Dr. Bob On 9 & 10 News

[+Malamute]

I would say that Dr Bob is supposed to understand "doctoring" and cleanD is supposed to understand "patienting/growing". I think both sides are best served if taking the time to understand one another and some of the intricacies of either of their positions. I am guessing Dr Bob is just as offended by the "marinol solution" as you are to Bob's understanding of the distribution or wtvr the topic was.

 

If Bob misinterprets a growers issues, simply explain how you see it differently, he is not an expert in marijuana growing, he is offering suggestions; as well as Bob has pointed out how people do not understand "doctoring" the way he does as an actual doctor.

 

 

 

:-)

 

Suggestions and ideas and merely that; suggestions and ideas. We all gain when they are discussed.

Edited May 9, 2012 by Malamute

[Dr. Bob]

Not really offended, just another opportunity to learn a different point of view. I think he is raising some good questions. I'll look into them.

 

Dr. Bob

[HEMP4LIFE]

now we can go back to bonified relationship

a caregiver, doctor, and patient should be having discussions on patient needs, caregiver grow forecast and plant types, doctor recommendation on type and ways to administer meds.

then the patient/doctor should have a forecasts of blood work, immunological tests for function, toxicology tests but that may vary depending on patient known condition i was using the cancer perspective

[Dr. Bob]

Sorry, but I am having some difficulty following your question.

 

I think I mentioned that doctors are limited due to the schedule 1 status of MMJ. We just can't write a prescription and I don't have the familiarity with individual strains to give a recommendation other than in rather broad terms. Due to a lack of formal studies, I can't really say one is better than the other on an objective basis, I don't have the experience to recommend something based on specific patient reports. With the surveys that were returned (which requested the strain used to give me an idea of what type works with what condition) most did not specify a particular strain.

 

Dr. Bob

[anonymousgrower?]

Understood, My post was out of frustration and my apologise for that. I just have heard so many times that why haven't you sued them or I would sue the pants out of them, then I read your post of owning there cars and their k-9.

 

I just wish I had found that lawyer that would acomplish that goal of taking on a MM case and getting justice for those that have lost everything and those that may have this issue in the future. thus I posted about when you find that guy please let all the victims out here know his number I'm sure he will appricate the business

 

Anywho, I'm not sure if that was the artical in referance I will check the site later to see if any updates have been made, good day hope its a pain free one!

 

Trix

 

 

Rick Convertino

 

Ex federal prosecutor, The guy is one of the best

[Croppled1]

Sorry, but I am having some difficulty following your question.

 

I think I mentioned that doctors are limited due to the schedule 1 status of MMJ. We just can't write a prescription and I don't have the familiarity with individual strains to give a recommendation other than in rather broad terms. Due to a lack of formal studies, I can't really say one is better than the other on an objective basis, I don't have the experience to recommend something based on specific patient reports. With the surveys that were returned (which requested the strain used to give me an idea of what type works with what condition) most did not specify a particular strain.

 

Dr. Bob

 

I appreciate this answer and I like what you put on your profile page here allot . I am starting to appreciate you more . I think often the short responses on message boards do not do you justice displaying your caring for patients and since any rules equals a potential violation many patients are resistant to any further complex interpretations of the Act to " clarify it " you often discus .

 

Honestly with this addmission I wonder why you feel patients should be held accountable for what licensed Doctors ever do to be considered a mill signing them up . No patient should be required to do more then go to a State licensed Doctor for a recommendation and if a Judge has a problem with any Mill that is for the Medical Standards Board to enforce on the Doctor not the patient who has absolutely nothing to do with the process of licensing in this State .

 

You say in one post how you now see how Federal Constriants would of put patients at risk of your distribution method proposed labled " Weed Bay " . Can you now not see how your wanting to define by law more then the formentioned interpretation of a bonna fide Doctor patient relationship places patients at risk . I approve of what your doing to try to seperate and protect yourself from being accused of being a mill ....but that is excatly what it is more then protection for patients who should not be held to as high a standard . Anyone but those against the act trying to convict understand a bonna fide Doctor Patient relationship to only refer to obtaining a recommendation from a State vetted and licensed qualifying Doctor . There simply are no accepted dosing or other guidelines a Doctor can follow nor is cannabis supply of uniform standards to do so . We just know it appears to work well in adjunctive use , some patients report amazing benefits and schedule 1 has to come down to reflect the truth so non biased research on medicinal cannabis can occur .

