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One Doctor Approved 11,800 Patients


Zerocool

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what kind of doctor only sees 8 patients in a day? 

 

The one I use. From what I have seen in his office he probably doesn't even do 8 new MM patients a day, every day. Just guessing from what I have seen in 8 years. My wife's mm doctor is about the same. Slow and steady. 

 

The only thing I can think of that I have heard about that might be higher volume is "The doctor will be at the dispensary on Wednesday". But that's just one day a week. I can imagine they could turn over patients in about 30 minutes that way. But no way they have a successful turnover of near 9 minutes all day every day all year long. 

They go to another despense or hydro store the next day dude!

 

Peace

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some cert dr.s are at,,,,,,,,at least 5 despense at the same time, the same time, and it dont take more than 15 minutes, they already have all of your paper work typed and ready and even signed, than at the very last minute they sit you down in front of a laptop, some dr. comes on and asks a few questions of the worker he sent to see you and set up the laptop and printers, he tells them what to write in notes and boom pay and go with your renew!

 

It happens every day all over michigan, all over MI!

 

Man wake up, smell the mm, it is all around you!

 

Peace

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what kind of doctor only sees 8 patients in a day? 

 

The one I use. From what I have seen in his office he probably doesn't even do 8 new MM patients a day, every day. Just guessing from what I have seen in 8 years. My wife's mm doctor is about the same. Slow and steady. 

 

when the population of your small city is under 50,000 people total, i wouldnt doubt 8 patients a day.

combined that with the number of patients in that county is under 2000. yeah, not many certs to be done in a day.

 

comparing your county to wayne or oakland county is stupid.

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Maybe. The volume is very suspect though. 

Your very lucky you and yours get to go to the same dr. every yr, I have been getting certed from the same for 5 yrs now, buttttttt!

 

 

I hope I never have to use my dr. in court,,,,,,,,,That is what people need to ask themselves when they get certed from a circus dr.

 

a circus dr. is what I explained about golf course confrence room (bay city) and despenses and hydro stores,  I wish I was making this up, It is gonna smack me and alot of others in the face one day soon,,,,,,,,,my pain clinic lets me have thc in my system as long as I have an upto date card, but they wont renew me.

 

Peace

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when the population of your small city is under 50,000 people total, i wouldnt doubt 8 patients a day.

combined that with the number of patients in that county is under 2000. yeah, not many certs to be done in a day.

 

comparing your county to wayne or oakland county is stupid.

lol ok 

 

One of our doctors is in Oakland County. And he sees a low volume of MM patients and other patients too.

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Your very lucky you and yours get to go to the same dr. every yr, I have been getting certed from the same for 5 yrs now, buttttttt!

 

 

I hope I never have to use my dr. in court,,,,,,,,,That is what people need to ask themselves when they get certed from a circus dr.

 

a circus dr. is what I explained about golf course confrence room (bay city) and despenses and hydro stores, I wish I was making this up, It is gonna smack me and alot of others in the face one day soon,,,,,,,,,my pain clinic lets me have thc in my system as long as I have an upto date card, but they wont renew me.

 

Peace

Isn't that what doctors do? They go where they are needed and help as many as they can . It w.as a philanthropic gesture from the golf course, kudos to the owner.

Would you be happier if they worked outta the drug house in the hood?

 

Why do some always look at things in a bad light?

Edited by beourbud
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I've helped out at a few clinics around the state and the average turn around I've seen is about 30 minutes if they are working perfectly 100% of the time. Then some mess up their paperwork. At 9 minutes a rec, all day long, every day, all year long, it would have to be a computer program doing it because people are just not that fast and efficient. It's a bogus report. An exaggeration. 

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I've helped out at a few clinics around the state and the average turn around I've seen is about 30 minutes if they are working perfectly 100% of the time. Then some mess up their paperwork. At 9 minutes a rec, all day long, every day, all year long, it would have to be a computer program doing it because people are just not that fast and efficient. It's a bogus report. An exaggeration. 

 

There seems to be an assumption that the doctor is doing all of the work himself.

I'm guessing most doctors spend 10 - 15 minutes with the patient. Checkups and paperwork is done by office staff.

 

It isn't unreasonable for a doctor to see four patients an hour and still review their records in a reasonable manner.

 

"I see from your records that you are undergoing chemotherapy and it makes you nauseated. In my professional opinion cannabis will help with the side effects." "Next patient please."

