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Good Press In Saginaw.


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http://www.mlive.com/opinion/saginaw/index.ssf/2011/07/torn_from_the_front_page_medic.html

 

 

This was an excellent commentary from a detached observer. We are finally seeing common sense approaches from the media and law makers and law enforcement need to listen to what their bosses, the people, are saying.

 

When I was asked to comment on the proposed laws, specifically requiring certifications to be written only by primary care doctors with a long standing relationship with the patients, my response was that it was a 'nice' sounding proposal, but the end result would be the end of certifications in Michigan and the complete undermining of the MMMA. This is because many patients in Michigan get their primary care from federal physicians (VA, Indian or Tribal Health), or physicians associated with many hospital systems that do not allow their doctors to write certifications.

 

The end result is that only 2200 of 30,000 active physicians in this state have written even ONE certification, and there are a core of 55 physicians like myself that write the majority of the certifications because THAT IS WHAT WE DO as our main practice. To further break this down, the 55 have averaged 2 certifications a business day for the life of the Act, and the remainder of the 2200 physicians that have written a certification average 1 every 2 months over the same time frame.

 

I am an Internist with a clear record. I don't 'have' to write certifications to make a living- I can do colonoscopies, echocardiograms, and take care of hypertension and do well, thank you. I am in this field because I believe MMJ helps people and reduces the need for the real 'problem' meds, prescription narcotics.

 

Yes, there are abuses, there are damaged docs out there that don't follow good medical practices. There are marketing companies out to make a quick buck in certifications (you can generally identify them by the 'no records, no problem' ads). But there are also professionals such as myself, THCF, Dave Crocker and others that do things by the book and stand behind our patients.

 

If the legislature really wants to make a difference, to get rid of the 'certification signature mills' and whatever else they need to 'take control' of the process- the answer is SIMPLE. Pass a law REQUIRING all physicians, regardless of what the hospital systems or employers say or want, to write certifications for any QUALIFIED patient that requests one. Patients have a right to have a say in their medical care. To refuse to write a certification for a qualified patient because your hospital or practice 'doesn't want to get involved', and then CUT THEM OFF from their medication or simply discharge them from the practice if they get a card, is the mark of a physician that does not have his or her patient's interests at heart. They are not doctors, they are politicians.

 

Dr. Bob

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So right!! My "primary physician" is a PA, who said to me (before passage of the law) that he had no problem with marijuana, he thought it was better than a lot of the pills.

 

But, since the law passed, he / his clinic is not doing certs. because, well I don't know why - either the MD behind him wont do it, or because of pressure from the feds - he always says how much scrutiny they put docs under regarding narcotic prescriptions.

 

I would LOVE to have my PA do my certs, like Schuette wants, but my PA won't, so I had to find someone else.

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What if the Dr had to register with the state to write certs for non-primary care patients? So Dr's that can write certs are a) Primary Care Dr's with long standing relationship with a patient and b) Dr's certified to write certs with the state can write them for anyone.

 

My thoughts are this. Primary care dr is the good case scenario, because that dr sees the pt more often. But some are just refusing or have agenda against it (paid by big pharma everytime they write a script). So how do you regulate in a logical way a place for these people to get certs? Take some of the 8 million dollar surplus and create a "Dr required training for writing certs to non-primary care patients". That dr is shown what to look for, what records have to be kept, etc. In the thought of compromise, if that dr is ever found handing out pre-signed certs or something, they will have their MMJ cert taken away.

 

this would help take away "no records" centers and give the state and medical review board more teeth against "no records" dr's. But it would leave Dr's who do it right alone.

 

Sure, this adds more red tape, and prices would probably go up for certs. However given the proper patient coding, you could keep records anonymous while still allowing review of certs written. It would also add a sense of relief to the general public. Fake patients and no record Dr's would be a thing of the past.

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What if the Dr had to register with the state to write certs for non-primary care patients? So Dr's that can write certs are a) Primary Care Dr's with long standing relationship with a patient and b) Dr's certified to write certs with the state can write them for anyone.

 

My thoughts are this. Primary care dr is the good case scenario, because that dr sees the pt more often. But some are just refusing or have agenda against it (paid by big pharma everytime they write a script). So how do you regulate in a logical way a place for these people to get certs? Take some of the 8 million dollar surplus and create a "Dr required training for writing certs to non-primary care patients". That dr is shown what to look for, what records have to be kept, etc. In the thought of compromise, if that dr is ever found handing out pre-signed certs or something, they will have their MMJ cert taken away.

 

this would help take away "no records" centers and give the state and medical review board more teeth against "no records" dr's. But it would leave Dr's who do it right alone.

 

Sure, this adds more red tape, and prices would probably go up for certs. However given the proper patient coding, you could keep records anonymous while still allowing review of certs written. It would also add a sense of relief to the general public. Fake patients and no record Dr's would be a thing of the past.

 

That sounds like a very reasonable compromise to me.

 

Of course then we get back to the fear of 'opening up' the MMMAct to any changes. Are we afraid that a bunch of new amendments will be forced through along with our proposed change? Is that why BlueBerry is always saying that we cannot allow any changes?

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Guest Happy Guy

My primary care doctor, who happens to be located in Saginaw, says that cannabis specialists should be the ones to write the recommendations. He says that the specialists know more about cannabis and they are the ones that are qualified. When I asked a cannabis specialist from Saginaw (who writes recs for THCF) about this, he said he personally knows my primary care doctor, and because he works/affiliated for St. Marys, he can't write a rec or he would lose his affiliation. Two stories that come to the same conclusion, specialists will be writing most of the recomendations for medical cannabis.

