People vs McQueen; your thoughts?

[Cory and trevor]

Here is a scenario that may be looked at I just thought of. If it's only 10 dollars to change caregiver and patient status, I think I could easily sell single weeks of the month to 5 patients a week and up the charge for "transfer" 20$. 10 for signing up, making copies and doing a "transfer" then another 10 for dropping them a day or 2 later freeing me up for next week's new patients. I haven't read anything about this idea anywhere and now that I had it I can't stop thiinking about LOL. expensive, but bulletproff? foolish and easily shot up in court?

 

[Dr. Bob]

I thought about that a year or more ago, the problem is that while there is no specific waiting period for a caregiver change form, most attorney's I have discussed it with it feel that since waiting periods are outlined in the act, and the department needs time to complete their work (caregiver qualifications need to be explored for example). As a result, the courts will probably say the change requires a 20 day waiting period, and MAY say since there is no waiting period specified the department can take their sweet time and it goes into effect when you get the new caregiver card.

They shot my notion that it took effect upon receipt by the department all to hell. I was thinking along the lines you are discussing now.

Dr. Bob

 

[McMedical]

I don't know buddy. In the arguments McQueen's lawyer did a decent job of defining transfer ranging from a transfer that involves monetary gain to a transfer that doesn't.

She also did a good job of describing a caregivers responsibility to aid five patients in their "medical use". She interprets this as aiding their patients in all areas covered under the acts legal definition of "medical use".

She also argues very well what a caregiver legally is. How the language of the law does describe not being able to aid more than five patients in their medical use, but how this can be interpreted as not being able to engage in all areas of medical use for more than five patients.

Regardless if you completely ignore the caregiver model, there is no legal reason from what I can see how a patient who grows their own medicine cant transfer medicine legally.

 

[Dr. Bob]

I think the best definition of 'assisting' I can come up with is making it easier for someone to do something they could otherwise do on their own. Example would be helping a lady with her coat or helping your buddy climb into the back of the truck. Neither example involves compensation or adding something to the mix, like a product.

Either way, good discussion, good points and we shall see how they rule.

Dr. Bob

 

[McMedical]

I think the best definition of 'assisting' I can come up with is making it easier for someone to do something they could otherwise do on their own. Example would be helping a lady with her coat or helping your buddy climb into the back of the truck. Neither example involves compensation or adding something to the mix, like a product.

Either way, good discussion, good points and we shall see how they rule.

Dr. Bob

For sure Dr.Bob!

Whats great about these cases is that they are so unpredictable, and leave you in an ocean of suspense.

 

[TheMan13]

What do you mean by "start point"?

MMMP simply authorized medical use and cultivation of marijuana within Michigan without specifying exactly where these meds and genetics would come from, but they still came?!?

 

[McMedical]

MMMP simply authorized medical use and cultivation of marijuana within Michigan without specifying exactly where these meds and genetics would come from, but they still came?!?

Now I get you. Yeah I imagine its beyond frustrating for you guys. No matter what outcome is delivered. I think it would be best for the Michigan medical marijuana community to organize and lobby for the changes that are collectively wanted.

 

[TheMan13]

Sad but true, change is often like justice. Only those whom can afford it will receive it

 

[McMedical]

Sad but true, change is often like justice. Only those whom can afford it will receive it

Yes sir! IMO the best way to begin organizing such an organization is at the clinical level. If Doctors were willing to provide information about the organization during the exam process it would hopefully lead to new patients getting involved on a widespread basis, while dispensaries/caregivers could help organize the existing patients.

It would pretty much be the NRA for Michigan's medical marijuana patients.

