Primary Doctor Won't Sign My Medical Marijuana Recommendation

[Baron23]

To the OP or a couple of posts down the thread my response to 'coming out' to your dr's would be not to, or hold off, or wait till it is more main stream and find a natural specialist so to speak.

I'm sorry but I just don't see it like that. If I find I can't trust my Dr to discuss anything health related then I will find a new Dr.

Now, the VA ain't a Dr. Its a Federal Govt institution...the same Fed Govt that ludicrously has cannabis on Schedule 1. I'm a Vietnam era vet myself but the last people I would ever talk to about cannabis is the VA because I would, in effect, be talking to the Fed Govt and I already know what is their position on med MJ.

I had a long talk with my primary a week ago. She thinks my using med MJ is a wonderful answer to my problems and is fully supportive BUT she knows nothing about cannabis, the Maryland Medical Cannabis Commission has done a totally shit job of out reach and education of physicians in my state, and her physician associations have advised her that the issue of medical license liability is not 100% completely cleared up...or at least its not iron clad that there will never be any ramifications to her license from participating in Maryland's program. I don't resent her at all about declining to participate.

So, I found a Dr for whom med MJ is more of a mission in life. Matter of fact, she came out of retirement to open her clinic. I think she feels rather free of professional worry in that position.

Just my view.

 

[newVaper420]

My doctor wouldn't recommend it for me in NYS either. I stopped going to him. I still don't know what to do. That was 4 months ago.

 

[CarolKing]

What you might find in the new medical cannabis states there maybe clinic that spring up to fit the need of the medical cannabis patient.

Early on a lot of people found that the doctors didnt know a lot about medical cannabis. Many in my state didn't even want to broaden their education regarding it. Often they are worried about their medical lisence. Since the Feds have made it difficult for the states, alternative clinics sprung up in WA, CO, OR and CA and elsewhere when medical cannabis became legal. Many were and are run by Naturopaths, RNs and physicians assistants. You pay a fee and bring in your medical documentation.

I personally went to a clinic that provided me with a medical certification. My HMO didn't agree with medical cannabis unless you had cancer and on chemo. I think they are softening a bit with more knowledge. My doctor doesn't know enough about it. He's been my doctor for 20 years. I told him I was using cannabis oil on my arthritis the last time I was in. Not sure what the clinic will do that I go to? They may not be open in 6 months.

The laws have changed where we are (WA state) We are suppose to use our primary care physicians to get a cannabis medical certificate. I will see next time I need to renew my medical card.

I may need to have a heart to heart talk with my doctor. Recreational cannabis is legal here.

 

[Baron23]

Early on a lot of people found that the doctors didnt know a lot about medical cannabis. Many in my state didn't even want to broaden their education regarding it. Often they are worried about their medical lisence. Since the Feds have made it difficult for the states, alternative clinics sprung up in WA, CO, OR and CA and elsewhere when medical cannabis became legal. Many were and are run by Naturopaths, RNs and physicians assistants. You pay a fee and bring in your medical documentation.

Hi Carol - that's exactly what I found and exactly what I did except that this 'clinic' is a one Dr show and she is a physician. In Maryland, latest change to the law allows Med MJ certs to be issued by midwives, podiatrists, dentists, Nurse Practitioners, as well as MD Physicians. Might be a few more types on the list.

I have wondered what reaction I would get if I was certified by a mid-wife? hahaha

 

[OldOyler]

Peace all!

Well, my two cents now that we have a nice bit of input on the thread here.

And I'll only address Maryland where I live.

I think I am seeing two distinct questions that our original thread statement gets broken into now:

1. How do I get medical cannabis certification in Maryland?
2. How can I get that certification from my Primary Care doctor in particular?

I don't think the two will co-exist most of the time.

Follow @Baron23 's route and work to find out what doctors are already registered, then hope to find a nearby doctor. Maybe, just MAYBE, yours will make it on to the list. Probably not. And then there are insurance issues of course.

But the core problem will continue to exist in Maryland for many years - a filthy rich "respectable" Medical Mafia already exists here. We have both Howard and Montgomery counties here. And the record is, quite plainly, the record here in Maryland.

The "Compassionate Care Act" was signed in 2004, would take 10 years to go into effect so that cannabis could be taught in teaching hospitals - med school plus the length of residency. Dispensaries, prescribers, etc. would all then go online Jan 2014. (Please note today's date...)

Johns Hopkins and Univ of MD both refused outright. They based it on the never-ending cyclical b.s. used to cover up "We're haters and just don't want to do it" - that their Schools of Pharmacology already HAD cannabis, and it was listed as a Schedule I drug, so anyone certifying it could (not would) immediately lose their license. The respective Schools of Pharmacology in particular could lose research grants, federal funding, etc.