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There seems to be an assumption that the doctor is doing all of the work himself.

I'm guessing most doctors spend 10 - 15 minutes with the patient. Checkups and paperwork is done by office staff.

 

It isn't unreasonable for a doctor to see four patients an hour and still review their records in a reasonable manner.

 

"I see from your records that you are undergoing chemotherapy and it makes you nauseated. In my professional opinion cannabis will help with the side effects." "Next patient please."

No assumption at all. I've watched the process and it takes longer than 9 minutes even if the doctor didn't see the patient. Just think about 9 minutes. Every 9 minutes, all day long for a whole year. That couldn't happen even if we planned it that way. The staff would have to be so efficient. The patients would have to be trained to be fast too. The real world doesn't work like that. Maybe you would have to have watched the process for a few hours to get an idea of how crazy it would be to get patients through at that rate. The only way this would be able to be pulled off is if the doctor was writing recs at a few offices at once. Like with a rubber stamp. Then the patients could be going through at the regular, believable, 30 minute rate at maybe three locations at once. Then it's still mind boggling to even see that being pulled off every day for a year. 

The simple answer is the inspector is not reporting truthfully or is mistaken.

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Even in the beginning when we had people flocking to doctors it was taking over 30 minutes a rec. These are cannabis patients. They aren't always really fast. Most don't have any idea about the process. They have questions. This isn't McDonalds drive thru. I don't think you could get patients to provide a valid drivers license, a signature, and pay in 9 minutes. Not time after time all day long for a year. It's impossible. 

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No assumption at all. I've watched the process and it takes longer than 9 minutes even if the doctor didn't see the patient. Just think about 9 minutes. Every 9 minutes, all day long for a whole year. That couldn't happen even if we planned it that way. The staff would have to be so efficient. The patients would have to be trained to be fast too. The real world doesn't work like that. Maybe you would have to have watched the process for a few hours to get an idea of how crazy it would be to get patients through at that rate. The only way this would be able to be pulled off is if the doctor was writing recs at a few offices at once. Like with a rubber stamp. Then the patients could be going through at the regular, believable, 30 minute rate at maybe three locations at once. Then it's still mind boggling to even see that being pulled off every day for a year. 

The simple answer is the inspector is not reporting truthfully or is mistaken.

What process was that resto, you primary care dr.?  I beleive that, have you been to the despense's and grow shops and seen how fast it is?

 

They send 2 people out, them 2 people set up a secure or unsecure internet connection, they set up a printer, and then they hang their open sign,,,,,there are 2 people at another despense or grow shop, than there are 2 more and 2 more and 2 more at other places, the dr. is at his house or his office!

 

1 month before your appt you send in copy's of every thing required, a copy of your i.d a copy of your old card, a copy of the same stuff for your c.g if you have one,,,,,,,then they set you a apointment at a despense or grow shop nearest to you/me/us, they are there for maybe 4 hrs they see at least 5 pt's an hr, all of your paper work was already done by you/me/us a month before your appt, they have you check out your paper work, than they have you sit in front of a laptop, a dr comes on skype, he dont say shiiit to you/me/us he tells his lackey to write down wtv on your cert in the notes, and says chronic pain, nail patella, etc and your done and out of there, they give you your paper work, your envelope, your lil green card for the post office and a peice of instruction paper and what to save, shiiiit they even make copy's for you to keep, because your app is your card untill you get your plastic, and its done, times that by 5 to 10 places, now how many do you think the can put out that way,,,,,,and that is the way it happens, beleive me I have been there,,,

 

theres a lot that goes on. remember LARA issued rules and guidelines for bonafide patient relationships. so lots has to occur...

all that did was make these circus dr.'s go on skype so they can say they seen you.

 

Even in the beginning when we had people flocking to doctors it was taking over 30 minutes a rec. These are cannabis patients. They aren't always really fast. Most don't have any idea about the process. They have questions. This isn't McDonalds drive thru. I don't think you could get patients to provide a valid drivers license, a signature, and pay in 9 minutes. Not time after time all day long for a year. It's impossible. 

Like I said your lucky you have your primary care dr renewing and rec'ing you!

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Like I said your lucky you have your primary care dr renewing and rec'ing you!

