Ron Strider
Well-Known Member
Dr. Mitchell Gittelman can't say whether medical marijuana will help any of his patients.
But he can't say it won't help them either.
"I think since you're not going to die from cannabis," the Salisbury physician said, "it's reasonable to give people a chance to try it."
Not just anyone, mind you. Gittelman registered with Maryland regulators to be eligible to recommend the drug with his sickest patients in mind, he said.
Few of his counterparts have followed his lead on the Lower Shore. Gittelman is one of eight doctors and other medical providers based in one of the three counties who signed up as of late October, according to information obtained by the Salisbury Daily Times and DelmarvaNow through a public records request.
The Maryland Medical Cannabis Commission records list a total of 520 eligible medical providers statewide.
The region's dearth of participating doctors could lead to a clog in the medical marijuana pipeline, said Gene Ransom, CEO of MedChi, the state's professional association for physicians. But that's hard to know until the drug becomes available and patients start seeking it, he added.
"There will probably be pockets of Maryland that are disadvantaged," Ransom said.
He suspects the number of doctors actively seeing patients is much lower than 520, noting that several on the list are medical directors affiliated with marijuana businesses.
The first batch of medical cannabis is expected to hit the market some time before the end of the year, commission officials say. The state legalized the drug in 2013, but its rollout has been slowed by legal challenges and the effort of creating a multi-billion dollar industry from scratch.
Some fits and starts are to be expected even after the drug becomes available, said Patrick Jameson, executive director of the Maryland Medical Cannabis Commission.
"There has to be time for the industry to become operational," he said.
The state has permitted 14 growers, 12 processors and six dispensaries so far. Their fortunes, however, hinge on finding doctors willing to clear the way for patients to take a drug that is poorly understood and remains federally classified on par with cocaine and heroin.
As safe as possible
For its part, MedChi is trying to stay out of the debate over marijuana's medical merits while advocating on behalf of doctors who want to participate in the program.
"We have doctors who have positions all over the place on medical marijuana, so we have no official position," Ransom said. "So what we are trying to do is make it as safe, legal and easy as possible for the physicians to take advantage of the law."
To date, 29 states and the District of Columbia have legalized marijuana for medical purposes. Maryland's law limits its use to patients with certain documented conditions, including wasting syndrome, severe pain, glaucoma and post-traumatic stress disorder, among others.
Following the lead of other medical marijuana states, the Free State's law seeks to shield doctors from potential federal entanglements. Physicians write "recommendations" for the drug instead of "prescriptions" to skirt the federal prohibition on the practice.
"Any doctor that does this is taking a risk," Ransom said. "It's not legal under federal law."
So why chance it?
For one, the likelihood of prosecution for those who follow state law is almost nonexistent. The Justice Department has issued several memos informing its staff that cracking down on medical marijuana is a poor use of its limited resources.
Even if the window to criminal charges were completely shut, it wouldn't necessarily protect doctors from civil accusations of medical malpractice.
"It's a crapshoot"
That prospect weighed heavily on Gittelman's decision to sign up, he said.
Anyone who has ever been on the receiving end of his bedside manner knows he is a no-nonsense communicator and fastidious in his work. If anyone shows up to his office hoping to find a Dr. Feelgood, they will be sorely disappointed.
"There will be the doctor out there who will say, 'Sure, don't worry about it,' " Gittelman said. "And I'm sure there will be more cards signed by those people out there than from me."
As a family doctor, he sees a broad spectrum of patients, including people with terminal illnesses and severe, debilitating pain. People who have tried all traditional treatments and medicines and still suffer.
In those cases, the compassionate thing to do may be to let them try medical marijuana, Gittelman said.
"It's a crapshoot," he said. "I'm about as knowledgeable about it as you are because there is no medical evidence to support it. I'll be getting an education while they're getting an education."
But he doesn't want to run into legal trouble in the process. After hearing a lecture about what doctors can do to protect themselves from civil consequences, he had his lawyer draw up a form for patients to sign, releasing him from liability. If they don't sign it, he won't sign their recommendation.
Furthermore, if a patient is referred to him by a specialist for medical cannabis, Gittelman is asking those physicians to put that request in writing before he'll send them to a dispensary.
While he appreciates the state making the distinction between a prescription and a recommendation, he said the unusual arrangement could lead to an unusual problem. Typically, doctors specify in their prescriptions exactly what type of medicine the patient is getting, the dosage and how often they should take it.
That's not the case with medical marijuana, Gittelman said. The forms simply allow doctors to prescribe up to 120 grams of the drug at any one time. Everything else is left up to the discretion of patients and dispensaries, which, under currently law, are encouraged but aren't required to have medical directors on staff.
"The guy working at the dispensary could have been the night manager at Blockbuster for the last three years," Gittelman said.
Jameson said the cannabis commission is considering whether to make it mandatory for dispensaries to have clinical directors.
Gittelman said medical marijuana upends the traditional relationship between doctor and patient. He is accustomed to dispensing sound, evidence-based advice, and he can't do that with the newest drug at his disposal.
"People have an expectation that the physician has knowledge of the pros and cons of what they're prescribing, and that's not the case with medical cannabis," he said.
But it's a sacrifice he, if not many others in his shoes locally, is willing to make.
News Moderator: Ron Strider 420 MAGAZINE ®
Full Article: Medical marijuana: Shore medical community slow to embrace it
Author: Jeremy Cox
Contact: Contact Us | The Daily Times
Photo Credit: Tim McGivern
Website: DelmarvaNow.com - Home
But he can't say it won't help them either.
