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

Dr. Bob

Well-Known Member
I have ethical concerns about those that make a mockery of the law and the people of this state that gave it to us.

There are three failures here....
  1. Patients have been clearly told by me and many others that there are basic medical standards to certifications. The choice to go to a hotel or skype clinic, renew their certs by mail or not do followups is theirs and theirs alone. As long as patients give them money, these substandard clinics will exist.
  2. Physicians have an obligation to know the laws regulating their profession. Those that fail to know them or fail to follow them are ethically responsible for the outcomes of their failures. In this case, Proctor has been caught with substandard certifications in the past, yet continued to carry on because he wasn't punished by the state and patients continued to come to him.
  3. The State bears the ultimate burden of blame. They are holding patients responsible to a law they are not enforcing. They refused to provide guidance to physicians early on when we asked them, so those of us with ethics created our own. Those without ethics did anything they could get away with and continue to do so, putting patients at risk, because the state will not stop them despite the fact they know about the activity.
Now you have a really nice graphic, and stated with certainty that somehow I make a profit off of this at the expense of patients- despite the fact you have no evidence or reason to do so. That makes you, my friend, part of the problem, not the solution. Direct your anger at those putting patients at risk. The skype doctors that take your money and offer you the false promise of protection.

How many of you got a 'through the mail' renewal from Alternative Solutions in Petoskey and sent your $150 in with no expectation to be seen by a doctor? How many of you went to the 'mass certifications' complete with marijuana judging contests and dancing pot plants on the sidewalk in Muskegon and Traverse City? How many of you have paid for skype certifications in Traverse City or at the O-Zone in the Soo?

So don't preach to me about standards my Man. I have them, and ethics, and am proud of the fact.

Dr. Bob
 

Dr. Bob

Well-Known Member
PS, I have the goods to prove what I say. If any of those folks have a problem with me saying it, PM me and I'll give you the number of my lawyer and we'll dance.
 

TheMan13

Well-Known Member
You and your lawyers have a problem with your competitors and their lawyers as you fight over your subjective interpretations of MMMA and lobby our government to codify your subjective interpretations into law as innocent people are clearly being hurt, NOT your competitors and you. In my profession we called that collateral damage and often gave our lives to ensure it didn't occur. I'm simply trying to point out the facts of the matter here from an educated and objective point of view that you clearly lack. As for my opinion, your lawyers and you are nothing more than costly parasites on our society ...
 

Dr. Bob

Well-Known Member
You and your lawyers have a problem with your competitors and their lawyers as you fight over your subjective interpretations of MMMA and lobby our government to codify your subjective interpretations into law as innocent people are clearly being hurt, NOT your competitors and you. In my profession we called that collateral damage and often gave our lives to ensure it didn't occur. I'm simply trying to point out the facts of the matter here from an educated and objective point of view that you clearly lack. As for my opinion, your lawyers and you are nothing more than costly parasites on our society ...
Let's see if you even understand why it is there. Name five good things a bonafide dr/pt relationship law does to help and protect patients. If you cant this conversation is done because I am not going to discuss this with someone that doesn't understand the subject and cant look at both sides of the issue.
 
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Dr. Bob

Well-Known Member
I began my comments here by asking you that exact question ...
Ok, but sorry, I am not going to think for you. You have to reflect, perhaps re-read several things I wrote, and YOU tell me five benefits of the bonafide dr/pt relationship law. If you don't understand why it is there, and what it is intended to do, I am not going to explain it again only to have you take shots at everything I say about it. If you can't figure out what it was intended to to, I am not interested in your objections to how it isn't doing it.

BTW it is a moot point, it is the law now so deal with it.

Dr Bob
 
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Skylor

Well-Known Member
How bout 5 good and 5 bad reason, lol.....lets see

The good reasons

#1..the stronger the relationship with your doctor, the harder it be to discredit their findings about U.
#2.. the better your doctor knows U, the better chance they offer the proper medical advice to U
#3....the better U know your doctor, the more at ease-relax U would be with them for your examination.
#4..the doctor looks more professional by working inside a medical office building, vs a hotel room
#5 the doctor is able to have a larger staff to better serve their clients, maybe have more then one doctor working so help is more readily available

Now the bad.,hmmm

Well number 1 has to be the extra costs. My clinic wanted $100 for my exam and approval letter before this bonafida stuff started, I then let my card expired for a couple of months before I seen my doc again, that later visit also cost me $100 plus they wanted to see me again 6 weeks later for another fee of $50...which I did go and they made a copy of my new MM card and the doc gave me a brief exam. The 6 month check up also costs $50 but I could do it for free online but I don't see or even speak with my doctor.

