The Bonafide Dr/Pt Relationship- Pitfalls to Avoid in Certifications

[panhead]

Don't forget the literal felony prosecutions of third party patients/caregivers whom in turn have been denied protections under this "law" that Dr. Bob is using to market himself here.

That shit i cant even begin to wrap my head around , its now the patients responsibility to be sure his doctor patient relationship meets legal requirements , just another way government has figured out in order to continue feeding itself by the fines & court costs they collect , michigans government will never stop extorting dollars from citizens with the phony drug war & bullshit laws .

 

[panhead]

Don't forget the literal felony prosecutions of third party patients/caregivers whom in turn have been denied protections under this "law" that Dr. Bob is using to market himself here.

It just hit me , using this new definition of patient doctor relationship & face to face nonsense could hammer pain management patients like myself who get injections monthly .

Most visits to the pain clinic i dont speak with the doctor directly at any time , i sign in & answer the usual have you ate or drank anything in the last 8 hours , take a drug test then its off to treatment , im sedated via IV drip stuff then taken into the operating type room & laid out , then they inject stuff into nerves around the spine to kill the pain , once in recovery room a nurses aid type girl asks if i need refills & she takes care of the scripts without me ever speaking to the doctor .

I guess its ok to give out Oxycontin & Dilaudid without speaking to a doc face to face as long as you go to the office & pay .

This constant interference with the mmj law makes me happy i sold my dispensary .

All doctors who keep pushing this crap are gonna do is to drive everybody back underground like it used to be & there will be no patient $ to be had for anybody .

 

[leighgal]

Hi Bob,i am not angry at any of my doctors infact the doctor of our's who uses his I-Pod the most i absolutely love , i also understand why he needs to use an I-Pod to maximize patients per hour , the whole I-Pod reference was an example of doctors using technology to speed things up ,help more people & keep costs down .

I also used it to compare with other methods of medicine such as doctors faxing MRI test results to the primary care doc , faxing medical records , faxing prescriptions , using the telephone or skype for consult with other doc's ect , all non face to face interactions which have the possibility of errors , confusion & mix up's resulting in harm to a patient .

I dont see the difference with mail in , phone call , fax or skype cert's , its all just methods of obtaining information or passing information along , i fail to see how Dr Proctor is acting unethical , practicing bad medicine or putting any patients at risk or in danger , ive certified with DR Proctor as well as know him in real life & he is far from unethical ,he works his butt off helping people & he does care , ive witnessed DR Proctor decline to certify quite a few people on various occasions so i know he isnt running a prescription mill for profit .

IMO the whole mj as a scheduled narcotic idea is a farce , not only to users but to doctors as well , let's be real here were not talking about Fentanyl , Oxycontin , Dilaudid or other deadly & highly addictive schedule 2 narcotics , drugs where doctors involvement in its prescribed & monitored use is crucial to patients health & life its pot for gods sake ,the asprin of narcotic drugs .

Do we really need to train doctors in the use of pot ? Im not trying to disrespect you or belittle any medical mj training you've had but once again its pot , even the president of the United States ( Bill Clinton ) figured out how to use pot & not endanger himself .

IMO the whole idea of persecuting doctors over tiny non harmfull details is a waste of time & money as well as disrespectfull to the prescribing doctor & taking a step backwards in pain management .

I must agree with your entire statement here brother panhead.

 

[leighgal]

These public records (threads) may not fare well for him making it rain in the courtroom as an expert witness for his wealthy buddies in the future. A quick internet search (due diligence) should expose his conflicts of interest that would be hard to deny, no less his questionable character and adolescent tactics. We may be providing a public service here after all

Spot on!

 

[Dr. Bob]

Hi Bob,i am not angry at any of my doctors infact the doctor of our's who uses his I-Pod the most i absolutely love , i also understand why he needs to use an I-Pod to maximize patients per hour , the whole I-Pod reference was an example of doctors using technology to speed things up ,help more people & keep costs down .

I also used it to compare with other methods of medicine such as doctors faxing MRI test results to the primary care doc , faxing medical records , faxing prescriptions , using the telephone or skype for consult with other doc's ect , all non face to face interactions which have the possibility of errors , confusion & mix up's resulting in harm to a patient .

I dont see the difference with mail in , phone call , fax or skype cert's , its all just methods of obtaining information or passing information along , i fail to see how Dr Proctor is acting unethical , practicing bad medicine or putting any patients at risk or in danger , ive certified with DR Proctor as well as know him in real life & he is far from unethical ,he works his butt off helping people & he does care , ive witnessed DR Proctor decline to certify quite a few people on various occasions so i know he isnt running a prescription mill for profit .