 

I use a cannabis specialist doctor that helps other kinds of patients too. Even when he did a 'clinic' away from his office every patient had a private examination. If you don't get a real examination you really don't have a real rec. Don't pay for a worthless rec no matter how cheap and easy it is. Spread the word. Lots of patients, maybe over 11,000, are victims if this press release is true. 

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Even in the beginning when we had people flocking to doctors it was taking over 30 minutes a rec. These are cannabis patients. They aren't always really fast. Most don't have any idea about the process. They have questions. This isn't McDonalds drive thru. I don't think you could get patients to provide a valid drivers license, a signature, and pay in 9 minutes. Not time after time all day long for a year. It's impossible. 

 

The entire process could take two hours with paperwork and answering questions but most of that could be done by other staff, physicians assistants, clerical workers etc. The doctor only needs to see each patient for a couple of minutes if the rest of the staff is efficient. My primary care physician and pulmonologist generally only spend a couple minutes speaking with me even though I'm in the office for an hour or so. For a cert I think nine minutes per patient on average is doable.

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http://www.denalihealthcaremi.com/lara-audit-mmj-doctors/

 

 

LARA Audits MMJ Doctors

 

 

 

Audit Says Doctor Sees 11,800 Patients a Year- Waiting Rooms Still Full

 

 

LARA has just released the results of an audit of medical marijuana certification doctors.  As always, they are making a big play that less that 25 doctors have seen some 56% of all certification patients in Michigan and one doctor (gasp) saw 11,800 patients in 2015.  First, let me make it clear, that one doctor was not me, though I wish it was and so does my checking account.  I think a good number of attorneys wish it was me as well, because my certifications are pretty easy to defend and use for Section 8 hearings due to our high standards and procedures.  But as an experienced primary care doctor, I think I should put some of these numbers in perspective.

 

 

First, the quote we are seeing that the ‘average’ doctor sees 11-20 patients a day is nonsense.  That volume may be at the ‘peak’ of the bell curve, but it is a pretty wide bell curve.  Problems with this average is that it seems to be the answer to ‘how many do you want to see’ rather than how many do you actually see.  Second there is no breakdown between doctors that are paid by the hour and those in private practice that are paid by the patient.  When I was in private practice in Internal Medicine, I worked from 8-5 or later every day.  Assuming an hour for breaks, food, bathroom, or whatever, that is a good 8 hours a day.  I averaged about 5 patients an hour, or 40 per day.  Some had simple problems and only took 5 min, other were more complicated and took an hour.  Each got as much time as they needed.  Of note, when I worked for the VA, my ‘full load’ was 8-12 patients a day.  With 1/2 a day off on Thursdays to do ‘administrative paperwork’.  Volumes depend on the setting and need.

 

 

Five patients an hour is 12 min a patient.  Is that enough?  Actually, yes for an organized and experienced doctor.  My first full history and physical in medical school took 5 hours.  My last hospital H&P took 20min, but the patient had quite a few problems.  Second, I don’t greet the patient at the door to the office, get their clipboard and paperwork together, help them fill it out, see them, and check them out.  That whole process may take an hour.  That’s why I have staff.  Trained staff.  They get the patient and paperwork together, I meet the patient and evaluate them/answer questions, the staff then helps them with the nuts and bolts of the application and gets signatures, etc.  We all do our part to give the patient a comprehensive visit.  In Internal Medicine, I saw between 30 and 45 patients a day, and I was on the LOW end of the volume in my town.  Plus 10-15 in the Hospital after work.  As a small town doctor, I worked 7 days a week for months at a time, and when not seeing patients, was required to be within 45 min of the hospital.

 

 

A typical, but busy, primary care doctor such as me seeing a typical patient load of 35 patients a day and working a 5 day week would see 9,100 patients a year.  Note that isn’t even at ‘full capacity’ of 40 patients per day, nor does it account for weekends (recall I had a hospital load of 10-15 per day, weekends included, and I didn’t count that in the numbers for my outpatient office practice).  So to get real for a moment, the headline of ‘One Doctor Saw 11,800 Patients’ is only abnormal because it was ‘presented’ as abnormal.  I would present it as a ‘light load’ for a small town solo practitioner.

 

 

Are There Problems with Certification Clinics?