Then, Sheppard Pratt Mental Health System actually hired LOBBYISTS to keep "Anxiety" off the final list of covered conditions, thereby assuring "...cannabis would therefore not need to be included in clinical practices...". They succeeded.

IMO - it will be compassionate medical professionals and doctors - as that earlier post's list showed, from many specialties - who will step forward as individual practices.

But don't look to existing Primary Care doctors imo, not in large percentages. It will probably end up okayed by *some* pain mgmt here (as an aside, one of my old pain mgmt doctors won't do it, but asked me to contact him next year after the dispensaries are open, and come talk to him about how I am doing on cannabis then - since there is no risk to him he is interested in talking about it then!).

So what to do? My suggestion at this point is to *separate the issue of certifying doctor and primary care doctor*, perhaps seeing a specialty clinic when it opens as just that - a specialty clinic. (Of course, all of this is predicated on your health insurance situation - I have traditional Medicare *specifically* so that I do not need a referral to anything - physical therapy, etc. unless a doctor's prescription is required. Of course this is of the 20% of specialists who take traditional Medicare here in Maryland when I am lucky, of course). Heck, look at it like acupuncture or something many insurance companies don't cover anyway that you might never mention to your Primary Care doctor unless it became relevant. (Just trying to make the door to peace nice and wide here...)

I think it will take a few years for "regular" doctors to stop being afraid in Maryland, and until then we will have to make due.

Personally, I *may* choose to remain as I am until middle of next year - uncertified, glad only for the decriminalization. If I need to obtain, I pay $300/oz for dispensary-grade, $335 for tops only. Those are right around the projected prices here.

But my hope *will* always be to have an understanding "traditional" Primary Care doctor - one who realizes that pot-smoking Michael Phelps and his trillion gold medals kinda' makes cannabis hating from a medical perspective null and void...



Peace everyone!

 

[Lemmings]

But don't look to existing Primary Care doctors imo, not in large percentages. It will probably end up okayed by *some* pain mgmt here (as an aside, one of my old pain mgmt doctors won't do it, but asked me to contact him next year after the dispensaries are open, and come talk to him about how I am doing on cannabis then - since there is no risk to him he is interested in talking about it then!).
...
I think it will take a few years for "regular" doctors to stop being afraid in Maryland, and until then we will have to make due.

I've had to go to a specialty clinic to receive my mmj card here in MI also. It's pricey to pay for the card but so worth it.

I just renewed for the first time and for anyone else in MI a heads up. even the specialty pain clinic wants 'new' paper work from your regular MD at mmj card rewenal time showing that you 'still have a problem'. So plan on getting the right things on your family dr's visit papers a couple times a year even if like my situation they refuse to treat you for it or recommend mmj.

My doctor wouldn't recommend it for me in NYS either. I stopped going to him. I still don't know what to do. That was 4 months ago.

@newVaper420 Do you have clinics you can go to? I go to a chronic pain management clinic that specializes solely in mmj certs. If I have the supporting documentation, and I can verbalize it with the interviewing staff, then physician, pay the state extortion charges I have the card.

Then of course the mmj is even more expensive but that's a whole different thread! Good luck mate, let us know what you work out ok?

Peace!

 

[Baron23]

Well done summary, @OldOyler, but I'm not quite as hard bitten and cynical as it sound like you might be...or might be at least today.

Nice break down.

As to #1, how to/where to get a MMJ certification in Maryland:

https://www.marijuanadoctors.com/medical-marijuana-doctors/MD

Keep in mind that the patient registry is not yet open so the deal can't be closed yet. But, I have a letter, I have a Doc, she has my records, and I'm business.

As to how can I get that certification from my Primary Care doctor, I'm with you on this. I believe that general practice primary physicians will avoid participation in state MMJ programs until legalized at the Federal level thus eliminating ALL possibility of liability.

Now, I do share you contempt for the way that Maryland's miserable excuse for state Government has handled this. Yes, the first go was doomed to failure. I don't blame Hopkins or U of M system, given the structure and given their Federal grants and interstate commerce...well, if I was them I would have told the state to pound sand also.

My BIG gripe at the present is the complete lack of visibility, transparency, and accountability into how the MMCC is standing up this program. In particular, their website is laughably out of date and they don't have a schedule and NEVER HAVE HAD A SCHEDULE!!

They can never be criticized for taking longer than a geological era to get this program up and running because they never projected dates for ANY milestones and STILL have not.

Fuck my being an MMJ patient...I'm pissed at this as a fucking tax payer in this socialist state.

Ok, time to go off to my happy place and calm down.

Cheers

 

[MyCollie]

Baron,

I'm glad your approval came through. If you are able to purchase in the District at any point I would recommend TWC. It's family owned and operated and it's not very far from MD.

