Note to the SCC March 18
A spectre is haunting California physicians who in recent years have been practicing Cannabis-based Medicine: the likelihood of “legalization” in 2016. The economic viability of their specialty depends on how the new law is worded.
If legalization involves a very steep tax on cannabis sold for recreational use, many people will continue visiting MDs to confirm that their use is medical.
But what if the tax is not steep enough to induce such visits? How many people using cannabis to treat such common conditions as pain, depression and anxiety will feel the need to seek annual approvals?
This question was put to SCC members yesterday. The first responses follow (and serve as a reminder that for some SCC members, Cannabis-based Medicine is not their specialty). Confidentially guaranteed if requested.
• From Jeffrey Hergenrather, MD (verbally and off-the-top): Fifty to 90 percent.
• From Sue Sisley, MD: What’s interesting is that virtually none of my patients consult with me on this topic. They all know that they are more knowledgeable than the doctors. So post prohibition world would not change my medical practice at all.I do internal medicine and psychiatry so I’m treating primary care for him seriously mentally ill patients. They don’t come to meet to discuss marijuana. It’s often part of a side conversation where they are simply disclosing to me that they are using it, more like an FYI. Generally I’m the one who takes advantage of this to extract more information from the patient about how they’re using & what impact it has on the patient-in what form- is lab tested and if so what strain/cannabinoid profile works best for them for their particular illness etc.
• From Nancy Sajben, MD: I specialize in intractable pain, not in MMJ. Doubt any of my patients would ever use Mj for recreational use, even if they did not have pain.
• From A Ten-year Veteran: (referring to Dr. Malka’s put-down of 420MD):
65 dollars sounds awfully expensive for Los Angeles. LA Weekly has doctors advertising 25 and 30 dollars. Sometimes they’re only issuing letters for 3 or 6 months (which I believe to be illegal) though. Anyone doing the math knows they had to be churning out patients like a factory.
I still charge the same rate from a decade ago, 100 dollars. I used to charge 150 for new patients as the visit took much longer, taking as complete a medical history as I could get (some of the patients are incredibly stupid, not finding out they had major surgeries because when I asked “ever have surgery” they thought it meant “recent”) and taking five or ten minutes to explain indica/sativa, edibles, answer any questions. lowered it to 100 because we were losing too many first time callers.
discounts for seniors, veterans, referrals. several long time patients asked for a break because they’re unemployed and we just give it to them for free and thank them for their loyalty.
dwindling, barely paying my bills (which are not extravagant) some months. it’s been a good run, a fun decade. maybe eliminating some of the jack in the box doctors will help, but I suspect something will arise to take their place.
I’ve been ranting about this for almost a decade. when Sona Patel started flashing her cleavage all over LA (first time i’d seen a professional doctor, lawyer, architect, or whatever stoop to such a low level) I knew the game wouldn’t last forever.
kudos to Malka.
• PS from TYV I heard doctors in Colorado doubled their practices when they went legal, because the price structure of “medical” versus “legal” pays for itself in no time for all but the lightest of users.
indeed it’s amazing that my patients have been so loyal over the years. you’d have to have your head buried in the sand not to know about the 25 dollar jack in the boxes. they advertise in all the ganja magazines, at the trade shows, and in the dispensaries themselves. it’s because I spent so much time with them in the initial encounter, have helped scores get off their psych meds (with a boost from you and your wonderful writings ala Prozac) and other unnecessary meds, even diagnosed new onset CHF in 2 patients and sent them right to the ER via ambulance (both saying it helped their breathing, a cursory glance showed obvious pitting edema of the LEs).
it was only a matter of time until the ugliness of tinseltown spread its way north. at least the city didn’t turn the dispensaries into a travesty. although we have far too many, and maybe you have far too few.
By Ivan Artukovic
