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11/07/03 |
Regarding the MBC statement 11/07/03
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Frank H. Lucido M.D. Diplomate A.B.F.P. 2300 Durant Avenue Berkeley,
Ca, 94704 510-848-0958 fax
510-848-0961(office) [email protected]
/bigger> Presented
verbally 11/7/03
Dear Members of the Medical Board of California,
Division of Medical Quality:
You may remember me from my previous 2
visits to your Division of Medical Quality, this past May, and in August.
To
summarize my credentials, I attended University of Michigan Medical School from
1970-1974. I then came to California, where I completed my Family Practice
Residency through U.C. Davis, and then worked as an emergence room physician for 2
years, before beginning my Family and General Practice in Berkeley, California
which I continue to practice since 1979. I have been on Active staff of Alta
Bates Hospital since then, have been on the Credentials Committee, Family
Practice Advisory Committee, Medical Education Committee (chairman once). I have
been Medical Director of 2 Skilled Nursing Facilities, proctored new doctors to
the staff, and have done medical-legal consulting, reviewing malpractice cases
for the plaintiff. So I have seen the wide range of medical practice in
California, and seen good medicine and bad medicine, and all in
between.
I have found the vast majority of physicians to be caring,
knowledgeable and conscientious. I know most of the 15-20 doctors in
California, who are most knowledgeable and outspoken about medical cannabis, who
in spite of legal threats, have the courage to still perform medical cannabis
evaluations. I find that they compare favorably in safety and caring for
patients as do California physicians in general. . As you know, at least nine of
these 15 to 20 doctors have had investigations begun into their practice. So I
want to put this in context: it's not nine complaints out of 60,000, it's nine
investigations of the 15 or 20 most outspoken. I still contend that almost all
of these investigations were initiated by law enforcement, and almost none by
complaints from patients or family members. I think a review of Miss Jerzak's
audit should be done by somebody independent of the law enforcement part. Some
of the physicians should look at
that.
The question I pose to you is this:
Will medical practice be determined by doctors or
police?
Law enforcement: This brings up the question of
law enforcement's cultural bias. I checked again, and as recently as
yesterday, November 5, 2003, the website of the California Narcotic Officer's
Association at: http://www.cnoa.org/position-papers-1.htm continues to have this
untruth: "There is no justification for using marijuana as a medicine." This lie
is thoroughly contradicted by the federal government's own Institute of Medicine
1999 report.
I DO get the feeling that the committee members
appreciate seeing actual faces of doctors, patients, and caregivers and patient
advocates, to counter the mis-characterizations that have been promulgated about
them.
I will read you two quotes:
Dave Thornton (former chief of
Enforcement of MBC) to MBC Enforcement Committee 5/8/03: "Let me give you an
example, one of the physicians who, and I won't mention any names. The
medical office contained a computer, a printer and a cash register. There
were no other instruments in that office. There was very little the physician
was doing medically in that office to determine whether there had been an
indication for a prescription. You walked in, you paid your money, your name
was put in the computer, and a letter was generated."
Ronald Morton MD
(Secretary Division of Medical Quality of MBC) to CMA 3/22/03: "I disagree
with resolution two because it is not factually accurate. I sit on the MQ
[Medical Quality] panel and I read the cases that come across. Some examples,
rather than persecution, represent people that are offering no examination,
have no equipment -just a receipt book- and are charging $250 for a
recommendation. I don't think that's what we think is good
medicine."
(Dr. Morton said this in response to Dr. Mikuriya's
proposed resolution for the CMA: First resolutions: "1. The initial
examination is face-to-face, in person, confidential, and live. (Periodic
follow-up may be via video, photographic, telephonic, or email means.) 2. The
examination is memorialized with elements of the patient's name, sex,
birth date, address, phone number, date of examination, and coded diagnoses.
3. There is documentation supporting the diagnoses. 4. Compliance with HIPAA
[the Health Insurance Portability and Accountability Act] where
required."
Second resolution proposed: "That CMA urge the Medical
Board of California to cease harassing physicians and comply with the
recent federal injunctive decision protecting physicians who recommend and
approve medical marijuana…")
In denying that there is any systematic
attempt to target physicians who recommend cannabis, both of these statements
which seem to be taken directly from the same briefing paper, incorrectly imply
that the example given is typical, and fail to recognize that 8, if not all 9,
of the investigations discussed were initiated by law enforcement rather than by
patients or their families and caregivers. An honest, thorough, and independent
audit would, I feel, show a pattern of similar targeting.
I know
most of the 15 to 20 California doctors who are most knowledgeable and outspoken
about medical cannabis, who in spite of legal threats, continue to perform
medical cannabis evaluations. I find that they compare favorably in safety and
caring for patients as to California physicians in general. As you know, at
least nine of these 15 to 20 doctors have had investigations begun into their
practice. So I want to put this in context: it's not nine complaints out of
60,000, it's nine investigations of the 15 or 20 most outspoken. I still contend
that almost all of these investigations were initiated by law enforcement, and
almost none by complaints from patients or family members. I think a review of
Miss Jerzak's audit should be done by somebody independent of the law
enforcement part.
I must tell you that I think your legal counsel is
ill-serving you, as should be abundantly clear to you by the misinformation
given to you at the today's Division of Medical Quality meeting. This board
must call for it's own independent audit if it to salvage it's credibility for
its important work.
Sincerely, Frank H. Lucido MD
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Input to the Medical Board
of California by year: |
2004 |
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May 7,
2004 -- Transcript |
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Various question raised to the MBC. Comments on MBC positions. |
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2003 |
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May 8, 2003 |
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Defining standards of care, complaint initiation and
responsibility |
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