

 

Dear Dr. –

 

While I’m neither a Dr. nor lawyer I ask you to consider the following with regard to your position that doom could descend upon a patient who goes to a no record clinic.

 

There isn’t anywhere that says a patient loses the protection even if the Dr. who signed the cert hadn’t a clue. If a physician diagnoses a patient with qualifying condition, and a physician (doesn't have to be the same Dr.) signs a cert, then if the patient submits the cert and $100, he is legitimately in the program. As long as the patient has been diagnosed by a Dr. to have a qualifying condition, he meets the definition of “qualifying patient” So even if the cert mill Dr. does a donkey/2 evaluation of the patient and then signs the cert, by the letter of the law, the patient is good to go.

Of course a cornerstone of this is that the “defendant” establish he was a “qualifying patient” to begin with, e.g. he was --> diagnosed <-- by a physician with a debilitating condition

 

I believe the COA found that Redden was not diagnosed with a condition, rather the Dr. found evidence of a symptom (chronic pain) of a condition not specified and certified based on that. One might argue it is symantics because Redden was diagnosed with a bad hip, which is a “condition,” that resulted in chronic pain. As I understand it, the defense did not provide that there was a diagnosed condition (bad hip) specifically, so the judge didn’t have the tools to rule otherwise. There simply was not a diagnosis provided as evidence so Redden did not prove he met the definition of a “qualifying patient.” I think this tells us that the current case law is that the patient has to be able to prove that a condition exists...not merely prove that a Dr. said it does.

 

So it seems to me that if the patient has records that he has a qualifying condition and can prove a different Dr. diagnosed him, even if he only signs an affidavit with the cert doc but walks away with a cert, his qualifying patient status is defensible. So one might believe that if you are truly a qualifying patient and can prove it, it really doesn’t matter where you get your cert.

 

It looks to me like the folks who could get hurt by this practice are the ones who are not legit patients to begin with.

[Dr. Bob]

Dear Dr. –

 

While I’m neither a Dr. nor lawyer I ask you to consider the following with regard to your position that doom could descend upon a patient who goes to a no record clinic.

 

There isn’t anywhere that says a patient loses the protection even if the Dr. who signed the cert hadn’t a clue. If a physician diagnoses a patient with qualifying condition, and a physician (doesn't have to be the same Dr.) signs a cert, then if the patient submits the cert and $100, he is legitimately in the program. As long as the patient has been diagnosed by a Dr. to have a qualifying condition, he meets the definition of “qualifying patient” So even if the cert mill Dr. does a donkey/2 evaluation of the patient and then signs the cert, by the letter of the law, the patient is good to go.

Of course a cornerstone of this is that the “defendant” establish he was a “qualifying patient” to begin with, e.g. he was --> diagnosed <-- by a physician with a debilitating condition

 

I believe the COA found that Redden was not diagnosed with a condition, rather the Dr. found evidence of a symptom (chronic pain) of a condition not specified and certified based on that. One might argue it is symantics because Redden was diagnosed with a bad hip, which is a “condition,” that resulted in chronic pain. As I understand it, the defense did not provide that there was a diagnosed condition (bad hip) specifically, so the judge didn’t have the tools to rule otherwise. There simply was not a diagnosis provided as evidence so Redden did not prove he met the definition of a “qualifying patient.” I think this tells us that the current case law is that the patient has to be able to prove that a condition exists...not merely prove that a Dr. said it does.

 

So it seems to me that if the patient has records that he has a qualifying condition and can prove a different Dr. diagnosed him, even if he only signs an affidavit with the cert doc but walks away with a cert, his qualifying patient status is defensible. So one might believe that if you are truly a qualifying patient and can prove it, it really doesn’t matter where you get your cert.

 

It looks to me like the folks who could get hurt by this practice are the ones who are not legit patients to begin with.

 

Far too many folks in this forum do not take the time to consider their replies. Yours is one of the better written and thought out ones I've seen in awhile.

 

Your points are very valid.

 

1. If the patient had a qualifying condition- bad hip, seizures, etc my feeling is that there would be documentation of the condition somewhere. Recall the standard for pain is chronic AND severe. Chronic = 3 or more months (common standard) and Severe = affects the activities of daily living, causes the patient to seek treatment, requires disability or job change, etc. Note that by severe, we mean something that requires treatment, which also generates records.

 

2. If the patient has been diagnosed by their regular physician, their care is on going, they have discussed the certification with their primary physician and he or she has noted that they supported the request and or signed the certification, we are in good shape. Clearly there is an on-going, bona fide Dr/Pt relationship between the certifying physician and the patient. All would agree that not only would this be a defensible cert, but it is the BEST way to get one. Unfortunately not all primary care docs can or will write certs.

 

3. Ok say we have a patient as above in #2 whose doc wont sign the cert and he goes to a certification clinic for it. In the Kolanek decision on the affirmative defense, the courts applied a strict interpretation to the language of the act, seizing on the has in 'and has been evaluated' to say that unless the certification process was already started after the act was in effect and prior to arrest, the affirmative defense is not available. We have no reason to believe they will not hold the same thought process to the certification doctor. The certification clinic doc must have a 'bona fide' doctor patient relationship with the patient and must follow good medical practices, just like any other specialist. That means they have to do the work to confirm the dx, document it, and follow up on their treatment.

