Dr. Lucido’s Physician Survey on Medical Cannabis Practice Standards

Two Purposes:

FOR PATIENTS: It is useful to highlight the wide variety of medical cannabis practice standards of the many medical cannabis physicians now in practice, so that patients can choose their consultant wisely.

FOR PHYSICIANS: It is also hoped that some physicians will choose to improve their practices to give the patients better care improved medico-legal protection.

According to California NORML, over 1500 physicians in California have written at least one recommendation for medical cannabis.

As in most medical specialties, the majority of medical cannabis consultants have excellent knowledge and experience, appropriate ethical practice standards and offer good medical-legal protection;

Unfortunately, some offer a minimalist cursory, quick-in, quick-out, "fig-leaf" patient encounter, and are likely be a liability, should they need to be contacted by law enforcement.

As I have pointed out before, cannabis is so safe and effective that even a physician with the lowest standards I have heard of has never harmed a patient, and probably never will.)

Despite this, due to the irrational drug war we will still have inappropriate actions by law enforcement. Because of this, patients, caregivers and physicians must be particularly careful and thoughtful towards patient
medico-legal protection.

FINDINGS OF INITIAL SURVEY (first conducted in Fall, 2005. 2007 update in progress. Individual physician responses are confidential.)

GENERAL: I found a very wide range of services, fees, and other qualities (ethics, credibility, and time and effort taken by the medical consultant to establish medical-legal protection.

TIME spent with patient ranged from the 3-15 minutes "fig-leaf", assembly line, minimalist standards, to those who schedule 45 minutes for a first appointment, and 30 minutes for yearly follow-up.

FEES ranged from $100-250. Ironically, the worst and most embarrassing minimalist work
was done by those who charged $100, AND by those who charged $250! So cost didn't seem to be the best test of protection. (I would describe this as a $50 value for only $100-250.)

DOCUMENTATION of diagnosis: Requirements ranged from none, to yearly follow-up by the patient’s own doctor to establish a defensible, credible medical record, should the patient be challenged by inappropriate or overzelous law enforcement. Remember, not only is this consultation about physical health, but also about medico-legal health; that is, legal documentation that shows that the patient has a legitimate serious illness should he or she be challenged by law enforcement.

BUSINESS ETHICS:

For good or ill, physicians are the only ones involved in the medical cannabis movement to have federal protection, by virtue of the Conant v. Walters decision as long as they do not “aid and abet the patient in obtaining cannabis”.

http://www.medboardwatch.com/wb/pages/medical-cannabis-law-judgments-
legal-issues-etc.php

It should be obvious that physicians must keep an appropriate professional disengagement from cannabis dispensaries. This would be true even with a conventional pharmacy, but is even more important with medical cannabis dispensaries.

The worst abuses of this necessary distance involve doctors working directly out of dispensaries: a classic inappropriate relationship with a pharmacy that loses for physicians and their employees, the full protection of the Conant decision. Next in order of the worst abuses are the doctors who state that they no longer are associated with dispensaries, but still cross-refer patients.

PRACTICE STANDARDS REFLECT ON CREDIBILITY

I encourage patients to consult with reputable doctors with credible standards, and to avoid the rash of low standards "clinics" that have opened up next to many dispensaries.

I encourage physicians to maintain defensible standards in order to best protect patients, both medically, and medico-legally, and to best protect themselves from un-necessary scrutiny from the Medical Board. I do believe that any physician who follows my protocol “Implementation of the Compassionate Use Act in a Family Medical
Practice” will be better able to defend their patients to law enforcement, and themselves to the Medical Board.

http://www.medboardwatch.com/implementation-of-7-year-plan.htm


EMAIL ME for further information at:
[email protected] for any further questions about standards.

I am also soliciting patient reports of any adverse experiences with their
medical cannabis consultant, or with law enforcement.