 

[Baron23]

Baron,

I'm glad your approval came through. If you are able to purchase in the District at any point I would recommend TWC. It's family owned and operated and it's not very far from MD.

HI and thanks...yes, I know where the Takoma Wellness Center is and I have looked their menu over a bit. Not sure of time frame for Congressional action on DC legislation re: residency requirements but we will have to wait and see.

Thanks

 

[His_Highness]

Wanted to post the experience I had this week when I questioned a neurologist about medical marijuana and this looked like a good place to do it...

I was at the hospital visiting a loved one who had issues with debilitating, constant migraines. While trying to figure out why the migraines escalated so suddenly a test showed an aneurysm on the outside of the brain area that wasn't likely to be the cause. Brain surgery to clip the aneurysm was performed not because it was expected to help but because my loved one couldn't stand the idea of knowing it was there. The resulting pain was immense because it was now a combination of pain from the brain surgery AND the migraines themselves.

There was a team of neuro-centric doctors working the case as well as some very well educated neuro-nurses and nurse practitioners who were supporting the patient throughout.

During one neurologist's rounds I asked him to close the door of the patient's room so we could talk plainly. I explained that the patient has had some success with marijuana relieving the migraines but it wasn't consistent in that it only worked 50% of the time. I explained that when it worked it was like a miracle in how it either stopped the migraine cold or reduced the pain and how at other times it had no affect at all. I even went so far as to describe lower temp vaping to remove some of the THC and saving off the remainder for high temp, CBD based vaping so the patient could vape without getting too high but still get the benefit of the light buzz and CBDs. I wasn't sure what the response would be but was happy and amazed at what resulted.

The neurologist was VERY open to medical marijuana along with other less mainstream approaches. He told me he thought marijuana was something that should be made more mainstream for pain, nausea and appetite enhancement and went on to describe other variations for CBD availability such as organic oregano, cinnamon and something about carnations flowers I need to look into. He described how pain management was often the opposite because it caused addiction and in many cases rebound pain that was hard to treat and often more intense. He felt medical MJ in these cases was sorely underused. He also said he'd be happy to prescribe medical marijuana but is required to exhaust all other avenues available before he can write a recommendation and/or script. He also recommended a primary neurologist for outpatient care that was more open to alternative approaches as well.

Here's where it gets even more interesting....as the week wore on several other doctors and nurses who had read the charts and doctor's notes began unprompted discussions with us about medical marijuana and every one of them felt it was a underused approach. The initial doctor had entered into his notes that he felt medical MJ should be considered if the patient didn't show signs of improvement which is what prompted the others to feel open about the topic. The initial doctor did this to pave the way when we start working with the outpatient neurologist. In the case of my loved one who was experiencing the migraine pain along with migraine induced nausea it was a perfect fit.

I was surprised at how many of the healthcare professionals were all for it once I opened up the discussion. I was also saddened by the thought that they might not have been so forthcoming if I hadn't been. I also don't know how many of the healthcare professionals who didn't bring it up were against it.

 

[lwien]

^^^ The times, they are a-changing....

 

[Baron23]

Wanted to post the experience I had this week when I questioned a neurologist about medical marijuana and this looked like a good place to do it...

I was at the hospital visiting a loved one who had issues with debilitating, constant migraines. While trying to figure out why the migraines escalated so suddenly a test showed an aneurysm on the outside of the brain area that wasn't likely to be the cause. Brain surgery to clip the aneurysm was performed not because it was expected to help but because my loved one couldn't stand the idea of knowing it was there. The resulting pain was immense because it was now a combination of pain from the brain surgery AND the migraines themselves.

There was a team of neuro-centric doctors working the case as well as some very well educated neuro-nurses and nurse practitioners who were supporting the patient throughout.

During one neurologist's rounds I asked him to close the door of the patient's room so we could talk plainly. I explained that the patient has had some success with marijuana relieving the migraines but it wasn't consistent in that it only worked 50% of the time. I explained that when it worked it was like a miracle in how it either stopped the migraine cold or reduced the pain and how at other times it had no affect at all. I even went so far as to describe lower temp vaping to remove some of the THC and saving off the remainder for high temp, CBD based vaping so the patient could vape without getting too high but still get the benefit of the light buzz and CBDs. I wasn't sure what the response would be but was happy and amazed at what resulted.

The neurologist was VERY open to medical marijuana along with other less mainstream approaches. He told me he thought marijuana was something that should be made more mainstream for pain, nausea and appetite enhancement and went on to describe other variations for CBD availability such as organic oregano, cinnamon and something about carnations flowers I need to look into. He described how pain management was often the opposite because it caused addiction and in many cases rebound pain that was hard to treat and often more intense. He felt medical MJ in these cases was sorely underused. He also said he'd be happy to prescribe medical marijuana but is required to exhaust all other avenues available before he can write a recommendation and/or script. He also recommended a primary neurologist for outpatient care that was more open to alternative approaches as well.

