CO Health Dept calls for changes to doctor-patient rules

FOR IMMEDIATE RELEASE

Thursday, Dec. 17, 2009

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Mark Salley
Director, Office of Communications
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Medical Marijuana Registry Data Shows Cause for Concern

DENVER The latest data from the Medical Marijuana Registry maintained by the Colorado Department of Public Health and Environment shows, that as of Dec. 15, a total of 820 licensed physicians had authorized medical marijuana for 15,800 patients. Of those 820 physicians, just 15 accounted for 73 percent of total patients, and just five have authorized 49 percent of all recommendations.

These figures are representative of the concerns we have about whether some physicians really have a bona fide physician-patient relationship, as required in the constitution, with those for whom they are authorizing the use of marijuana, said Chief Medical Officer Ned Calonge. Working with the governorâ??s office, we have crafted statutory language changes that would, among other things, clarify what constitutes a bona fide physician-patient relationship.

The department is asking legislators crafting medical marijuana-related bills to include the following provisions to help address issues of fraud and abuse:

Define a bona fide physician-patient relationship that includes an on-going relationship, a complete assessment of a patients medical history and follow-up care.
Ensure a physician recommending medical marijuana is in good standing and has not had his/her federal Drug Enforcement Administration registration revoked or suspended.
Prohibit physicians from receiving remuneration from a primary care giver or dispensary.
On average, the 805 physicians with the lowest number of medical marijuana authorizations have approved just over five patients per doctor, while the 15 physicians with the most authorizations for medical marijuana have approved an average of 760 patients per doctor. These dramatic differences raise concerns about the medical care being provided to these patients.

According to Calonge, this latest data is all the more reason to make statutory language changes that will better ensure that the appropriate patients are participating in the medical marijuana program, with assessment and treatment that meet the medical standard of care in the community and assures the health outcomes intended by those voting in favor of the original constitutional amendment.

Many of these requirements parallel federal laws designed to provide protection from economic conflicts of interest that may arise when a physician stands to benefit directly from the sale of a medication or service that he or she prescribes, said Calonge.

The latest estimate from the Colorado Department of Public Health and Environment is that approximately 29,000 to 30,000 individuals now have submitted the necessary applications to be included on the states medical marijuana registry. An exact count is not available at this time due to the high volume of mailed applications being received by the registry each day.

I need an MJ doctor because I have a primary care physician in a large practice which won't do MMJ recommendations.

Should we also require such a relationship for plastic surgery or even abortion?

If I need a root canal, I go to a root canal doctor, not my primary dentist because the root canal doctor is better at it.

they should stop. what will it take?

Either a lawsuit or a large demonstration by passionate medicinal cannabis activists....

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Originally Posted by copobo

I need an MJ doctor because I have a primary care physician in a large practice which won't do MMJ recommendations.

Should we also require such a relationship for plastic surgery or even abortion?

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Now there's a way to solve CU's Med School money problems, offer a Doctor of Medical Marijuana degree/specialization.:thumbsup:

It should probably include extensive knowledge of something the medical profession seems only recently to be addressing - pain management.

I'm on Medicare w/Kaiser; they offered me an anti-depressant for my shingles because they said it gave pain relief. When I told them it didn't do shit for the pain but killed my sex drive they gave me Percocet, but made me go through extensive hoops for renewals, saying they feared addiction.

No MMJ prescriptions from them for my chronic back pain - and other than developing a historical record, I don't want them having anything to deal with my pain.

BTW - pretty interesting numbers in that press release; 15.8k registered patients a/o 15th, but nearly twice that in submissions!

The missing numbers, the ones some reporter should have asked Calonge about, are how far behind they are in processing applications and how far behind are they in filing/tracking change of caregiver forms? I've heard people say they applied six months ago and still haven't received their license.

If this was another approval situation, say in Social Services, the outcry from the media would be huge, the Gov would be holding major staff meetings - but since it's just pot licenses the state's approach seems to be no problem, they're not sick just a bunch of malingering stoners so let's screw with them..

I agree, we need to raise a stink. DoH shouldn't be worrying about rule making when it can't even take care of record keeping.

Haven't looked in on Westword recently - wonder if Patty Calhoun's given up jousting at windmills?

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Originally Posted by starter09

I've heard people say they applied six months ago and still haven't received their license.

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I was told by one of the assistants at the caregiver where I was preparing my paperwork that licenses were now taking 8 months. This came from a friend that works at the registry.

Looks like they are getting backed up, and therefore creating jobs that need to be filled to make it more like a month wait. and the reason is medical marijuana. Yah i was wondering myself about the missing numbers there. That must be the estimated amount of paperwork laying around in a office room that needs to be processed. Looks like they have some secure jobs also in this economy.:cool:

Every day's delay means another day one need not renew, since one's copies of paperwork submitted with proof of mailing and receipt, are legally sufficient as your license. Every once in a while, the govt's incompetence works to your benefit. I haven't got my license yet, but my check cleared about a month ago.

oh, nice lil loophole their eh'. Right, state law is state law.:thumbsup:

Colorado: Department of Public Health and Environment, Colorado Medical Marijuana Registry

one of these documents gives new and renewals 12-14 weeks approximate.
The other document says that after 35 days with no response your application is deemed approved. However I'm not sure reading further down if that's just a given, mean they could for whatever reason (perhaps missing info on the form, wrong ink) send you a rejection letter down the road, passed the 35 days.