 

[TheMan13]

My primary doc won't touch MJ with a ten foot pole, they are a go along get along group 4sho. He simply agreed with the alternative med and recommended that I go to a "mill" for the MJ script. I have known and worked with this man in emergency medicine for a decade prior to him becoming my primary doc. Furthermore, his brother is a well known and regarded MJ attorney here in Michigan. I just don't see the medical establishment changing or even a way in which it could

 

[Dr. Bob]

We do. I'm a big believer in the compassion club model (education, political power, local action, caregiver referral, etc --- not meds) and keep a list of active ones on my site. In my annual 'call to action' I outline what I see as important points for patients to help with the over all political action for the year. Past ideas have included recruiting 3-5 new patients over the course of a year each to build our numbers, reducing the use of narcotics and telling their docs WHY they no longer need them to show the results of using cannabis, and other ideas.

Many of us are also members of political action groups/lobbying on the state level, and as the changes from legislative concept to the final results of the 4 house bills show, these efforts are effective.

Dr. Bob

 

[McMedical]

I think the best definition of 'assisting' I can come up with is making it easier for someone to do something they could otherwise do on their own. Example would be helping a lady with her coat or helping your buddy climb into the back of the truck. Neither example involves compensation or adding something to the mix, like a product.

Either way, good discussion, good points and we shall see how they rule.

Dr. Bob

This is the language from New Yorks proposed medical marijuana act on transfers:

"IT SHALL BE LAWFUL UNDER THIS ARTICLE TO GIVE OR DISPOSE OF MARI-
28 HUANA, OBTAINED UNDER THIS TITLE, FOR CERTIFIED MEDICAL USE, BETWEEN
29 CERTIFIED PATIENTS AND OTHER CERTIFIED PATIENTS, AND BETWEEN A DESIG-
30 NATED CAREGIVER AND THE DESIGNATED CAREGIVER'S CERTIFIED PATIENT WHERE
31 NOTHING OF VALUE IS TRANSFERRED IN RETURN, OR TO OFFER TO DO THE SAME.
32 THIS PROHIBITION ON TRANSFERRING OR OFFERING TO TRANSFER A THING OF
33 VALUE SHALL NOT (A) APPLY TO SALE OF MEDICAL MARIHUANA TO OR BY A REGIS-
34 TERED ORGANIZATION UNDER THIS ARTICLE; NOR (B) PREVENT A DESIGNATED
35 CAREGIVER FROM BEING REIMBURSED FOR REASONABLE COSTS OR ACTIVITIES
36 RELATING TO CARING FOR A CERTIFIED PATIENT, INCLUDING, BUT NOT LIMITED
37 TO, REIMBURSEMENT FOR LEGITIMATE EXPENSES RELATING TO THE MANUFACTURE OF
38 MEDICAL MARIHUANA OR THE PURCHASE OF MEDICAL MARIHUANA FROM A REGISTERED
39 ORGANIZATION UNDER SECTION THIRTY-THREE HUNDRED SIXTY-SIX OF THIS TITLE.
40 S 3363. REGISTRY IDENTIFICATION CARDS AND HARDSHIP REGISTRATIONS. 1.
41 THE DEPARTMENT SHALL ISSUE REGISTRY IDENTIFICATION CARDS AND HARDSHIP
42 REGISTRATIONS FOR CERTIFIED PATIENTS AND DESIGNATED CAREGIVERS. A REGIS-
43 TRY IDENTIFICATION CARD AND HARDSHIP REGISTRATION SHALL EXPIRE AS
44 PROVIDED IN SECTION THIRTY-THREE HUNDRED SIXTY-ONE OF THIS TITLE OR AS
45 OTHERWISE PROVIDED IN THIS SECTION. THE DEPARTMENT SHALL BEGIN ISSUING
46 REGISTRY IDENTIFICATION CARDS AND HARDSHIP REGISTRATIONS NO LATER THAN
47 ONE YEAR AFTER THE EFFECTIVE DATE OF THIS SECTION. THE DEPARTMENT MAY
48 SPECIFY A FORM FOR A REGISTRY OR HARDSHIP APPLICATION, IN WHICH CASE THE
49 DEPARTMENT SHALL PROVIDE THE FORM ON REQUEST, REPRODUCTIONS OF THE FORM
50 MAY BE USED, AND THE FORM SHALL BE AVAILABLE FOR DOWNLOADING FROM THE
51 DEPARTMENT'S WEBSITE"

Now if lawmakers in Michigan passed an act with language this specific there would be a lot less room for interpretation.