Number 2 is the extra hassle of going to see my doctor, its a 40 min trip for me--good thing I have a good car to take and a drivers license and extra free time in my life to be able to go, not everybody has that luxury

Number 3 is the invasion of ones privacy..the local drunk needs not to explain why they want to drink alcohol yet we gotta prove marijuana is medical needed for us. Some people cringe on going to any doctors office, a hotel room they might well feel more comfortable in. If a person is very weak and only feels well enough to see others for a short amount of time each day, a hotel is a perfect place to go see a doctor, The person could even get a hotel room for the night inside that hotel the night before or after they see the doctor, maybe be on the same room floor the doctor is on, that means alot to those who can not walk very well or throw up easly



Number 4...i gotta get back with U on that, lol

What gets me is anybody, no matter how bad shape they might be in, needs to have this bonafide relationship with their doctor and have medical record to prove their problems. A person could have missing limbs, be way underweight from not eating, have a deadly form of cancer and still they gotta prove with medical records that they need MM. I'm no doctor yet I can tell just looking at some folks inside the compassion club that they are truly very ill-weak. I had a great time at the high times event in Flint last summer yet a few people over there made me feel sad just by how they looked. I'm looking forward to next years event but I doubt if those weak people there I seen there will still be alive come next summer, they looked that bad. It was nice to see a smile on their faces..that the ones that knew what was going on, some seen totally out of it and wasn't for their caretaker they would not have been there..why do those people have to prove anything. Why can't a doctor work inside a hotel room and or quickly approve those who have only months left to live ?
 

Dr. Bob

Well-Known Member
How bout 5 good and 5 bad reason, lol.....lets see

The good reasons

#1..the stronger the relationship with your doctor, the harder it be to discredit their findings about U.
#2.. the better your doctor knows U, the better chance they offer the proper medical advice to U
#3....the better U know your doctor, the more at ease-relax U would be with them for your examination.
#4..the doctor looks more professional by working inside a medical office building, vs a hotel room
#5 the doctor is able to have a larger staff to better serve their clients, maybe have more then one doctor working so help is more readily available

Now the bad.,hmmm

Well number 1 has to be the extra costs. My clinic wanted $100 for my exam and approval letter before this bonafida stuff started, I then let my card expired for a couple of months before I seen my doc again, that later visit also cost me $100 plus they wanted to see me again 6 weeks later for another fee of $50...which I did go and they made a copy of my new MM card and the doc gave me a brief exam. The 6 month check up also costs $50 but I could do it for free online but I don't see or even speak with my doctor.

Number 2 is the extra hassle of going to see my doctor, its a 40 min trip for me--good thing I have a good car to take and a drivers license and extra free time in my life to be able to go, not everybody has that luxury

Number 3 is the invasion of ones privacy..the local drunk needs not to explain why they want to drink alcohol yet we gotta prove marijuana is medical needed for us. Some people cringe on going to any doctors office, a hotel room they might well feel more comfortable in. If a person is very weak and only feels well enough to see others for a short amount of time each day, a hotel is a perfect place to go see a doctor, The person could even get a hotel room for the night inside that hotel the night before or after they see the doctor, maybe be on the same room floor the doctor is on, that means alot to those who can not walk very well or throw up easly



Number 4...i gotta get back with U on that, lol

What gets me is anybody, no matter how bad shape they might be in, needs to have this bonafide relationship with their doctor and have medical record to prove their problems. A person could have missing limbs, be way underweight from not eating, have a deadly form of cancer and still they gotta prove with medical records that they need MM. I'm no doctor yet I can tell just looking at some folks inside the compassion club that they are truly very ill-weak. I had a great time at the high times event in Flint last summer yet a few people over there made me feel sad just by how they looked. I'm looking forward to next years event but I doubt if those weak people there I seen there will still be alive come next summer, they looked that bad. It was nice to see a smile on their faces..that the ones that knew what was going on, some seen totally out of it and wasn't for their caretaker they would not have been there..why do those people have to prove anything. Why can't a doctor work inside a hotel room and or quickly approve those who have only months left to live ?
Ok, pretty good.

I'll respond to you because you took the time to think it through.
#1 Right on the money- A real relationship with the certification doctor goes a LONG way in court in a section 8.
#2 Good point, but most certifications are pretty binary, you have a condition or you don't, it would help you or, well I can't think of a good reason marijuana wouldn't be recommended to help you if you have a problem, but it is nice to have a specific target you are recommending it for.
#3 The bonafide relationship law has nothing to do with that, it has more to deal with personality.
#4 Yes, and the more professional the atmosphere, the harder it is for the prosecutor to claim the doc is back alley, but this isn't part of the bonafide dr/pt relationship law. It is just common sense.
#5 Again, not part of the bill, but a nice side effect of having an office.

