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
