When it comes to the availability of physician recommendations for
medical cannabis to patients, consumers across the country have an
enormous problem: access. Although there have been many thoughts about
why this access problem exists, I attribute it to the ignorance of
legislators regarding the benefits of medicinal cannabis and the
reluctance of my fellow physicians to educate themselves about the
conditions for which medical marijuana is a very effective treatment.
A perfect example of the former is the recently passed requirements in
New York
State. The
law there lists several medical conditions that patients must have to be
entitled to see a medical marijuana physician. Unfortunately, one of the
most commonly reported conditions, chronic
pain (a condition that cannabis has been scientifically
proven
to treat effectively), is not included in the list! This exclusion bars
pain suffers from accessing an effective and much-needed treatment.
The laws in New York aren’t just limiting for patients, though; if a
physician in New York wants to participate as a medical marijuana
physician, he or she is now required to take a four-hour continuing
medical education course at a cost of $250, a law that makes New York’s
education requirements the most stringent in the United States.
Low Levels of Physician Interest
Marijuanadoctors.com, an information site
and national clearinghouse that connects patients with physicians
willing to certify them, surveyed 500 New York doctors in the early
2015. The purpose of this survey was to gauge the number of doctors who
would potentially participate in the state’s medical marijuana program.
After the company informed physicians about New York’s stringent and
expensive training requirements, however, only one physician of the 500
originally surveyed was actually interested in participating in cannabis
recommendations! Is it fear of being investigated by the FDA? Ignorance
as to the benefits of cannabis in treating the acceptable medical
conditions? Time consuming training? I’m sure it’s a combination of all
three but it makes cannabis access much more difficult, if not
impossible, for patients.
Why Telehealth Access
For access to medical cannabis evaluations, Telehealth is the best
option by far. During a Telehealth appointment, a patient can meet with
a doctor via a remote platform from wherever he or she chooses. This
saves them the trouble of driving to a doctor’s office (sometimes in a
questionable part of town and at a great distance), parking, waiting and
missing out on other obligations. Telehealth fills an important gap in
the current medical marijuana access structure: by bringing medical
examinations to patients rather than making them trek to a provider’s
office, more patients can obtain the access to the care they need. At
the conclusion of the virtual meeting, if the doctor feels the patient
would benefit from cannabis, they can download a recommendation letter
immediately for use at a dispensary. This allows the patients to have
instant access for products to help their medical condition. It’s
obvious that Telehealth plays an important role in doing away with many
of the barriers medical marijuana consumers previously faced. In many
states, however, Telehealth care is impossible to access for cannabis
recommendations. Why? Because in all states other than California and
Nevada, its illegal!
The Current State of Telehealth
In enlightened states like
California
and Nevada, where
Telehealth cannabis evaluations are legal, patients can be "seen"
remotely at their own convenience. Why don’t more states allow this? The
answer, I believe, is the reluctance of physicians to suggest this to
the governing bodies as well as the Medical Boards allowing it. Is it
fear of liability? Fear of the FDA? Financial gain? Telehealth is
acceptable in 29 states right now. Why not for cannabis?
Unfortunately, in-person examinations are required in the other 21
states that allow medicinal cannabis, make accessing medical marijuana
virtually impossible for many qualified patients. For example, if a
patient is housebound, elderly, lacking transportation or unwilling to
visit an area of the city where medical marijuana clinics are often
located, that patient is essentially denied care. This is especially
unfortunate because seniors are currently the fastest-growing
demographic
of medical marijuana users, and they are also especially likely to have
difficulty attending in-person consultations. Telehealth care has the
potential to expand the reach of medical marijuana and help underserved
populations gain access to effective cannabis treatments.
There are many companies that presently use remote platforms to perform
Telehealth patient evaluations and prescribe medication, some more much
more dangerous than cannabis, when appropriate. They have been around
for several years, insurance companies use them as a way to increase
access and they are growing by leaps and bounds. Patients are flocking
to these sites for the convenience and privacy that they provide. Why
should cannabis recommendations be any different for a medication that
has been used medicinally for thousands of years and has a patient
safety record that is unbeatable?
Access for All
In states like California and Nevada, where it’s legal, Telehealth is
already a convenient and effective form of reaching out to connect
physicians and patients who need medicinal cannabis. In the states that
haven’t caught on to the changing tides, however, it’s imperative that
consumers speak out on behalf of Telehealth access. Promote Telehealth
to your legislators and explain to them that they are restricting your
access to care.
It is not enough to only increase the number of physicians who perform
evaluations. We must push for being able to do this remotely. Doing this
will help ensure that Telehealth care is available to every patient who
needs it and to provide medicinal cannabis access for all.