"I think since you're not going to die from cannabis," the Salisbury physician said, "it's reasonable to give people a chance to try it."
Not just anyone, mind you. Gittelman registered with Maryland regulators to be eligible to recommend the drug with his sickest patients in mind, he said.
Few of his counterparts have followed his lead on the Lower Shore. Gittelman is one of eight doctors and other medical providers based in one of the three counties who signed up as of late October, according to information obtained by the Salisbury Daily Times and DelmarvaNow through a public records request.
The Maryland Medical Cannabis Commission records list a total of 520 eligible medical providers statewide.
The region's dearth of participating doctors could lead to a clog in the medical marijuana pipeline, said Gene Ransom, CEO of MedChi, the state's professional association for physicians. But that's hard to know until the drug becomes available and patients start seeking it, he added.
"There will probably be pockets of Maryland that are disadvantaged," Ransom said.
He suspects the number of doctors actively seeing patients is much lower than 520, noting that several on the list are medical directors affiliated with marijuana businesses.
The first batch of medical cannabis is expected to hit the market some time before the end of the year, commission officials say. The state legalized the drug in 2013, but its rollout has been slowed by legal challenges and the effort of creating a multi-billion dollar industry from scratch.
Some fits and starts are to be expected even after the drug becomes available, said Patrick Jameson, executive director of the Maryland Medical Cannabis Commission.
"There has to be time for the industry to become operational," he said.
The state has permitted 14 growers, 12 processors and six dispensaries so far. Their fortunes, however, hinge on finding doctors willing to clear the way for patients to take a drug that is poorly understood and remains federally classified on par with cocaine and heroin.
As safe as possible
For its part, MedChi is trying to stay out of the debate over marijuana's medical merits while advocating on behalf of doctors who want to participate in the program.
"We have doctors who have positions all over the place on medical marijuana, so we have no official position," Ransom said. "So what we are trying to do is make it as safe, legal and easy as possible for the physicians to take advantage of the law."
To date, 29 states and the District of Columbia have legalized marijuana for medical purposes. Maryland's law limits its use to patients with certain documented conditions, including wasting syndrome, severe pain, glaucoma and post-traumatic stress disorder, among others.
Following the lead of other medical marijuana states, the Free State's law seeks to shield doctors from potential federal entanglements. Physicians write "recommendations" for the drug instead of "prescriptions" to skirt the federal prohibition on the practice.
"Any doctor that does this is taking a risk," Ransom said. "It's not legal under federal law."
So why chance it?
For one, the likelihood of prosecution for those who follow state law is almost nonexistent. The Justice Department has issued several memos informing its staff that cracking down on medical marijuana is a poor use of its limited resources.
Even if the window to criminal charges were completely shut, it wouldn't necessarily protect doctors from civil accusations of medical malpractice.
"It's a crapshoot"
That prospect weighed heavily on Gittelman's decision to sign up, he said.
Anyone who has ever been on the receiving end of his bedside manner knows he is a no-nonsense communicator and fastidious in his work. If anyone shows up to his office hoping to find a Dr. Feelgood, they will be sorely disappointed.
"There will be the doctor out there who will say, 'Sure, don't worry about it,' " Gittelman said. "And I'm sure there will be more cards signed by those people out there than from me."
As a family doctor, he sees a broad spectrum of patients, including people with terminal illnesses and severe, debilitating pain. People who have tried all traditional treatments and medicines and still suffer.
In those cases, the compassionate thing to do may be to let them try medical marijuana, Gittelman said.
"It's a crapshoot," he said. "I'm about as knowledgeable about it as you are because there is no medical evidence to support it. I'll be getting an education while they're getting an education."
But he doesn't want to run into legal trouble in the process. After hearing a lecture about what doctors can do to protect themselves from civil consequences, he had his lawyer draw up a form for patients to sign, releasing him from liability. If they don't sign it, he won't sign their recommendation.
Furthermore, if a patient is referred to him by a specialist for medical cannabis, Gittelman is asking those physicians to put that request in writing before he'll send them to a dispensary.
While he appreciates the state making the distinction between a prescription and a recommendation, he said the unusual arrangement could lead to an unusual problem. Typically, doctors specify in their prescriptions exactly what type of medicine the patient is getting, the dosage and how often they should take it.
That's not the case with medical marijuana, Gittelman said. The forms simply allow doctors to prescribe up to 120 grams of the drug at any one time. Everything else is left up to the discretion of patients and dispensaries, which, under currently law, are encouraged but aren't required to have medical directors on staff.
"The guy working at the dispensary could have been the night manager at Blockbuster for the last three years," Gittelman said.
Jameson said the cannabis commission is considering whether to make it mandatory for dispensaries to have clinical directors.
Gittelman said medical marijuana upends the traditional relationship between doctor and patient. He is accustomed to dispensing sound, evidence-based advice, and he can't do that with the newest drug at his disposal.
"People have an expectation that the physician has knowledge of the pros and cons of what they're prescribing, and that's not the case with medical cannabis," he said.
But it's a sacrifice he, if not many others in his shoes locally, is willing to make.
News Moderator: Ron Strider 420 MAGAZINE ®
Full Article: Medical marijuana: Shore medical community slow to embrace it
Author: Jeremy Cox
Contact: Contact Us | The Daily Times
Photo Credit: Tim McGivern
Website: DelmarvaNow.com - Home