The question was, what was the benefit of the Law, and that means the law as written.

Here are a couple I came up with:

1/ It is a professional evaluation based on standard medical practice, and it requires the same data that any doctor would need to make a considered medical judgement- records, visit with the patient, a chart is made, follow up is offered- just like any other medical visit.
2/ It defines the standard, follow the standard and the court cannot claim the relationship wasn't there. This specifically prevents prosecutors from trying to wing it every case, and gives the court a specific 'check list' to say yes or no.
3/ It protects the physician from the board. To say someone violated the standard of care, we must know what the standard of care is. To claim you followed the standard of care, again, you have to define it.
4/ It gives the regulatory authorities (like the medical board) the ability to specifically stop physicians that violate the standards, this in the end protects patients. Just as malpractice laws protect patients, just like the food and drug administration keeps bad drugs off the market to protect patients.
5/ It implies that physicians offering certifications meet a certain standard, thus letting patients going to these physicians take comfort in that they are getting good care from a qualified doctor.

Now your objections:

1/ Charges, that is up to the individual office and physician. We don't charge for follow up, others do. We offer on line follow for free, I review each one, sign it, act on it if needed (for example if you ask for a call), and scan it into your chart. If I need to show you did follow up, I can (and have in court- it saved a patient in Ionia Co. last week). You can also come in and see me face to face, for free, to do you follow up. The only reason we offer it on line is to save the patient time, expense, travel and allow them to do it on their schedule rather than mine.

2/ See my response above, we offer on line follow up for that very reason, to make it easy. The follow ups are not there to extract money, they are there for us to monitor you and protect you in court if needed. We want to make them as easy and cheap as possible so EVERY patient does them. Makes it much easier for us to defend you.

3/ As with response 1 and 2 above, it doesn't have to be that way- we can monitor you on line from home. As for 'having to do it' well sorry, but that is the normal way medicine works, we monitor our therapy be it cannabis or hypertension meds. As far as should you have to prove why you need cannabis, well the law says you have to have a condition, so you have to prove you have it. Just the way it is and the way the voters wanted it. They also wanted the legislature to be able to modify it with a super majority, and they got one and modified it, just as 63% of Michigan voters intended them to do (note the supermajority is there to make it harder, but they did it.)

Note on seeing people at hotel conference rooms. We do that to this day in a couple of areas. Why? Because we have patients in those areas and our nearest office is an hour away. We do it as a courtesy to the patients in the area, we do it to assess the need to have a full office in that area. They are done the same way there as they are done in the office, and fully backed up by a nearby (within an hour or so generally) office. Our offices show we are here to stay- and able and expect to do your followup. The traveling circus style hotel or dispensary clinics? Who knows if you can find them for your follow up, renewals or even to support you in court. You know where to find me if you need me. That's because I follow the bonafide laws, and my patients are protected. Folks like Proctor don't, and his is now looking at potential jail despite having a qualified conditions, simply because he went to Proctor instead of someone like me.

Dr. Bob
 

TheMan13

Well-Known Member
Like most, I have a “bona fide physician-patient relationship” with my real doctors and I pay a Pot Doc to simply certify my obvious qualifying medical conditions with my real medical records as documentation for licensing purposes under the law. All my real doctors know of my medical marijuana use, they just won't sign my MMMP form at the advice of their legal council. I, like most others, have no need for an additional medical follow up from my Pot Doc, I leave that up to my real doctors and associated health systems. The only benefit I need from my Pot Doc is a signature so that LARA will provide me a licence. Get over yourself, you're nothing more than an overpriced notary with "professional" credentials, regardless of whatever legal interpretation/business model you have weaseled into the law.
 
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Dr. Bob

Well-Known Member
Like most, I have a “bona fide physician-patient relationship” with my real doctors and I pay a Pot Doc to simply certify my obvious qualifying medical condition with my real medical records as documentation for licensing purposes under the law. The only benefit I need from my Pot Doc is a signature so that LARA will provide me a licence. Get over yourself, you're nothing more than an overpriced notary with "professional" credentials, regardless of whatever legal interpretation/business model you have weaseled into the law.
What a tool you are. Thanks for the smile my man- I find you sad, but in an amusing sort of way. Some folks will never get it, but hopefully enough learned something from this to protect themselves. Have one of them explain it to you.
 