 

I think high quality cannabis can assist patients who need to slowly taper dependent medications originally taken for comfort they otherwise cannot due to terrible suffering and out of the norm withdrawl profiles who are now abused in our State and others . The current system has terribley injured and led to the deaths of many who felt abandoned with no way out they could tolerate .

 

This Veteran did not die in vain at least as long as one patient remembers .

 

http://www.daytondailynews.com/news/veteran-commits-suicide-in-front-of-dayton-va-center-656012.html

[Restorium2]

Excellent point croppled. That was my take on the bona fide stuff right from the get go at the Schuette Press conference. Rep. Irwin saw it from our perspective too and started an investigation into the doctor group that sent their leader to the conference. He found that those doctors were acting beyond their normal scope of activities.

Edited May 11, 2012 by Restorium2

[Celliach]

If you ask me, the idea of a doctor knowing different strains is ludicrous. The main reason I think that is that different growers can grow the same strain with different results. There's always going to be at least a minor variation in the same strain grown by two different individuals. There too many peopel relying on inaccurate strain information if you ask me.

 

Here's another problem I've encountered along these lines. Almost every new patient I meet says they want Indica. They did some reasearch and that seems like the MMJ they want for their ailments because that's what everyone on the internet says. When I sign a new pateint up and they tell me that, I always do a blind test with them, giving them Indica for half of their medicine and another separate bag with Sativa. I don't tell them which is which, but I do tell them we are having a blind test to see what works better for them. Every single patient that I've run this experiment with has preferred Sativas over Indicas for their medical conditions.....every single one. I encourage all CGs to try this with their patients. I'm not saying your going to get the same results, but it might be a good experiment to find out what your patient really needs.

[Restorium2]

Yes, everyone needs to experiment. That's the beauty of cannabis compared with the 'one size fits all drugs'. We can fine tune our medicine to our bodies, where with prescriptions, our bodies have to get used to the drugs.

[Dr. Bob]

I think that you may be missing the point on patient responsibilty with mills and the ability of the medical board to enforce standards.

 

All of you have been to the doctor, and all of you have a basic appreciation of the fact that the medical marijuana act is essentially giving you special permission to use a schedule 1 controlled substance and thus is held to a different standard than routine medical care. Speeding is against the law. You will get a ticket if you speed. IF you have a child with a broken arm in the back seat and you are speeding in the general direction of the emergency room, the police officer that stops you MIGHT let you go given the circumstances, but you are not 'entitled' to speed any more than you are 'entitled' to get a MMJ card. You can request one, but you may be asked to prove your story with records, an interview, and other things.

 

As for going to a doctor. Let's look at a few things and see how they stand up to the 'smell test' when it comes specifically to medical marijuana.

 

Do you think it is ok to buy a pre-signed certification from an appliance store with no contact with the doctor?

Do you think it is ok to fill out a form listing your symptoms, with no records, and have it sent to a doctor for signature?

Do you think it is ok to do a certification through the mail with no doctor contact?

 

Do you think that any of the above practices, when viewed by the general public (legislature) or the medical community give a either a positive or negative impression of medical marijuana or certification?

 

If you got your card at a kegger, with no medical records, and maybe even no doctor visit, do you HONESTLY think that will stand up in court?

 

Come on folks, a little common sense.

 

It is because these practices were supported by patients, who clearly knew something was amiss with the process, that the mills florished to the point you can't pick up a newspaper without seeing the 'no records, no problem' ad favored by the mills. And then you can renew that by mail, even if you never were seen by them in the first place. And I bet the checks just pile in and will continue to do so until the new law forces them to stop. Or the AG does.

 

You don't have to be a doctor to realize this is not the way things are done in real medical clinics, especially when you are looking to get special permission to do something that is not allowed normally. So yes, you can't escape some responsibility for your actions and your use of these 'signature mills'. Even if you are claiming complete ignorance of good medical practices, you are still the one sitting in a cell. Not the folks running the mill. Let the buyer beware.