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My primary care doctor, who happens to be located in Saginaw, says that cannabis specialists should be the ones to write the recommendations. He says that the specialists know more about cannabis and they are the ones that are qualified. When I asked a cannabis specialist from Saginaw (who writes recs for THCF) about this, he said he personally knows my primary care doctor, and because he works/affiliated for St. Marys, he can't write a rec or he would lose his affiliation. Two stories that come to the same conclusion, specialists will be writing most of the recomendations for medical cannabis.

 

And they currently are. The problem is they are trying to restrict it only to primary care docs, who as you point out are not 'allowed' to do so. Either certify the specialists and leave them alone, or require all doctors to write for qualified patients on request, or hold their 'handlers' like St. Mary's accountable legally.

 

The threat of REAL civil liability in state court, vs THEORETICAL liability from the feds will make the difference.

 

Dr. Bob

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And they currently are. The problem is they are trying to restrict it only to primary care docs, who as you point out are not 'allowed' to do so. Either certify the specialists and leave them alone, or require all doctors to write for qualified patients on request, or hold their 'handlers' like St. Mary's accountable legally.

 

The threat of REAL civil liability in state court, vs THEORETICAL liability from the feds will make the difference.

 

Dr. Bob

 

PS, meanwhile I am in Dr. Buck's old office every Thursday evening from 6-9.

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That sounds like a very reasonable compromise to me.

 

Of course then we get back to the fear of 'opening up' the MMMAct to any changes. Are we afraid that a bunch of new amendments will be forced through along with our proposed change? Is that why BlueBerry is always saying that we cannot allow any changes?

 

My only comment on this is that we've had the law for a couple of years. There have been problems identified, like the no record, pre-signed mills. These are problems that can and should be addressed. It is kind of like a marriage, sometimes it takes a year or two to figure out your partner really likes cheese on their eggs. Observe, assess, adjust is never a bad idea- be it a law, a marriage, or calling in artillery.

 

Dr. Bob

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Guest Happy Guy

And they currently are. The problem is they are trying to restrict it only to primary care docs, who as you point out are not 'allowed' to do so. Either certify the specialists and leave them alone, or require all doctors to write for qualified patients on request, or hold their 'handlers' like St. Mary's accountable legally.

 

The threat of REAL civil liability in state court, vs THEORETICAL liability from the feds will make the difference.

 

Dr. Bob

St. Marys handles a majority of the doctors in the area. They got together early on and made their policy clear to their doctors. And they also told their doctors they can't say that it is St. Mary's policy to not provide recs for medical cannabis. They are cunning and know they could be held accountable for these blanket policies that restrict patient rights. It would be very difficult to sue them, and even more difficult to break them of their policy.

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St. Marys handles a majority of the doctors in the area. They got together early on and made their policy clear to their doctors. And they also told their doctors they can't say that it is St. Mary's policy to not provide recs for medical cannabis. They are cunning and know they could be held accountable for these blanket policies that restrict patient rights. It would be very difficult to sue them, and even more difficult to break them of their policy.

 

And that is why I do what I do. To meet the need. The only way to change it is to make them legally accountable, despite their policy, otherwise, we need the certification clinics.

 

Dr. Bob

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Guest Happy Guy

And that is why I do what I do. To meet the need. The only way to change it is to make them legally accountable, despite their policy, otherwise, we need the certification clinics.

 

Dr. Bob

How do you fight the arguement that a specialist is needed? I need some ammo, going to see the primary doc in a week. LOL Pushing some buttons like usual. Sparring. At least he will talk about it. And his golf buddy is a cannabis specialist and also my doc.

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How do you fight the arguement that a specialist is needed? I need some ammo, going to see the primary doc in a week. LOL Pushing some buttons like usual. Sparring. At least he will talk about it. And his golf buddy is a cannabis specialist and also my doc.

 

Why fight the argument, I'll do the cert for your doctor, so long as he doesn't 'punish' you for getting one, especially if he is unwilling to write it himself and wants you to see someone like me.

 

Dr. Bob

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The paper's editorial board seems to have come around on the matter altogether. From coming out against the Ballot Initiative that established the law, to subsequent statements that Saginaw is not seeing any significant problems with it, to this, almost sounding like they support it altogether, with a couple of minor asides.

 

Thanks for your piece Dr. Bob.

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Guest Happy Guy

Why fight the argument, I'll do the cert for your doctor, so long as he doesn't 'punish' you for getting one, especially if he is unwilling to write it himself and wants you to see someone like me.

 

Dr. Bob

The argument is weak that he isn't qualified to recommend cannabis. He prescribes other drugs that are much more dangerous and require just as much education to understand the effects. It is a cop-out so he can comply with St. Mary's policy. Cop-outs never work in the long run. He needs to change and I will apply gentle pressure until he does. Then his wife, a Saginaw doctor, will also be on board. I think I will ask him why he feels qualified to prescribe a blood pressure medication, that requires a regular blood test every few months to see if it is hurting your organs, and an all natural drug like cannabis is too complicated for him to deal with. I'll fight him with his own talking points. We shouldn't need a specialist to recommend our cannabis. Thanks to all that do this for us in this time of need.

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I completely agree that primary care doctors can and should sign certifications for qualified patients upon request. This is not a motrin vs naprosyn question, it is a personal preference concerning a health care decision made by a patient. IF a doctor does not wish to participate and respond to the needs of his patient and wishes to refer, then he should do so, not punish his patient for seeking the card elsewhere.

 

Dr. Bob

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