The Impact Of 4851, 4853, 4856, & 4834

[Restorium2]

For example;

One of my doctors that prescribes medicine to me says he wants me in every 3 months but I can stretch it to a year. This is just for blood pressure meds and I'm stable. If I'm not stable he INSISTS that I come in every month to make sure I'm getting stable. It's medicine and it's complicated at times. It's case by case.

[Dr. Bob]

I will tell you what the law does do.

 

Affidavit certifications, where you sign a paper saying you 'swear' you qualify, have always been a way for the clinics to PROTECT THEMSELVES rather than the patient. It was designed to give them the excuse, if questioned by the board or in court, to say 'well the patient said they were sick and I believed them'. That protects the doctor, and the patient is left to hang...and in many cases paid double the cost of a records based certification for the privilege of taking that risk.

 

Renewals or Initial Certifications through the mail, like the affidavit certifications, were always questionable practice. They clearly are NOT allowed under the bill and after 4-1-13 you can BET if you have a 'through the mail' certification or renewal, the prosecutor will hammer on that as it is not a bona fide relationship. That means even before 4-1 if you got yours through the mail and ended up in court AFTER the law took effect. So if you are even considering responding to a postcard today offering a through the mail renewal, that is what you could end up bringing to court with you after April 1. Don't do it, go to see the doctor in person, and make sure the person you see IS a doctor.

 

Dr. Bob

[Dr. Bob]

For example;

One of my doctors that prescribes medicine to me says he wants me in every 3 months but I can stretch it to a year. This is just for blood pressure meds and I'm stable. If I'm not stable he INSISTS that I come in every month to make sure I'm getting stable. It's medicine and it's complicated at times. It's case by case.

 

The law says 'reasonable expectation for follow up'. The doctor decides what is reasonable follow up. What is reasonable follow up for narcotics, blood pressure medications, and cannabis is different and doctors view them differently (I think I can say that with authority and close the issue).

 

BTW, you are followed up every three months for blood pressure medication because in many cases they are diuretics (fluid pills) and remove potassium. We check that every three months so it doesn't get low, which causes your heart to beat irregularly and die. The three month follow up you are complaining about is not unnecessary or worthy of complaint. What you should be complaining about is the fact your doctor didn't explain his reasoning to you so you felt more comfortable coming in.

 

Dr. Bob

[cristinew]

I guess we will have to wait until the supreme court rules on what a legal follow up is,,

 

 

So Dr Bob after your 6 month in person follow up do they have to have another one in 6 months or are they good for the next year and a half... until their 2 year state certification,,??

 

You guys are selectively trying to find the most difficult language you can to say the standards are difficult to meet.

yes only looking out for the safety of the patients,,

Edited December 20, 2012 by cristinew

[Restorium2]

The law says 'reasonable expectation for follow up'. The doctor decides what is reasonable follow up. What is reasonable follow up for narcotics, blood pressure medications, and cannabis is different and doctors view them differently (I think I can say that with authority and close the issue).

 

BTW, you are followed up every three months for blood pressure medication because in many cases they are diuretics (fluid pills) and remove potassium. We check that every three months so it doesn't get low, which causes your heart to beat irregularly and die. The three month follow up you are complaining about is not unnecessary or worthy of complaint. What you should be complaining about is the fact your doctor didn't explain his reasoning to you so you felt more comfortable coming in.

 

Dr. Bob

I was not complaining at all. You are stilting things with your mind. I was stating facts from my own personal experience to help folks here. My doctors explain everything to me and I understand my medical treatments 100%. I wouldn't have it any other way.

Edited December 20, 2012 by Restorium2

[Dr. Bob]

I guess we will have to wait until the supreme court rules on what a legal follow up is,,

 

 

So Dr Bob after your 6 month in person follow up do they have to have another one in 6 months or are they good for the next year and a half... until their 2 year state certification,,??

 

You guys are selectively trying to find the most difficult language you can to say the standards are difficult to meet.

yes only looking out for the safety of the patients,,

 

No, doctors doing their job properly in certifications are looking out for the safety of patients on this issue. We are the experts on follow up and as long as we have a reasonable plan in place the courts will accept it. Trying to second guess them on what 'reasonable follow up' is based on how methadone or lasix therapy is followed up and comparing that to cannabis- and claiming extra cost for that follow up, is not helpful and encourages patients to think that it is an impossible standard to meet. It is NOT.