 

Dr. Bob

[Dr. Bob]

Sorry, didn't address the medical board.

 

Their party line is that without the standards written out they couldn't prosecute the mills. Total BS, and I suspect they were hoping the abuses were so bad that they could rally the support of the legislature to restrict the practice of certification. Think of the chaos caused by LARA by refusing to print the cards in a timely manner- cops refuse to accept the paperwork as they are required to do, folks get arrested, headlines are generated unfavorable to to the program.

 

Unfortunately, it worked. The abuses were there- presigned certs, no doctor, no records, certs through the mail, gee, even though you are a resident of another state, we'll accept your library card and certify you as long as you have the cash because there is a loophole we can exploit. Just because the law doesn't specifically tell you you can't doesn't always mean you can or that it is a loophole you can use to make a few more dollars. The abuses were there and as a result we got a 75% supermajority for the first time I can remember.

 

We are all guilty to some extent. I was guilty of not properly explaining telemedicine or clearly explaining the difference between a consult about a known condition (based on medical records) and a patient presenting for the first time with a new complaint of weight loss or back pain. The work up and standards are different. I was interested in explaining the difference, the problem was the folks writing the new bills and on the medical board didn't want to hear the justification from MMJ, they just wanted to restrict it. And 'mail order certs' didn't help my case, because all certification physicians are lumped together with the worst elements of 'certification clinic events'.

 

I'll try and do better next time.

 

Dr. Bob

[CGorganic]

Many doctors are not allowed to write a recommendation stating the patient could benefit from medical marijuana. (U of M affiliated doctors for example.)

That is a factor in creating the vacuum for the card mills to fill the void and thrive.

[Dr. Bob]

Many doctors are not allowed to write a recommendation stating the patient could benefit from medical marijuana. (U of M affiliated doctors for example.)

That is a factor in creating the vacuum for the card mills to fill the void and thrive.

 

You are quite correct. The cause of this is uncertainty of what was expected, lack of education, and corporate politics. We are addressing the education by doing a study which will be presented to physician groups, there are standards published by the medical board now and in pending changes to the law. Time will increase the comfort level with primary care docs, look at where you expect this to be in 10 years.

 

Though your points are correct, I do take exception to your 'card mill' characterization of ALL certification clinics. They are not all card mills. Michigan Holistic, Dr. Bix, me and others do things well, didn't have to change our practices to reflect the new laws, and have been available all along. It is a choice to renew by mail, go to no doctor/no record clinics, or buy presigned certs in the face of legitimate alternatives that are readily available.

 

The problems for patients going to mills are best seen by asking yourself where all those dispensary doctors are now? Are they available to defend you if needed? Do you even know if you saw a doctor, and if so, who was it and where are they now?

 

Dr. Bob

[CGorganic]

I wasn't implying that all card certification clinics are card mills.

[Dr. Bob]

Just wanted to be clear. There is a difference between and 'clinic' and a 'certification event'. A clinic is run by a doctor according to the standards of medical care, just like any medical clinic.

 

The problem is, the legislature and for that matter the general public doesn't always make the distinction or understand the difference between medical clinics and sales events.

 

Dr. Bob

[HEMP4LIFE]

from a patient perspective, I would perfer the one on one relationship from a doctor who i can openly discuss my self medicating pratice with. we all need to realize that a large part of the healing process is compasinate conversations with your doctor. just knowing he is on board with you now frees us to heal.. remember its mind, spirit, body and soul. which in compasses healing.

its a process that is why i love the caregiver therory. from my caregiver i should be able to get a friend, a professional, a guide, a person to vent to, somebody who knows more than i do about mmj. a caregiver you see to me is more than just somebody who supplys meds and takes risks. a caregiver is part of my healing process such as a doctor is but on a different level.

i know we must play by the rules but sometimes rules become secondary like when iT comes To oil. so we accept the risk.

the doctor's role here i feel is to keep track of progress and provide support AND MAKE RECOMMENDATIONS

the doctors main goal should be to provide relief and improve health and vitality.

the doctor should do a battery of tests to track results of the therapry. again blood,immune function, pain level, organ and liver function, tumor monitoring, nutritional sugggestions, supplment advice and finally patient positive support.

should we be having a caregiver + doctor + patient discussion? YES WE SHOULD.

this is a learning process people we can all learn from eachother how in the hell can you get that at a mill.

if you ask me a mill is no better than that "milking parlor therory" what i mean by milking parlor theory is when i had to get chemo all i said about it was i didnt want to go to that BIG milking parlor. i knew i needed a smaller enviroment to heal i didnt like the thought of going to a big chemo room. same is true for doctor, caregiver in my opinion. keep it small and productive.

