I think the disconnect here may be considering some clinics to be "doc-in-the-box's".
The law isn't written to only allow health care professionals with or at private practices. The way it's written explains that the health care professional licensed under the appropriate chapters have the right and authority to recommend medical marijuana.
Now, on the renewal/expiration issue. Some clinics are a little dishonest, or they don't quite give all of the information. There's actually nothing written in the laws stating that the recommendation ever expires. HOWEVER, if a recommendation is written with an expiration date, it can be interpreted that the Dr is terminating the recommendation on that date, depending on the judge, jury etc. How does the judge know that you're "scheduled to be better" by that date?
The renewal at our clinic covers all of the benefits included with a membership, and is only $100. We also offer programs with yearly renewals and three year renewals. This means that your membership is valid with us until the expiration date passes. This means that we will go to bat for you in the unfortunate event something should happen all the way until your membership expires.
Now of course we don't want your membership to expire, because we want to be able to defend you as much as possible. But, if you can't keep up with your membership costs, and aren't eligible for our scholarship program, you'll have to defend your expired authorization. And again that's possible, but it boils down to the judge and jury you get. But it does appear precedence has been set already anyways, so a lapsed recommendation may be dependable. But, that's a risky venture right there if you ask me.