 

Right on the websites of legitimate certification specials- for example Dr. Dave in Kazoo/GR, Dr. Kenewell in Troy, or Bob in N. Michigan, you can tell we take good medical practice and a bona fide Dr/Pt relationship seriously. To make a diagnosis, we need data (records), we examine the patient, and we follow up with them. We take responsibility for our work and our certs stand up in court.

 

Now take Billy Bob's Certification Emporium... No records required. How are you going to diagnose Crohn's disease by looking at a patient? You could say 'I saw rheumatoid changes in his hands' ok, that probably has been there for awhile. What about clinics that don't even have a doctor on site? Does signing a 'affidavit' protect the patient? Or does it just protect the doctor?

 

I'll put on my prosecutors hat for a sec. My job is to put YOU in jail. I'll do it by any legal means I can, I will play with the psychology of the jury/judge. I need to show you got your cert by fraud and aren't entitled to it. My strategy? Call your doctor on the stand and question his qualifications. He doesn't have a DEA registration, which is essential to write for controlled substances, and very few docs can function without. Having one pulled by the feds shows SERIOUS QUESTIONS about a doctors judgement. I can and will bring that up and your doctor is seriously damaged as far as his credibility, competence and judgement go. Same goes for discipline by the medical board. The board doesn't take that step, which is available to public eyes, without an investigation, hearing, and serious consideration. You really need to screw up to get punished by the Medical Board. I'll bring that up too.

 

Next, I'll attack the Dr/Pt relationship. Did the doc even meet with you? If so, did he examine or question you? Did he record his interaction on a note which remained in your record, like ANY other doctor visit you, the jury and the judge had in their lives? Let's go over that note.... Ok, when you get a prescription, you are told how much to take, how many times a day. Did the doc make a 'recommendation' on how to use MMJ, suggest any limits of use, etc. Is that recorded on his note, like any other recommendation? Did the doctor want to follow up to see how the MMJ was working? Again, like EVERY OTHER DOCTOR VISIT you, the judge and jury had in their lives. Or did he just sign the cert and say go with God and sin no more? Finally, how did he confirm the diagnosis. If a doc thinks you have cancer, he wants a biopsy report. Is that in your note from your visit with the certification doc? Are notes from your primary talking about your migraines or Crohn's there? What did your certification doc use as a basis for his diagnosis of your qualifying condition, or did he just wing it?

 

What the law says doesn't matter. What the court think it says does, because the courts are the ones that put you in jail. We know their play book, what they want. You have a choice, go to court and show how you and your certification doctor complied with those things, or try and convince the court the Court of Appeals doesn't understand the law and 'educate them' to the true path. You can be a test case if you want to educate the court, I'll read about your appeals for years and cheer you on. Or you can do it the way THEY want it and go home. Your choice.

[bobandtorey]

Dear Dr. –

 

While I’m neither a Dr. nor lawyer I ask you to consider the following with regard to your position that doom could descend upon a patient who goes to a no record clinic.

 

There isn’t anywhere that says a patient loses the protection even if the Dr. who signed the cert hadn’t a clue. If a physician diagnoses a patient with qualifying condition, and a physician (doesn't have to be the same Dr.) signs a cert, then if the patient submits the cert and $100, he is legitimately in the program. As long as the patient has been diagnosed by a Dr. to have a qualifying condition, he meets the definition of “qualifying patient” So even if the cert mill Dr. does a donkey/2 evaluation of the patient and then signs the cert, by the letter of the law, the patient is good to go.

Of course a cornerstone of this is that the “defendant” establish he was a “qualifying patient” to begin with, e.g. he was --> diagnosed <-- by a physician with a debilitating condition

 

I believe the COA found that Redden was not diagnosed with a condition, rather the Dr. found evidence of a symptom (chronic pain) of a condition not specified and certified based on that. One might argue it is symantics because Redden was diagnosed with a bad hip, which is a “condition,” that resulted in chronic pain. As I understand it, the defense did not provide that there was a diagnosed condition (bad hip) specifically, so the judge didn’t have the tools to rule otherwise. There simply was not a diagnosis provided as evidence so Redden did not prove he met the definition of a “qualifying patient.” I think this tells us that the current case law is that the patient has to be able to prove that a condition exists...not merely prove that a Dr. said it does.

 

So it seems to me that if the patient has records that he has a qualifying condition and can prove a different Dr. diagnosed him, even if he only signs an affidavit with the cert doc but walks away with a cert, his qualifying patient status is defensible. So one might believe that if you are truly a qualifying patient and can prove it, it really doesn’t matter where you get your cert.

 

It looks to me like the folks who could get hurt by this practice are the ones who are not legit patients to begin with.

 

Thanks

we both have a qualifying condition and have been on S.S.D for a long time so am not too worried about that part

and i/we have lots of chart notes over 10 years of them we just wont give them to the P.A like she wants why should we with out a court order then we will

let see if they get it and go from their

[Highlander]

You can be a test case if you want to educate the court, I'll read about your appeals for years and cheer you on. Or you can do it the way THEY want it and go home. Your choice.

 

Thanks for the reply. This has more or less been my mantra....Know the truth but account for LEOs and PAs who don't and understand, as Attorney Greg Schmid put it, the "trauma of litigation."

 

Good post Dr. Thanks for your insight and your professionalism and service to the mmj community.