A report to the Society of Cannabis Clinicians by Joe D. Goldrich, MD, August 6 2015.
The California Medical Board met at the San Francisco airport Marriott Hotel, July 30 and 31. Here’s the agenda.
Agenda item 5 included presentations on Physician Health Programs. Physician Health Programs are programs designed to address health issues that affect physician performance and impairment, e. g. alcoholism, drug abuse and psychiatric illnesses. The director of the Colorado program stated that if a physician had a medical marijuana card, it was evidence of impairment and that they should not be practicing medicine as long as they had a medical marijuana card. It was further stated that the use of recreational marijuana was a manifestation of unprofessional conduct and as such, might result in disciplinary action by the Medical Board.
Agenda item 6 involved discussions of all of the current legislation in progress that relates to medical board issues. Among these thirty two bills, the only active bills dealing with medical marijuana are AB 266 and SB 643. There was very little discussion of these bills in the report of Jennifer Simoes, Chief of Legislation for the Medical Board. After the meeting on Thursday afternoon adjourned, I approached Ms. Simoes and asked her to please bring me up-to-date on the status of AB 266 and SB 643.
AB 266 contains provisions found in previous bills (AB 26 and AB 34) now merged into AB 266. This bill states that physicians recommending cannabis to a patient for a medical purpose without an appropriate prior examination and a medical indication, constitutes unprofessional conduct.
The bill would also prohibit a physician from recommending cannabis to a patient unless that person is the patient’s attending physician, as defined by subdivision (a) of section 11362.7 of the Health & Safety Code (HSC). The HSC defines an “attending physician” as an individual who possesses a license in good standing to practice medicine or osteopathy the state of California and who has taken responsibility for an aspect of the medical care, treatment, diagnosis, counseling, or referral of the patient. The physician also must have conducted a medical examination of the patient before recording in the patient’s medical record the physician’s assessment of whether the patient has a serious medical condition and whether the medical use of marijuana is appropriate.
The bill would also require that the Medical Board consult with the California Marijuana Research Program, known as the Center for Medical Cannabis Research (CMCR), located at UCSD, in developing and adopting medical guidelines for the appropriate administration and use of cannabis. This provision might result in changes in the Board’s current statement on recommending marijuana.
This bill would give the Board enforcement tools to more efficiently regulate physicians who recommend marijuana for medical purpose. The bill would also make marijuana recommendation cases a priority of the Board. This bill would also prohibit physicians from being employed by cannabis clinics or dispensaries which will help to ensure that physicians are not making marijuana recommendations for financial or employment reasons.
SB 643 would establish a comprehensive licensing and regulatory framework for the cultivation, manufacturer, transportation, storage, distribution, and sale of medical marijuana to be administered by the Office of Medical Marijuana Regulation within the Business, Consumer Services, and Housing Agency.
Many of the key issues (attending physician, responsibility for an aspect of the medical care, medical examination) in SB 266 are also found in SB 643. This bill would subject physicians recommending marijuana to the definition of “financial interest” in the Business and Professions Code section 650.01. It would not allow a physician to accept, solicit, or offer any form of remuneration from or to a licensed dispenser, producer or possessor of cannabis products in which the licensee or his or her immediate family and financial interest. The bill would also place anti-kickback and advertising restrictions on physicians who recommend marijuana.
The bill would provide that specified acts of recommending marijuana for medical purposes without a good faith examination are among the types of cases that would be given priority for investigation and prosecution by the Medical Board. The bill would further prohibit a physician and surgeon from recommending medical marijuana to a patient unless that person is the patient’s attending physician, as defined. Because a violation of that provision would be a crime, the bill would impose a state-mandated local program.
Agenda item 17 was a presentation and update from the Federation of State Medical Boards by Jacqueline A. Watson, D.O. and Mike Dugan. The inserted slide below mentions medical marijuana.
I attempted to ask the presenter to provide more details, but was told that only comments (not questions) were allowed by the audience.
Respectfully submitted by Joe D. Goldstrich, M.D. August 6, 2015