14 weeks , is almost 4 months.

The "deemed approved" language is from the amendment itself, but the CDPHE ignores it. My first application was returned to me for just such a clerical error long after 35 days had passed.

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Originally Posted by senorx12562

The "deemed approved" language is from the amendment itself, but the CDPHE ignores it. My first application was returned to me for just such a clerical error long after 35 days had passed.

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Right which is what I was thinking. In between the 35 days and the date they notify on is probably an open window where technically you were legal..

I've been told that the actual date on the license is the issue date, not the date 14 weeks earlier (or whatever) that they received your paperwork. I'm not complaining.

Question...does any of the cannibis medical uses help you shingles. My Grandfather suffered from them for many years and I was always interested in if there was anything he could do to help him with his continuous pain??

Please advise

I read most of this earlier, but not all of it, so if this got stated please forgive me.

Doctors have their drug prescription license thru the DEA. (Feds) They will loose the ability to prescribe if the Feds become anal pores. Therefore, the majority of doctors prefer not to 'prescribe' cannabis for fear of the damage to their license...............

So, the need for these clinics and for local clinics that specialize. I do hope the State looks at that aspect of the issue.

It definately is worrisome that only a few doctors are the prescribers and I am sure it is sending up red flags. Those of you that can contact your state reps should provide that aspect to them before they change any laws.

Approved 6-1. Goes into effect on March 1.

Colorado Medical Marijuana Dispensaries Split Over Pending Legislation

Dispensaries will always support regs that result in them staying in business while others are forced to close.

Am I correct in assuming that the only direct effect this will have on patients is that the MMJ license will cost a bit more and require more checkups, visits, etc.?

So, gone are the days of the walk-in/walk-out medical rec... but I'm sure places will remain like that clinic in Boulder - Grassroots I believe - where you have to visit 2-3 times before your rec. Those kind of places can adapt to the regs I would imagine.

it just got out of committee. it will likely get voted on in the next week.

I saw where they're 5 months behind processing cards...if you get licensed soon, you'll have 17 months

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Originally Posted by lampost

Am I correct in assuming that the only direct effect this will have on patients is that the MMJ license will cost a bit more and require more checkups, visits, etc.?

So, gone are the days of the walk-in/walk-out medical rec... but I'm sure places will remain like that clinic in Boulder - Grassroots I believe - where you have to visit 2-3 times before your rec. Those kind of places can adapt to the regs I would imagine.

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yea but it's bs why should i need to go to a doc 10 times a year? my ddd, nerve dmg,3 buldged and protruding discs,peripheral neuropathy,severe headaches and so on is'nt going anywhere.it's not like im gunna wake up 1 day and it all be cured.things like this is with you for life.so why, whats the need for me to have to go to a doc and spend atleast a 100$ per visit just for them to say yup your still fucked up see ya next month so we can rob another 100 outta ya.i could see it for those that went in with no records claiming they get aches and pains here and there.it's just another way to control and rape money from us.

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Originally Posted by palerider7777

yea but it's bs why should i need to go to a doc 10 times a year? my ddd, nerve dmg,3 buldged and protruding discs,peripheral neuropathy,severe headaches and so on is'nt going anywhere.it's not like im gunna wake up 1 day and it all be cured.things like this is with you for life.so why, whats the need for me to have to go to a doc and spend atleast a 100$ per visit just for them to say yup your still fucked up see ya next month so we can rob another 100 outta ya.i could see it for those that went in with no records claiming they get aches and pains here and there.it's just another way to control and rape money from us.

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I agree man, it is bullshit, but it could've been worse...

Sucks for the terminal patients and those in severe pain who will have to go through extra bullshit and pain just to get access. Not to mention all the additional money it'll cost.

And it won't weed out the seriuos rec users either, they'll just have to pay more.

I'm afraid you're missing some significant points here. This Bill is written in such a way that it gives the power to the Dept. of Health to refer a Physician to the Colorado Medical Board for review based on certain criteria, i.e., # of recommendations written, age of patients written to, etc. This is the financial impact study written for the Bill which clearly indicates funds will be set aside for training (how to spot trends of "abuse") and setting aside funds for Lawyers to go after Doctors who write recommendations.

http://www.leg.state.co.us/clics/cli...e=SB109_00.pdf

A Dr. could be looking at a cost of $75,000+ to defend themselves to the Board and risk sanctions that could be devastating to a career, even if the only sanction is that they are no longer allowed to write recommendations, the damage will be done.
The point is, there is a reason so few Dr's do this and now that # will be even fewer. I highly doubt the patients who have received recommendations this year will have any Dr. available to them for renewals, and that may well include truly ill people who rely on this medication.

one physician recommendation is all anyone needs to be good for life. The health Dept. cards are not required to be protected from prosecution.