 

 

Are there problems with certification clinics?  OF COURSE THERE ARE.  The Main Problem is that they are needed at all.  When 63% of Michigan Voters approved the MMMA in 2008, there was an implied understanding that, once approved, qualified patients would be able to see their primary care doctors and get their certification.  Unfortunately, this did not occur.  In fact, many patients are now AFRAID to discuss it with their doctors.  First, we see many offices post signs in their (full) waiting rooms instructing patients not to even ask about medical marijuana.  Second, many doctors not only refuse to look into medical marijuana, they dismiss or cut off pain medication when they discover their patient has a card.

 

 

This is something that really concerns me as a physician.  In order to properly treat my patients, I need them to feel comfortable telling me their secrets.  I need to know about the state of their health, their complaints, and what they are doing about it.  I need to know their vices and marital infidelities, so I know to look for things.  I need to know if they find something that helps them, not only because I want to know about what they are doing, but because it may help my other patients.

 

 

That is how my patients working through narcotic withdrawals got me interested in medical marijuana (which was helping them greatly with withdrawal).  If the average primary care physician learned that they had several patients reduce their need for narcotic pain medicine by 50% simply by eating celery, how long would it be before they recommended celery to all their pain management patients?  Not long at all, because doctors don’t like writing narcotics.  Yet change celery to medical marijuana, and they lose their freaking minds and start punishing patients by cutting them off, putting them in withdrawal and dismissing them from their practice.  How do you reconcile that with ‘Do No Harm’???  Don’t even get me started on lawyers (judges and prosecutors) demanding people be taken off ‘celery’ and put back on hard narcotics and ulcer causing NSAID’s.

 

 

Where to from here?

 

 

Without getting into legalization and decriminalization, what should we do with the current certification system?  First, since primary care doctors are not participating, we will have certification clinics and doctors that spend most of their time doing certifications.  It is not unexpected that there are relatively low numbers of doctors in this field.  Hospitals and large clinics generally do not allow their doctors to do certifications, either does the VA.  As a result only private practice doctors (especially solo providers) are the only ones that can really become certification doctors, and there are relatively few available.  Many already have busy practices, don’t know much about the field, or simply don’t wish to be known as ‘pot doctors’.  But there were 55 doctors doing most of the certifications in 2011 (the last time a number was reported), now we are fewer than 25.  Patient numbers are higher than ever.  Our waiting rooms are full, and we are seeing the patients.

 

 

Using patient numbers to imply improper certifications or to label individual doctors as ‘problem doctors’ is not accurate.  Assuming physicians are following the law- Seeing patients in person (not on Skype or through the mail), reviewing records and doing follow ups, more power to them.  They found a market and are meeting the needs of that market in a professional way.  If I were LARA, I would concentrate on doctors that don’t do certifications correctly.  Doctors that do renewals through the mail, or see patients on Skype.  Doctors that have been to court and have had their certifications overturned.  Was it an isolated ‘bad’ visit or a pattern of cutting corners or ‘signing for dollars’?  That is a question for a LARA investigator to answer.  Perhaps rather than look at a spreadsheet and say a doctor is ‘bad’ because they are busy, they should actually work and identify problems in procedures and those that don’t follow the law.

 

Bonus Feature!

Do you want to learn more about medical marijuana and the patients that use it?  Have a look at the last 2 years worth of statistics from our practice– Average ages, condition breakdowns, ages by conditions etc.

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The entire process could take two hours with paperwork and answering questions but most of that could be done by other staff, physicians assistants, clerical workers etc. The doctor only needs to see each patient for a couple of minutes if the rest of the staff is efficient. My primary care physician and pulmonologist generally only spend a couple minutes speaking with me even though I'm in the office for an hour or so. For a cert I think nine minutes per patient on average is doable.

Lets look at it from another perspective;

 

Ever sit in the waiting room? Ever see a doctor take patients in every 9 minutes? Never. No doctor ever does that and I've seen a lot of doctors. It's a patients dream for sure. 

 

Maybe I'm just an unlucky person? So I'm asking, has anyone ever sat in a doctor's waiting room and seen them take patients in any where near the rate of every 9 minutes? Any kind of doc? Maybe my life experience is just lacking in this matter. My doctors are always way too slow. 

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11,800 people. Went to a football game yesterday and the stadium seats 6800 and it was FULL. I was looking around at all the people and realized that one MM doctor saw about twice that many patients in a year. It's mind boggling ..... I don't know whether to bow down and tell the doctor "I'm not worthy" or to wonder how he could actually help that many people. It's an enigma.

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