Pubdate: Thu, 16 Aug 2001 Source: Oregonian, The (OR) Copyright: 2001 The Oregonian Contact: http://www.oregonlive.com/ Details: http://www.mapinc.org/media/324 RESPECT PATIENT CONFIDENTIALITY Oregon officials acted appropriately in tightening up rules on medical marijuana, but the change goes too far. Nobody, not even the most ardent campaigner for Oregon's medical marijuana law, wants to open the way for a doctor mill churning out pot-user cards by the hundreds. That's why state officials have come up with a new rule physicians must follow when authorizing patients' requests for medical marijuana. One part of the rule makes perfectly good sense, but another part makes you wonder what the state rule-makers are smoking. Call it the Leveque Rule, for lack of a name. The change is entirely the result of the recent discovery that one doctor, 77 year old Molalla osteopath Phillip Leveque, had signed 40% of the approved applications under the Oregon Medical Marijuana Act that voters passed in 1988. An audit showed he had signed 890 of the approved application, and now the board of medical examiners is investigating an allegation that he signed one woman's request, "without first examining her, diagnosing her condition, charting (her) care, or conferring with any of her other providers," according to documents obtained by The Oregonian. The Leveque Rule's sensible part requires that a doctor who signs a patients request for medical pot must actually do some doctoring. In other words, there must be an "attending physician" relationship, which means the doctor "has reviewed a patient's medical records at the patient's request, has conducted a thorough physical examination... and documented theses activities in a patient file." Who could argue with that? Though worried that the change will create hardships for some patients, some of the original sponsors of the marijuana law say they have no fundamental objections to the new requirements. However, they feel quite the opposite, and rightly so, about a second part of the Leveque Rule. It allows officials of the Oregon Department of Human Services, which manages the medical marijuana program, to examine a patients file if they question an applications validity. Authors of the program say that's a blatant violation of medical privacy, and we agree. So does the Oregon Medical Association, the state's largest doctor group. "We certainly don't disagree with the intent of these changes, " says Bob Dernedde, executive director of the medical association. "But our position on the confidentiality of medical records is that it's not acceptable for third parties to wander in and start plowing through them. That's not only a violation of ethics, but its a violation of law." One solution that the doctors' group might support involves tweaking the application process. The way Oregon's new law is structured, physicians don't write prescriptions for the medical marijuana; rather, they sign applications, permitting qualified patients to grow and use marijuana for medical purposes. The applications could be amended to require patients to OK, in advance, possible scrutiny of their medical files. Making the ill give up their privacy privileges is not a remedy we would rush to embrace. Fortunately, though, the Leveque Rule is only temporary pending a public hearing this fall. that will afford plenty of opportunity for cautious debate of the confidentiality issue, which seems loaded with potential trouble for the state officials who run the new marijuana program. Until then, the should resist rummaging through confidential records of the patients of Dr. Phillip Leveque or any of the other 547 doctors who have signed applications for medical marijuana in Oregon. - --- MAP posted-by: Derek