Here's where it gets even more interesting....as the week wore on several other doctors and nurses who had read the charts and doctor's notes began unprompted discussions with us about medical marijuana and every one of them felt it was a underused approach. The initial doctor had entered into his notes that he felt medical MJ should be considered if the patient didn't show signs of improvement which is what prompted the others to feel open about the topic. The initial doctor did this to pave the way when we start working with the outpatient neurologist. In the case of my loved one who was experiencing the migraine pain along with migraine induced nausea it was a perfect fit.

I was surprised at how many of the healthcare professionals were all for it once I opened up the discussion. I was also saddened by the thought that they might not have been so forthcoming if I hadn't been. I also don't know how many of the healthcare professionals who didn't bring it up were against it.

Thank you for this post.

May I ask what state of the union this was in?

 

[His_Highness]

Thank you for this post.

May I ask what state of the union this was in?

Florida

 

[gemgirl]

Wow I had no idea each state was so different. Here in California there is a medical mj doctor on every corner like starbucks, okay might be exaggerating a bit. But you just walk into one, they have you sign a bunch of paper work. Send you back to the doctor, who you can tell you have any number of things, he signs a paper you pay 40 bucks, boom medical card. Easiest thing I have ever done. I can't imagine having to ask my primary for permission. I am so sorry.

 

[TeeJay1952]

On Saturdays my Doctor has a "No Paper Saturday" $50 extra but satisfaction guaranteed.

 

[Baron23]

"No Paper Saturday"

What is the "No Paper Saturday"???

And what state if you are comfortable sharing that?

 

[TeeJay1952]

Most Doctors at these places want recommendation from Personal Physician. On Saturday this Doc will listen to you and proscribe sans other Doctor. I have been to weed expos where there are booths onsite to proscribe.
Michigan. (G0 Blue)

 

[Baron23]

Most Doctors at these places want recommendation from Personal Physician. On Saturday this Doc will listen to you and proscribe sans other Doctor. I have been to weed expos where there are booths onsite to proscribe.
Michigan. (G0 Blue)

Ah, here in Maryland, while my primary knows nothing about MJ and won't participate, I also have a Dr who will and its a one shot deal. If she thinks you qualify, that's all that's needed.

 

[newVaper420]

I have a similar situation here in NY. None of my doctors want to prescribe me marijuana or even can (you have to be licensed here and they won't go for the course).

However I do have specifically a cannabis doctor, who is completely interested in my use of cannabis as it relates to my pain and Crohns. Also interested in the positive effects it has on me for my work, etc. he's awesome. Except it's $150 for the first visit year and $100 the next 6 months. So $250 a year for this guy. But he fills out my Maine certification as well and is completely awesome.

So I'm down.

 

[C No Ego]

School those doctors YAW.... they need to know and cannot prescribe something they do not know of...

http://www.greenstate.com/explainers/a9255813/americas-best-marijuana-medical-schools

why they need to know..................
https://unitedpatientsgroup.com/blo...anding-the-dangers-of-drug-drug-interactions/

 

[grokit]

Most Doctors at these places want recommendation from Personal Physician.

Right, you need a recommendation to get a recommendation, and it's still not exactly a 'prescription'

My old pp/gp wrote me a recommendation, no problem. But then he left the state, and my new (old) doctor wants me to have a recommendation, but wants to outsource the writing of it to a $300/year 'specialist'.

Of course the specialist gives a referral fee, or 'kickback' to the personal physician that's recommending the recommendation. Because this is so f*cking ridiculous I've decided to continue with my medical use, but without a physician's recommendation since we're a recreational state anyways (so f*uck it).

 

[psychonaut]

I'm totally fine keeping the cannabis doctor separate from a general practitioner doctor---at this time. Mostly because the general practitioners don't know what they are doing cannabis wise. The advocacy groups can help with finding the right doctors as many of them are advocates. Never give up, if this is medicine for you, seek any path you can to attain it.

That $250 in NY sounds high out here, but I know the cost of living difference account for that. I am paying around $100, and only an annual visit needed. It's still $100, and that's at least an ounce of flower meds wasted, but if I were to go to a primary doctor, how much would that visit cost? Probably about the same I guess

One issue is that you can find a lot of retail cannabis cheaper but it's debatable if it's better or not. I do find more pain assisting strains on the medical side. More cultivars that are grown from seed and less from clone. There's also the issue of producers only being medical vs only being retail vs both.