 

[TheMan13]

Dr. Bob how is it that we can get the medical establishment to not view docs as yourself as MJ mills? Considering our current setup they essentially are by necessity correct?

 

[Dr. Bob]

My primary doc won't touch MJ with a ten foot pole, they are a go along get along group 4sho. He simply agreed with the alternative med and recommended that I go to a "mill" for the MJ script. I have known and worked with this man for a decade prior to him becoming my primary doc. Furthermore, his brother is a well known and regarded MJ attorney here in Michigan. I just don't see the medical establishment changing or even a way in which it could

I got into medical marijuana because it solved a problem in my practice, the over use of narcotics in patients coming to me and my efforts to wean them down. Don't expect a doc to change his/her practice because you ask them to, they will change when you show them results.

Example.

Two patients both on high dose narcotics for pain. Both get cards without the knowledge of their primary doc.

Patient 1 starts asking for fewer narcotics each visit. They go from 120 vics a month to 20 over 3 months. Doc asks what is different, patient shows card.
Patient 2 gets 120 and month, and 120 a month thereafter. Doc finds thc in urine, ask patient about it. Patient shows card and asks for 120 vics.

Patient 2 reinforces the Doctor's mindset that mmj does nothing, it is just an excuse to get high. It had no effect on pain med needs as doctor expected. Patient 2 is invited to find another provider.

Patient 1 throws a curve to the doc, if mmj has no effect, why doesn't patient need pain meds? I hate giving pain meds, maybe this may help me solve that problem. I find this interesting and I'll ask some of my other patients that are asking for fewer vics if this is the reason...

Be patient 1. Don't tell the doc how great cannabis is, show him/her with results.

Dr. Bob

PS, the lack of respect for certification clinics your doctor showed by referring to them as 'mills' is typical. This is why HB4851 was written, to make the clinics practice medicine or get out of the field. Many of the no record/no doctor/dispensary 'clinics' are gone because this was coming. Overall, the reputation of those that remain will improve, because only the good ones are going to be left.

 

[TheMan13]

Great example Dr. Bob, but now that you have told my story know that my docs positive experience did not and cannot change his very well scripted business model. To become an MJ doc you have been forced to change your business model and are now shunned by the medical establishment correct?

 

[Dr. Bob]

This is the language from New Yorks proposed medical marijuana act on transfers:

