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]


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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