 

Dr. Bob

[Dr. Bob]

I was not complaining at all. You are stilting things with your mind. I was stating facts from my own personal experience to help folks here. My doctors explain everything to me and I understand my medical treatments 100%. I wouldn't have it any other way.

 

Excellent, you are correct, I misunderstood the issue you were having.

Edited December 20, 2012 by Dr. Bob

[bobandtorey]

I agree its not complaining its about wondering how the courts will see it

 

And none of this will matter

1. If the patient really has a condition That qualifies them

2. Does the patient have medical records

3. Is the jury allowed to hear all the facts

 

The courts know if you have cancer and the jury knows it and say you have

To many plants lets say 1 over and you can tell them WHY

63% of the jury will set you free

 

 

[Restorium2]

No, doctors doing their job properly in certifications are looking out for the safety of patients on this issue. We are the experts on follow up and as long as we have a reasonable plan in place the courts will accept it. Trying to second guess them on what 'reasonable follow up' is based on how methadone or lasix therapy is followed up and comparing that to cannabis- and claiming extra cost for that follow up, is not helpful and encourages patients to think that it is an impossible standard to meet. It is NOT.

 

Dr. Bob

Right. It should be pretty much the same as with your prescription pain meds. Just like LARA told the doctors with that memo.

[Dr. Bob]

Oh and sorry, didn't answer the other question. My 6 month follow up is based on 1 year cards. With the two year cards, I'll offer the free follow up and recommend they come in every 6 to 12 months. Again, any time they have a question they are welcome to a free follow up visit to discuss it.

 

Dr. Bob

[Restorium2]

Excellent, you are correct, I misunderstood the issue you were having.

No issues here. I actually have a blood test every 3 months to check on my blood pressure meds. But I didn't want to complicate the issue in that post. That's another proof that things need to be case by case. Every patient is different. I feel plenty comfortible seeing all my docs. They are good folks and are practically my friends now. I don't feel as comfortible paying them as I do seeing them though, lol. That's why I stretch my blood pressure appointments to a year when I'm stable.

[Dr. Bob]

I agree its not complaining its about wondering how the courts will see it

 

And none of this will matter

1. If the patient really has a condition That qualifies them

2. Does the patient have medical records

3. Is the jury allowed to hear all the facts

 

The courts know if you have cancer and the jury knows it and say you have

To many plants lets say 1 over and you can tell them WHY

63% of the jury will set you free

 

What my experience was:

1. Did the patient have a bona fide relationship (chart note, supporting evidence for condition, risk/benefits, etc)?
   
2. Did they have a qualified medical condition supported with documentation?
   
3. Was there a plan for follow up?
   

The case I was involved with was a card holder that didn't qualify for a section 4 immunity (grow not secure but legal number of plants).

 

He easily won the case dismissal, because the answer was yes to all three questions.

 

That is what happens when these cases come to court. Make sure you are prepared to answer yes to all three on the chance you might have to.

 

Dr. Bob

[cristinew]

so do you charge on the second and 3rd 6 month follow up? for the 2 year certifications?

 

 

I am just asking this stuff because i want to to safe

Edited December 20, 2012 by cristinew

[Restorium2]

Ah yes, IMPACT:

So when it switches to two years, how many patients are going to want to only see the doc every two years? I'm not so sure this helped 'the situation' as much as some want to say.

[Dr. Bob]

so do you charge on the second and 3rd 6 month follow up? for the 2 year certifications?

 

 

I am just asking this stuff because i want to to safe

 

I don't, the reason is that it really doesn't take much of my time, it is an opportunity to learn from the patient their experience with strains and methods of use, and it is a good way to keep in contact with the patient.

 

The main reason I offer the free follow up is to STRONGLY encourage patients to take advantage of the follow up, make their chart complete, and protect them if questioned in court. Really it is free, why would anyone NOT want to do the follow up? Just a matter of a little time, I'm giving you mine, give me a little of yours. And have a cup of coffee with me while you do it. You know many docs that do that for patients? This isn't new for me.

 

But remember what Timmah and the others like to say, I hate patients, don't know what I am doing, and am only in it for the money....lol

 

Dr. Bob

[Restorium2]

I don't, the reason is that it really doesn't take much of my time, it is an opportunity to learn from the patient their experience with strains and methods of use, and it is a good way to keep in contact with the patient.