IMO the whole mj as a scheduled narcotic idea is a farce , not only to users but to doctors as well , let's be real here were not talking about Fentanyl , Oxycontin , Dilaudid or other deadly & highly addictive schedule 2 narcotics , drugs where doctors involvement in its prescribed & monitored use is crucial to patients health & life its pot for gods sake ,the asprin of narcotic drugs .

Do we really need to train doctors in the use of pot ? Im not trying to disrespect you or belittle any medical mj training you've had but once again its pot , even the president of the United States ( Bill Clinton ) figured out how to use pot & not endanger himself .

IMO the whole idea of persecuting doctors over tiny non harmfull details is a waste of time & money as well as disrespectfull to the prescribing doctor & taking a step backwards in pain management .

Very good post. I am closing office down and getting on the road, but I want to respond, you raise very good points.

Dr. Bob

 

[panhead]

PS, Obama has also said he used pot also when he was young and unlike Bill, he did inhale, that was the whole point in smoking

I knew about Obama but dont post much about him mainly because i get tired of the people who call everybody who says anything about him a racist ,the whole racist deal around here has got old .

 

[Skylor]

Yeah well least Obama didn't try to hide it and say he did not inhale...just like Bill did not have sex with that women....Bill was an OK president compared to GWB but some of the things he said and did made me want to smash the TV set...he could not a be a man and say what happen between them was a private matter, no, he tried lying about it and go caught red handed...just like he lied about never inhaling

 

[Dr. Bob]

ok Pan, finally home from Gaylord and wanted to respond.

Personally I am a huge advocate of telemedicine. Most of my testimony to the house Judiciary involved the need for telemedicine for certifications, especially in the rural north I serve. But they didn't go for it and specifically required a face to face, in person meeting with the physician. It should be noted that right across the hall they were approving a general telemedicine bill, which passed and is in effect, but they still clearly and specifically said cannabis certs MUST be live and in person, not on skype. Therefore, ALL skype certification visits after 4-1-13. There are some clinics still doing them for the money, be unless there is something so overwhelming to require it (bedridden cancer patient in the far western UP that has a long history with the doc and a housecall cannot be done for example) it puts a hole in the section 8 defense. Not only don't I like this exception, but it resulted in an extra 1500 miles of travel for me a month. What really burns my ass is that there are lazy clinics doing it to this day, and putting patients at risk, but the state does nothing to enforce the law. I could easily make a boat load of money with little or no risk if I opened all my clinics to skype, but that would put patients at risk even though I would get away with it as they are. So I get in my jeep and go see the patient.

Different standards for different drugs- just a fact of life that there are different rules for writing a script for antibiotics and writing one for methadone or Roxy. We got special permission to recommend schedule 1 cannabis, and there are special rules for doing it. Just the way it is, and until it changes, thats the way it is done. Fair, right or reasonable don't come into play, it is the law and if we don't do it we go to jail.

Train doctors better- you bet. I was taught medical marijuana was a thinly veiled excuse for illegal drug use. My patients taught me otherwise. Doctors need to learn that marijuana can replace some of the 740,000,000 doses of vicodin, 90,000,000 doses of oxycontin, and 30,000,000 doses of methadone written in Michigan each year. I can routinely cut narcotics in half with marijuana, so apply that to the numbers above and do the math as to what it would mean to the state. Also note that according to JAMA, states with MMJ laws are seeing a 25% decrease in death by opiate overdose.

So the peanut gallery can call this all bs, and tell everyone I don't have morals or ethics and blame me for whatever unfairness is in their lives, but there it is.

Dr. Bob

 

[Dr. Bob]

Now this has gone completely off topic and I have other things to do. Later y'all.

Dr. Bob

 

[CashCrops]

You are correct. Sativa strains would cause issues. The exact strain depends on what is available to the patient and is a question for the caregiver. Giving a theoretical answer based on the thousands of strains available with no consideration to what the patient can get would be pointless. I could say 'Charlotte's Web' is best for seizures to a child with seizure's parents, but really, what good would that do unless they were moving to CO.

That is why I don't answer questions like that, each caregiver has their own strains, and the best I can do on my end is suggest general considerations, not specifics. But you already know that, because you asked a question I clearly cannot have the information to answer properly.

Dr. Bob

You completely avoided the obvious, and even tried to steer away from it. Nice try but you didn't defend the fact you stated your an expert concerning medical marijuana for patient use. Care to elaborate deeper as to what exactly makes you an expert other then being a "DR" and I tread lightly on that abbreviation as it can be given to anyone who went to school for dentistry, chiropractic care and psychiatry?

 

[Skylor]

Thats still way more eduction then I've had, lol

I agree its not cool to put down other doctors and clinics, if he feels certain business practices are not for him, fine but don't go saying other places are no good.

