Dr Frank Lucido's Blog: PotShots from the Bully Pulpit
or: Everyone’s Entitled to My Opinion
Why Are Credible Practice Standards Important?
Turf issue? Or are credible standards really important?
As I have struggled with the realization in the past 4 years of an influx of low standards clinics trying to cash in on what they see as “easy money” writing recommendations, and advertising their “compassion” and “green-ness” with expensive advertising, I have attempted to articulate what the benefits of good standards are in the age of the “drug war.” Most of the ethical medical cannabis community do support those with good safe standards. Some just roll their eyes and wish I’d be silent, knowing that cannabis is one of the safest substances known.
Others agree with me: friends don't let friends drive drunk, or clothe themselves with a fig leaf when they may need a suit of armor.
My good friend, Michelle Aldrich, who has been active in cannabis law reform since the 60’s sent me an article called the “Four minute Pitch” which outlined 4 questions to ask when making your case.
1. What is my goal?
2. What needs do I meet?
3. How am I different?
4. Why should people care?
Below are the answers for my practice.
I wrote a similar version for possible use in the preamble to the newly formed AACM’s (American Academy of Cannabinoid Medicine) statement on practice standards. It was well received, and we should be announcing the group soon.
Here is the original version for my practice.
I hope this gives you an idea of what the difference is between an appropriate evaluation and a “signature.”
MEDICAL CANNABIS, A Problem with a Solution:
Safe and Appropriate Recommendations for a Safe and Effective Medicine
What is my goal?
My commitment is to encourage the highest and most defensible practice standards, giving the patient not only competent MEDICAL advice, but also competent MEDICAL-LEGAL advice to avoid legal problems and expenses due to overzealous or misguided law enforcement and/or Medical Board.
What needs does my practice meet?
Patients need honest, competent, and credible advice not only on whether their use of medical cannabis is appropriate, but also on how defensible their use is legally in the event that the patient or their doctor is targeted by overzealous law enforcement.
How is my practice different?
I take the time to give patients an honest evaluation of their medical history and medical records, along with my overall impression of how well the combination of their medical records and my own evaluation (including my experience) will serve to defend them should the need arise. I know patients need an honest appraisal of whether their medical records and/or their history are likely to be sufficient documentation to support them in any legal proceeding.
I have been performing medical-cannabis evaluations since the passage of the California Compassionate Use Act (CCUA) in 1996 and I have successfully defended patients in court. More often, I have been able to help patients avoid legal expenses by speaking with law enforcement, attorneys, employee health officers, and even judges by phone or by writing authoritative letters.
Why should patients, caregivers, and patient advocates care?
Even for patients with entirely legitimate reasons for using medical cannabis, there are still elements of law enforcement who haven’t gotten the message, and who will act inappropriately either out of ignorance or less often, intentionally.
Any patient with good documentation of the ongoing care of a serious illness or symptom which they medicate with cannabis should be advised to obtain a recommendation for their use of marijuana from an experienced physician with a reputation for giving the best medical-legal consultation available.
Caveat Emptor: Let the Buyer Beware:
I would strongly advise patients to avoid the quick-in, quick-out, low standard clinics. Particularly for those who grow their own medicine, using a clinic that does not do a credible and thorough evaluation of the patient’s serious illness gives the impression that:
1. You don’t have a serious illness, or
2. You don’t want to be bothered having a good defense.
My standards are designed to give patients protection while some quick-in, quick-out, low standard clinics are giving patients a fig leaf!
Don’t waste good money on a poor pseudo-defense.
Doctors are free to choose lower standards -- but at what cost to the patient’s protection?
Doctors may choose to be the next “canary in the coal mine” but shouldn’t take their patients with them.
Sincerely, in peace and health,
Frank H. Lucido MD
Family Practice since 1979
Medical Cannabis Consultation
2300 Durant Avenue
Berkeley Ca 94704
510.848.0958 (by appointment only)
Dr. Frank Lucido’s blog:
“Pot Shots from the Bully Pulpit”
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Dr Frank Lucido's Blog: PotShots from the Bully Pulpit: Everyone’s Entitled to My Opinion
Medical Cannabis has been legal under state law in California since passage of the California Compassionate Use Act of 1996 ("Prop 215" or California Health & Safety Code 11362.5) under a certain conditions.
Unfortunately, it is still illegal even for legitimate patients, under Federal law (Gonzales v Raich Supreme Court case).
Physicians making appropriate recommendations, are also protected under State law, when acting appropriately.
Furthermore, physicians are also protected Federally by Conant v McCaffrey (Federal District Court) and Conant v Walters (Federal Appellate Court) as long as they do not aid and abet a patient in breaking Federal Law. On further appeal by the Federal government, the Supreme Court declined to take the case. Therefore, physicians are the ONLY ones protected all the way to the Supreme Court, as long as they do not "aid and abet" a patient in breaking Federal law.
The purpose of this blog is to discuss for patients, physicians, caregivers and other patients advocates, who, in my experience, is most protected, and under what circumstances, and to discuss to what extent the inability of the State of California to regulate cannabis (due to Federal threats and interference) has led to the "wild west" atmosphere that the newspapers love to write about (you know: "Man bites dog" will always sell more papers than "Dog bites man".)
This is my effort to "clean up Dodge". I know I am not alone in this. There are good physicians, good caregivers, and lots of sick patients. I aim to let people know how to spot the good, and avoid the others.