"IT SHALL BE LAWFUL UNDER THIS ARTICLE TO GIVE OR DISPOSE OF MARI-
28 HUANA, OBTAINED UNDER THIS TITLE, FOR CERTIFIED MEDICAL USE, BETWEEN
29 CERTIFIED PATIENTS AND OTHER CERTIFIED PATIENTS, AND BETWEEN A DESIG-
30 NATED CAREGIVER AND THE DESIGNATED CAREGIVER'S CERTIFIED PATIENT WHERE
31 NOTHING OF VALUE IS TRANSFERRED IN RETURN, OR TO OFFER TO DO THE SAME.
32 THIS PROHIBITION ON TRANSFERRING OR OFFERING TO TRANSFER A THING OF
33 VALUE SHALL NOT (A) APPLY TO SALE OF MEDICAL MARIHUANA TO OR BY A REGIS-
34 TERED ORGANIZATION UNDER THIS ARTICLE; NOR (B) PREVENT A DESIGNATED
35 CAREGIVER FROM BEING REIMBURSED FOR REASONABLE COSTS OR ACTIVITIES
36 RELATING TO CARING FOR A CERTIFIED PATIENT, INCLUDING, BUT NOT LIMITED
37 TO, REIMBURSEMENT FOR LEGITIMATE EXPENSES RELATING TO THE MANUFACTURE OF
38 MEDICAL MARIHUANA OR THE PURCHASE OF MEDICAL MARIHUANA FROM A REGISTERED
39 ORGANIZATION UNDER SECTION THIRTY-THREE HUNDRED SIXTY-SIX OF THIS TITLE.
40 S 3363. REGISTRY IDENTIFICATION CARDS AND HARDSHIP REGISTRATIONS. 1.
41 THE DEPARTMENT SHALL ISSUE REGISTRY IDENTIFICATION CARDS AND HARDSHIP
42 REGISTRATIONS FOR CERTIFIED PATIENTS AND DESIGNATED CAREGIVERS. A REGIS-
43 TRY IDENTIFICATION CARD AND HARDSHIP REGISTRATION SHALL EXPIRE AS
44 PROVIDED IN SECTION THIRTY-THREE HUNDRED SIXTY-ONE OF THIS TITLE OR AS
45 OTHERWISE PROVIDED IN THIS SECTION. THE DEPARTMENT SHALL BEGIN ISSUING
46 REGISTRY IDENTIFICATION CARDS AND HARDSHIP REGISTRATIONS NO LATER THAN
47 ONE YEAR AFTER THE EFFECTIVE DATE OF THIS SECTION. THE DEPARTMENT MAY
48 SPECIFY A FORM FOR A REGISTRY OR HARDSHIP APPLICATION, IN WHICH CASE THE
49 DEPARTMENT SHALL PROVIDE THE FORM ON REQUEST, REPRODUCTIONS OF THE FORM
50 MAY BE USED, AND THE FORM SHALL BE AVAILABLE FOR DOWNLOADING FROM THE
51 DEPARTMENT'S WEBSITE"

Now if lawmakers in Michigan passed an act with language this specific there would be a lot less room for interpretation.

Certainly agree, but that is NY and this is MI, we don't have that in place and can't use it. Would be nice, and that might be the next step after the SC rules. This goes hand in hand with fixing the distribution system while protecting the current rights of self growing patients and caregivers. The hazard is that every state with a dispensary bill it comes with strings from the people that had the money to promote it. Those strings included the removal of the 'competition' to the dispensary- home grows. We cannot allow that to happen here. Any dispensary/farmers market bill has to be a THIRD source along with patients and caregivers, not a replacement for them.

Dr. Bob

 

[Dr. Bob]

Great example Dr. Bob, but now that you have told my story know that my docs positive experience did not and cannot change his very well scripted business model. To become an MJ doc you have been forced to change your business model and are now shunned by the medical establishment correct?

No, I didn't change my business model. A medical practice is a medical practice and run by the same rules as my internal med practice was. It was actually the first step in a master plan to deal with the issue of working people needing primary care doctors but not having insurance, and a public health project concerning the use of chronic narcotics for pain management.

What is needed is that primary care doctors need to see benefit to incorporating cannabis into their routine care. To do that we need standards of care, results, and evidence supporting it. Then there will not be a need for certification clinics. I've already moved in that direction by expanding the scope of my practice to cover other aspects of medicine to the point cannabis certification is no longer my main focus or source of income. Hopefully by setting that example, primary care doctors will see how it is incorporated into a 'regular' medical practice.

Dr. Bob

 

[McMedical]

I agree with you buddy. Just trying to show that its really hard to gauge what the SC will rule, with how vague the language is. So much is up to interpretation.

 

[Dr. Bob]

Good doctors have a goal in mind. Getting the patient better. Down South, in addition to medicine, surgery, and other traditional modalities, sometimes patients would have members of their church come in to pray for them. I don't have a study, it may not have done a damn thing for the patient, but honestly, as long as it didn't interfere my attitude was 'I'll take all the help I can get to help the patient'.

If nothing else, and I am convinced cannabis helps many things, if nothing else cannabis will not hurt the patient. And if it helps them in ANY way, I don't object to it. Especially if they go from 120 to 20 vics a month.

Dr. Bob

 

[TheMan13]

I hear ya, progress is a slow process... I just hope that true answers will begin to appear and become adapted into the medical establishment.