Pubdate: Fri, 06 Jul 2001 Source: Register-Guard, The (OR) Copyright: 2001 The Register-Guard Contact: http://www.registerguard.com/ Details: http://www.mapinc.org/media/362 Author: Bill Bishop, The Register-Guard Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal) BOARD PROBES MARIJUANA APPROVALS A Portland area doctor has signed almost 40 percent of the approved applications for medical marijuana users in the state and is under investigation by the Oregon Board of Medical Examiners. At the same time, state officials are moving to tighten rules governing when a doctor can sign off on a patient's application for the medical marijuana program. The large number of signatures by one doctor raises concerns about who is getting the cards and for what purpose. The doctor himself said he's filling a gap because other doctors will not participate in the program for fear of prosecution and professional repercussions. Many of his patients also are veterans who cannot get help from their government-employed doctors, he said. Since the program's inception 2 1/2 years ago, 2,227 Oregonians have obtained cards permitting them to use marijuana to treat a medical condition specifically covered by the law. Of the state's 7,000 doctors, 538 have signed paperwork necessary for a patient to get a card. Only 13 Oregon doctors have signed 10 or more medical marijuana applications. One of them, the Portland area doctor, signed for 890 patients, according to the latest state data on the program. The second most active physician in the state signed for 71 patients. The state released the numbers after a public records request by The Register-Guard. The doctor's name was not part of the information provided by the state because the 1998 medical marijuana law requires officials to protect the names of all doctors and patients who participate in the program. The newspaper learned the doctor's identity independently, but agreed not to publish his name because of his concern about receiving an unmanageable flood of doctor referrals and private requests for help to enter the program. Bruce Johnson, a spokesman for the state Board of Medical Examiners, said he cannot comment on whether the agency is investigating the doctor. So far, no Oregon physician has been disciplined for conduct related to the medical marijuana law, Johnson said. But the 77-year-old doctor confirmed Thursday that he is under investigation for not meeting professional standards as an "attending physician." He said he sees "95 percent" of his medical marijuana patients and reviews every patient's records before signing applications, but he does not have a long-term relationship with the patients. He does not charge for the exams and is not enrolled in the program himself, he said. "I am helping people because I am in a similar position," he said. "I can truly empathize with these people." He is a World War II combat veteran and has suffered chronic pain from prostate surgery eight years ago, he said. He is barely able to walk, cannot maintain an office practice and takes a triple dose of sleeping pills to rest every night, he said. He has followed the requirements of the voter-passed medical marijuana law and believes that federal agencies are pressuring Oregon officials to limit participation in the program, he said. "I think it is absolutely terrible that most physicians in Oregon are absolutely, totally fearful of what the DEA (Drug Enforcement Administration) or the Oregon Board of Medical Examiners might do to them," he said. The state has received no federal pressure to curtail the program, said Mac Prichard, spokesman for the Oregon Department of Human Services, which oversees the medical marijuana program. State officials have long been aware of the disproportionate number of patients served by the doctor, Prichard said. Nothing in the marijuana act nor in Oregon law limits the number of patients a doctor can serve, he said. The agency is proposing a new rule to require doctors to verify that they have an ongoing doctor-patient relationship before they may help a patient enter the program, he said. The proposed rule is intended to standardize the system, not reduce the number of patients the doctor can serve, he said. "There was no link between this issue and the proposed rule change," Prichard said. "This rule only verifies that the physician is following a standard procedure in the medical world. We don't expect it to have any effect on the number of doctors participating in the program." The revelation about the Portland area doctor is the latest to test the medical marijuana program. The state last month demoted the program's director and began an investigation after discovering three forged signatures on approved applications and four other forged signatures on pending applications. All seven forgeries were of the Portland area doctor's name. The doctor said he discovered the identity of the forger and told the Oregon State Police. Results of an investigation have been turned over to district attorneys in Clackamas and Multnomah counties for potential criminal prosecution, state police spokesman Gregg Hastings said. An internal audit ordered when the forgeries were discovered found that the medical marijuana program staff kept no written records of their efforts to verify physicians' signatures. The audit also found other shortcomings and called for more staffing and management controls to reduce the backlog of applications. Supporters of the medical marijuana law said the rules change and the investigation of the Portland area doctor will discourage other doctors from participating in the program. "If both agencies are coming after him like this, then it certainly would have a chilling effect on the program," said Leland Berger, a Portland lawyer who helped write the medical marijuana initiative. A medical marijuana card must be renewed annually, requiring each participant to again get a doctor's opinion about the need for the treatment, according to state regulations. "I am not fearful for myself," the Portland area doctor said. "I am fearful for those 800 people who cannot get help." He said he is especially concerned about veterans receiving proper care because Veterans Affairs policy bars the agency's doctors from participating in Oregon's medical marijuana program. John Sajo, director of Voter Power, a citizen group that helped draft the law, said his group is grateful that the doctor is willing to help so many patients whose regular doctors refused to sign paperwork for the program. "From my perspective, the doctor is a hero," Sajo said. "Where is the problem. Where is the patient who had some adverse health effect. It seems they are putting a lot of effort into solving a problem that doesn't exist and at every level making it as difficult as possible on the patient." His group routinely refers patients to the doctor because other physicians refuse to sign necessary forms, even though they tell the patient to use illegally obtained marijuana as a treatment, Sajo said. Oregon Medical Association spokesman Jim Kronenberg said most Oregon physicians specialize in areas in which they are not likely to treat patients whose conditions qualify them for the medical marijuana program. Among the cancer and nerve disease specialists who do treat such patients, a few doctors feel strongly one way or the other about the program, but most have never been asked for the help, he said. The majority of people who phone the medical association for information about the program are veterans, he said. Given the other challenges of the medical profession - for example, regulations concerning the state's doctor-assisted suicide law - the medical marijuana program does not intimidate doctors, Kronenberg said. "There is a lot less emotion and trepidation by physicians than the public appreciates. I disagree that physicians are at all afraid of it," he said. "Legally, technically, the DEA or FBI could try to prosecute. Practically speaking, the chances are so remote, it's not an issue." Medical Marijuana Program Who qualifies: The law identifies specific medical conditions for which marijuana may prove beneficial to a patient. To qualify, a patient must obtain a doctor's signature on a statement acknowledging that the patient suffers from the condition and may be helped by the drug. What's the cost: The patient must submit the doctor's signature, complete other paperwork and pay a $150 fee to apply. If approved, the patient or his/her caregiver may grow a designated number of plants for medicinal use, or may possess a specific amount of dried marijuana. Who does this: Oregon and eight other states now allow use of medical marijuana. Federal law continues to view it as a drug with no legitimate use. In Lane County Lane County residents hold 363, or 16 percent, of the state's 2,227 medical marijuana cards. Eugene: 187 Springfield: 50 Cottage Grove/Creswell: 29 Florence: 27 Blachly/Deadwood/Greenleaf/Horton: 20 Dexter/Lowell/Fall Creek: 17 Veneta/Elmira: 12 Oakridge: 7 Junction City/Cheshire: 7 Marcola: 4 Walton: 2 Pleasant Hill: 1 - --- MAP posted-by: Josh Sutcliffe