If a person wants to get a MM card and then start growing MM and selling it, they should have a lawyer or lawyers overseeing what they are doing to make sure they are not...I'm not sure, why I'm not a lawyer, doctor, etc. I'm just a patient who finds MM works great for me.

 

[Skylor]

I can routinely cut narcotics in half with marijuana, so apply that to the numbers above and do the math as to what it would mean to the state. Also note that according to JAMA, states with MMJ laws are seeing a 25% decrease in death by opiate overdose.


Dr. Bob

I use MM so I don't have to use any other drugs, not pills, alcohol, nothing...I'm drug free expect for MM. Only that allows me to have an active lifestyle and enjoy life to the fullest. Other drugs get me dizzy if i over do it, I just don't want to lay around and feel OK, I want to bike, hike and do other good stuff.

Once one starts using other drugs with MM, they are asking for problems, IMO.

Yes I know sometimes its needed, hopefully MM alone will always work good for me, if i get to the point where it doesn't, I'm not sure what I will do. Using both MM and narcotics seems like too much, IMO.....last thing I need is to fall off my bike. I guess I might have to give it up one day but then I seen people in their 80's still bike riding, I hope I become one of them someday.Maybe after age 75, the training wheels should go back on the bikes, ha ha...U never see that, adults using training wheels to stop them falling down, just helmets that help protect U only after U fall down..why not something to help prevent falls in the first place ? Oh what do I know, I'm just some uneducated dude, lol

 

[Dr. Bob]

Thats still way more eduction then I've had, lol

I agree its not cool to put down other doctors and clinics, if he feels certain business practices are not for him, fine but don't go saying other places are no good.

If a person wants to get a MM card and then start growing MM and selling it, they should have a lawyer or lawyers overseeing what they are doing to make sure they are not...I'm not sure, why I'm not a lawyer, doctor, etc. I'm just a patient who finds MM works great for me.

It is not cool doing substandard certification when the rules are clear and easy to follow. It puts patients at risk. Unless you think it is ok you go to jail so they can make some cash and sign a form without following the rules. I am not ok with that, and I am willing to bet you aren't either.

There are those physicians that work hard to be correct and protect their patients. Unfortunately there are those that are experts on doing the least they can get away with. I think the COA was pretty clear what they thought of that one. My record in court tells you what they think of me.

 

[Dr. Bob]

You completely avoided the obvious, and even tried to steer away from it. Nice try but you didn't defend the fact you stated your an expert concerning medical marijuana for patient use. Care to elaborate deeper as to what exactly makes you an expert other then being a "DR" and I tread lightly on that abbreviation as it can be given to anyone who went to school for dentistry, chiropractic care and psychiatry?

I replied adequately and correctly and don't care to try to impress you with my vast knowledge. What's deeper that simply being a physician? Well there are enough patients out there that feel I give pretty good advice, and the courts consider me an expert (and so do defense attorneys), so I guess that is enough. I don't feel the need to try and meet your expectations, just theirs. Given the fact I win in court and my patients reduce their meds, I guess that makes me enough of an expert to not have to justify 'why'- especially to someone that will find fault with any answer I give.

Nite all.

 

[CashCrops]

LOL, Thanks doc....I'm sleepy now

 

[Bigtacofarmer]

You are correct. Sativa strains would cause issues. The exact strain depends on what is available to the patient and is a question for the caregiver. Giving a theoretical answer based on the thousands of strains available with no consideration to what the patient can get would be pointless. I could say 'Charlotte's Web' is best for seizures to a child with seizure's parents, but really, what good would that do unless they were moving to CO.

That is why I don't answer questions like that, each caregiver has their own strains, and the best I can do on my end is suggest general considerations, not specifics. But you already know that, because you asked a question I clearly cannot have the information to answer properly.

Dr. Bob

Nice. Thanks for proving my point.

Recommend someone moves a thousand miles away instead of sourcing perfectly good genetics here. Brilliant. You have a ot to learn. A lot. I could go on for days and you would keep proving how bright you are. Thanks. I'm done here. Hopefully sick people have luck finding a doc with a brain.

 

[CashCrops]

Exactly Taco, he claims to be an expert but when asked for proof he googles, answers, and gets owned again.

 

[Dr. Bob]

Don't confuse not know with not caring or not wanting to play your little game

 

[CashCrops]

Don't confuse not know with not caring or not wanting to play your little game

Don't get mad because you claimed something and we asked for proof which you have none of now robert!

 

[CashCrops]

Also, lets not confuse the situation, this is your game. Your the one who argue's with everyone on here not me. I'm just pointing out all the mistakes