TheMan13

Well-Known Member
Make sure to get back with us on how successfully this fear/extortion marketing plan of yours works out ginning up business. Keep us posted on all those collaterally damaged patients/caregivers/families produced by your competitors/lobbying as well. I'm sure we all have a lot to learn ...
 

Skylor

Well-Known Member
Like most, I have a “bona fide physician-patient relationship” with my real doctors and I pay a Pot Doc to simply certify my obvious qualifying medical conditions with my real medical records as documentation for licensing purposes under the law. All my real doctors know of my medical marijuana use, they just won't sign my MMMP form at the advice of their legal council. I, like most others, have no need for an additional medical follow up from my Pot Doc, I leave that up to my real doctors and associated health systems. The only benefit I need from my Pot Doc is a signature so that LARA will provide me a licence. Get over yourself, you're nothing more than an overpriced notary with "professional" credentials, regardless of whatever legal interpretation/business model you have weaseled into the law.
I see where U are coming from but understand some people need more help using marijuana then others. We are old school and me even used pot back in HS, yep, in HS, we were tick we had to go outside to smoke--the teachers had a smoking lounge..but they told us they never smoke weed in there and we would, ha ha

What about those who never used weed all of their life, for sure they get more out of their MM doctor then we do. They likely ask many more questions and need more advice
 

Skylor

Well-Known Member
These MM doctors might well be using the system to make money but its nothing compared to what the police have done.

Look how the police are so quick to call up their buddies on the bomb squad any chance they get. When people protest the police, the police show up and get paid in overtime. So the worst the police become, the more people protest and the more money the police make.

These MM doctors are still HELPING people, everybody should get paid a fair amount for what they do. I would not be surprise if a surgeon makes more money then most MM doctors do. I got no idea how much doctors make, I think I seen $200,000 a year is the norm. Thats great money..maybe the problem is we aren't being paid enough for what we do, not that doctors make too much money.
 

Dr.Pecker

Well-Known Member
What societal harm were/are these "mills"/"sham clinics" causing that justifies your lobbying and that excuses the fact these innocent patient/caregiver's (whom are oblivious to your inside baseball) are now being persecuted as serious felons for another's (your competitor's) actions/inactions?



Regulatory capture is a form of political corruption that occurs when a regulatory agency, created to act in the public interest, instead advances the commercial or special concerns of interest groups that dominate the industry or sector it is charged with regulating. Regulatory capture is a form of government failure; it creates an opening for firms to behave in ways injurious to the public (e.g., producing negative externalities).

http://en.wikipedia.org/wiki/Regulatory_capture
I was wondering if you were going to get to that part. Most people go into the mmp thinking they have rights and are protected under the law. Just leave it to some monopolizing Drs to make criminals out of unsuspecting patients and the competition. Thanks for ruining innocent patients lives. You know who you are I don't have to point fingers. But I will @Dr. Bob. I would have normally left it alone but you continue to post this shit. I thought I reamed your ass good enough last time, apparently I didn't so here you go. Your not doing anything but hurting your colleagues and making criminals out of innocent people. Your utter lack of foresight has made the very people you say your trying to protect criminals. Its also terrible business practice. Is anyone else tired of looking for a new Dr because some other dr or lawyer got a hair up their ass? How fucking dare you come on a public forum and threaten people with the lawyer in your back pocket. The people of michigan created the very law you are stuffing your face with. It will be the people of michigan that legalize it and take that fucking golden spoon out of your mouth. Save your pennies, you will not be in business in a few years. And good luck keeping up your current lifestyle. DP
 
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Skylor

Well-Known Member
Sadly I have not kept up what all has been going on with MM in the entire state of Michigan. I live in SE Mi and know its better to hang out in Genesee county vs Kent county.

I do feel the MMMP do also have some duty-responsibility if they need to prove they have medical problems. Something like past broken bones and other injures, like internal bleeding from broken bones..I had tubes up my nose pumping blood out of my lungs for 2 weeks cause I was bleeding from the inside from a nasty car wreck..in today's "safer, air bag, cars" I would have been killed, IMO. (maybe they are safer cause I been off the road forever, ha ha )

Years before that happen I rode dirt bikes and got thrown off them a few times, another time I broke my foot, then other times I got into fights....by age 25 I've had more stuff happen to me then some have all their life...edit, was in hospital from another car wreck going to kindergarten , I forget about that one cause it was only for a night or two, no broken bones that time, just some bad cuts from flying glass,,,5 years old and I'm already going to hospitals, lol

So I don't worry getting hassled by the police, then again I only treat myself and medicate at home and expect bring the stuff home, I never drive around with any MM. In fact once the MM gets in my home, it never leaves, all goes up in smoke, eventually..I don't grow either
 
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