 

The main reason I offer the free follow up is to STRONGLY encourage patients to take advantage of the follow up, make their chart complete, and protect them if questioned in court. Really it is free, why would anyone NOT want to do the follow up? Just a matter of a little time, I'm giving you mine, give me a little of yours. And have a cup of coffee with me while you do it. You know many docs that do that for patients? This isn't new for me.

 

But remember what Timmah and the others like to say, I hate patients, don't know what I am doing, and am only in it for the money....lol

 

Dr. Bob

You're a good man Dr. Bob. I can't see where many doctors are going to give free follow ups. They will probably just do it like they always have and charge you. I believe you are a little different than most.

[cristinew]

Some patients are very ill and live 2 hours from the dr,, But i understand that your trying to help with this,, And i thank you for answering my questions

[kak1963]

Ah yes, IMPACT:

So when it switches to two years, how many patients are going to want to only see the doc every two years? I'm not so sure this helped 'the situation' as much as some want to say.

why would u have to only see ur doc every 2 years i see mine every month... i am long term every year is a pain knowing i will be on either pain pills for life or med m..... i think like pills there should be diff lengths of cardtime to fit the docs said term of injury if ur long term and the doc knows it why should i have to apply every year ....

[Dr. Bob]

Some patients are very ill and live 2 hours from the dr,, But i understand that your trying to help with this,, And i thank you for answering my questions

 

Gosh, I wonder if housecalls and skype might be of help there??? What do you think the chances are I thought of that a year ago? lol

[Dr. Bob]

why would u have to only see ur doc every 2 years i see mine every month... i am long term every year is a pain knowing i will be on either pain pills for life or med m..... i think like pills there should be diff lengths of cardtime to fit the docs said term of injury if ur long term and the doc knows it why should i have to apply every year ....

 

Because that is the requirement of the law that gives you the privilege of using a schedule 1 narcotic. The same can be said about all those posts comparing the requirements for cannabis vs handguns vs narcotics vs booze. It doesn't matter if you can hold an unopened bottle of whiskey in one hand and a bottle of percs in another and ride in a car all day. If you want to ride with your cannabis, lock it away. That is the price of getting to have it to ride around with it, it has nothing to do with booze or other narcotics.

 

Recall what I said earlier about reasonable follow up being defined by the physician. Our decision goes a long way in court, especially if we actually can justify that decision. Just not a concern if there is a reasonable procedure in place on the part of the doctor's clinic. I can't speak for non-physician run certification services.

 

Dr. Bob

Edited December 20, 2012 by Dr. Bob

[+washtenaut]

I hate patients, don't know what I am doing, and am only in it for the money.

 

Dr. Bob

 

Would this be called taking something out of context?

 

Just askin... lol

[Restorium2]

Because that is the requirement of the law that gives you the privilege of using a schedule 1 narcotic. The same can be said about all those posts comparing the requirements for cannabis vs handguns vs narcotics vs booze. It doesn't matter if you can hold an unopened bottle of whiskey in one hand and a bottle of percs in another and ride in a car all day. If you want to ride with your cannabis, lock it away. That is the price of getting to have it to ride around with it, it has nothing to do with booze or other narcotics.

Doc,

When I compared to handguns it was THE SPECIFIC WORDING in the handgun law as compared to the same wording in the new bill for locked up meds. No way were the two things compared, guns and marijuana. It was the interpretation of the wording that was compared for legal reasoning.

[phaquetoo]

With the gun law, where the wording says this, you just have to have your gun in a locked box anywhere in the interior, if it's a van-like vehicle. You would think it would be the same for cannabis, even though you can't up and shoot someone with your jar of meds.

 

Yea but you need to keep your pipes and papers in a different spot than your meds, just like your handguns, they need to be seperate so you cant use either while you drive!

 

Peace

Jim

[Dr. Bob]

Would this be called taking something out of context?

 

Just askin... lol

 

Not a bit, hear it all the time from that crowd.

[Dr. Bob]

Doc,

When I compared to handguns it was THE SPECIFIC WORDING in the handgun law as compared to the same wording in the new bill for locked up meds. No way were the two things compared, guns and marijuana. It was the interpretation of the wording that was compared for legal reasoning.

 

Then lock it up like a handgun. Was there a question there?

 

Dr. Bob