On Oct. 9, 2015, Governor Jerry Brown signed into law California’s Medical Marijuana Regulation and Safety Act (MMRSA). The political insiders call it “mersa.” No physicians were involved in the drafting process, obviously, or they wouldn’t be calling it by the name of a deadly pathogen (MRSA, Methicillin-Resistant Staphylococcus aureus, for which some compounds in Cannabis might provide a treatment). It’s almost like the truth sung by Mose Allison.

Mersa consists of three separate bills, each addressing —according to Rob Bonta, the Assemblyman who steered them through the legislature— a problem supposedly stemming from the passage of Proposition 215.  The language directly affecting doctors who approve cannabis use by patients is found in Senate Bill 643, which was introduced by Mike McGuire, a Democrat who represents North Coast counties. Here’s the money shot.  —FG

SEC. 2. Section 2220.05 of the Business and Professions Code is amended to read:

2220.05. (a) In order to ensure that its resources are maximized for the protection of the public, the Medical Board of California shall prioritize its investigative and prosecutorial resources to ensure that physicians and surgeons representing the greatest threat of harm are identified and disciplined expeditiously. Cases involving any of the following allegations shall be handled on a priority basis, as follows, with the highest priority being given to cases in the first paragraph:

(1) Gross negligence, incompetence, or repeated negligent acts that involve death or serious bodily injury to one or more patients, such that the physician and surgeon represents a danger to the public.

(2) Drug or alcohol abuse by a physician and surgeon involving death or serious bodily injury to a patient.

(3) Repeated acts of clearly excessive prescribing, furnishing, or administering of controlled substances, or repeated acts of prescribing, dispensing, or furnishing of controlled substances without a good faith prior examination of the patient and medical reason therefor. However, in no event shall a physician and surgeon prescribing, furnishing, or administering controlled substances for intractable pain consistent with lawful prescribing, including, but not limited to, Sections 725, 2241.5, and 2241.6 of this code and Sections 11159.2 and 124961 of the Health and Safety Code, be prosecuted for excessive prescribing and prompt review of the applicability of these provisions shall be made in any complaint that may implicate these provisions.

(4) Repeated acts of clearly excessive recommending of cannabis to patients for medical purposes, or repeated acts of recommending cannabis to patients for medical purposes without a good faith prior examination of the patient and a medical reason for the recommendation.

“Excessive recommending” probably refers to how many plants doctors are authorizing patients to grow, not how many patients are seen in a day. Doctors who issue approvals at events like the Hemp Expo will probably draw the heat.  Doctors who frequently recommend juicing —which requires a constant supply of plant material— may find themselves explaining the benefits of cannabinoid acids and terpenes to an administrative law judge.

(5) Sexual misconduct with one or more patients during a course of treatment or an examination.

They’ve made “excessive recommending of cannabis” a higher-priority offense than sexual misconduct with a patient —which says something about the ethical standards of the California Legislature. It can’t be an oversight —establishing “investigative priorities” is the very purpose of their directive to the med board.

(6) Practicing medicine while under the influence of drugs or alcohol.

There should have been an explicit exception protecting doctors under the influence of legally prescribed or recommended drugs.

(b) The board may by regulation prioritize cases involving an allegation of conduct that is not described in subdivision (a). Those cases prioritized by regulation shall not be assigned a priority equal to or higher than the priorities established in subdivision (a).

(c) The Medical Board of California shall indicate in its annual report mandated by Section 2312 the number of temporary restraining orders, interim suspension orders, and disciplinary actions that are taken in each priority category specified in subdivisions (a) and (b).

The Enforcement Division will hear this as: “Sic ’em!” If you think their investigators can distinguish between the quick-buck artist and the serious specialist —both of whom approve cannabis use by large numbers of patients— you are an optimist.