 

HEMP4LIFE

[+mayorherb]

There are plenty of good Dr.s signing aps..If we could get more family Dr.s signing aps..We wouldnt have to worry about it..Just keep educating your Dr.s they all can learn a thing or two from there patients..And in time, Hopefully we can get more signing, we wont need these fly by nite dr.s.

[+mayorherb]

sure lol but never mind they violated ur rights b4... thats ok....its hard to watch people try to twist this law so they can get rich...makes me sick. no sorry i need a real doctor

and if you dont agree you are off the point.

[+mayorherb]

Actually, though a bit pointed, I pick up on it too... A certain nonchalance in the presentation of ideas.

 

It makes me feel that you don't grow, you don't medicate, you don't particularly appreciate the very real theat we live with on a daily basis. Sure you can intellectually understand it, but can you really say you know what it is really like... Living in very real state of fear? Just that the presentation suggests otherwise.

 

I'l give up an example... A way for you to help us out with a proactive defense in attempt to progress the law... One that involves you putting up to the risk... For the fight, for the cause of progression... Yet that post goes skipped, ignored, passed on by... Though a very real suggestion employed by other dr's for the cause in several other states. It comes off as you aren't really interested in putting it on the line, yet suggest to us to push and advance the law...? It's ok for us to do it right? U even asked for 'outside' the box suggestions...

 

Just a reasonable point of view. Take it how u wish. Peace all... Wishing us a safer future.

Walk a mile n my shoes, then tell me how my feet feel.

[Dr. Bob]

Lost

[+mayorherb]

Of course..

[Dr. Bob]

Of course..

 

Sorry, I guess you missed the connection. If I were your feet, in your shoes, with you directing the shoes, I would feel lost. I was answering your question, not making a statement about my own positional awareness. My apologies for the confusion. Kind of like your recommendations about certifications, your suggestion patients be excused from taking any responsibility for their own safety, or your complete indifference to the perception of the Act/Certifications/Patients by the general public. Puff Puff, pass, and do whatever you want to do without thinking past our own individual wants seems to be the message you put out.

 

Unless we want more restrictive regulations or loss of the Act in general, I think we need to be a little more proactive about our own compliance/safety and not simply rely on those looking to make money off us while patients take all the risk. There are some bad folks out there. And many of them don't give a darn about your safety, they care about their bottom line.

 

Dr. Bob

[+mayorherb]

Didnt say Patients shouldnt take responsibility. A patient goes to a dr. (he thinks is real) and finds out latter its not. or someone else finds him wrong..Why should all the punishment go on to the patients? I would say if the Dr.s are wrong..They should get punished more then the patient.EVEN double or Triple the punishment..See the thing is People been taught for ever Dr.s are right. Or Dr.s know what they are talking about..But not all that is true....and as far as walking n my shoes.I was talking bout being a patient and having all the blae going onto the patients.Dr.s obvisouly are not getting in any trouble for there actions,,Cops getting away with arresting harraseing patients..Some get charged others dont..but opening up more holes for them is wrong..How many years you been fighting this war on us ,Bob? 2 maybe 3? I been fighting it for along time..I know alot of patients who have also..The alw was written so people could understand..We did and voted it..If they would just leave it alone?

[+mayorherb]

And about the people making the money. Them are the ones i found out we have to look out for..The ones who are filling there pockets left and right..running all over Michigan trying to get every dollar out there is to be had..Cutting peoples throats to make sure they get the every last dollar, lieing cheating..The ones filling there pockets left n right..

[+mayorherb]

Here is a story (nothing to do about Marijuana) but how the police treat people..for Example. : http://americanvisionnews.com/3369/mother-of-3-arrested-abused-for-taking-pictures-of-tourist-attraction-at-airport