Pubdate: Sat, 27 Jul 2013
Source: National Post (Canada)
Copyright: 2013 Canwest Publishing Inc.
Contact: http://drugsense.org/url/wEtbT4yU
Website: http://www.nationalpost.com/
Details: http://www.mapinc.org/media/286
Author: Tom Blackwell

UP IN SMOKE

Rob Kamermans was tending to a sick toddler in the emergency ward of 
the Sturgeon Falls, Ont., hospital last summer, when they came to get him.

As astonished staff and patients looked on, two Ontario Provincial 
Police (OPP) officers arrested the 67-year-old doctor and charged him 
with multiple counts of fraud, forgery and money laundering.

Clasping handcuffs around his wrists, they led away the ER's only 
physician, capping a short, extraordinary chapter in Canada's tangled 
experiment with medical marijuana.

What had piqued the investigators' interest was Dr. Kamermans' 
unofficial reign as Canada's foremost medical-marijuana physician - a 
role he says he never asked for, or wanted. Mostly in the course of 
one year, he signed 4,000 of the forms Health Canada required to let 
patients consume or grow an otherwise illicit plant. At the time, 
just 13,000 of the forms had been signed in total across the country. 
The physician from a town of just a few hundred people, 90 minutes 
northeast of Peterborough, Ont., had become, either deliberately - if 
you believe the criminal charges - or accidentally (if you believe 
the physician), Canada's most prominent provider of medical pot.

Despite telling patients not to spread the word, demand for his 
signature grew so great that he would find as many as 30 patients at 
a time lined up at his homey practice in the Ontario hamlet of Coe 
Hill. He eventually ran pot clinics from hotel rooms in Montreal, 
Halifax and Miramichi, N.B.

"He changed the landscape of medical marijuana in Canada," said Adam 
Greenblatt of the Medical Cannabis Access Society, a dispensary in 
Montreal. "[But] it just got out of control for him. It hit a point 
where everybody knew about him ... He was just inundated with patients."

To those who had been turned away by other physicians, Dr. Kamermans 
was a "God, an angel from heaven," said Mr. Greenblatt. To the 
police, he is an alleged fraudster who endorsed patients ineligible 
for the controversial treatment - while charging them a tidy $100 to 
$250 each for the service.

Officers laid the same charges against his wife, Mary, the clinic's 
nurse, even though the Health Canada marijuana forms can only be 
signed by a doctor. In Halifax, the RCMP charged him with two counts 
of attempted trafficking.

Sgt. Kristine Rae, an OPP spokeswoman, said she could not comment on 
details of the alleged offences.

Dr. Kamermans admits freely that he earned between $650,000 and 
$700,000 - netting about $500,000 after expenses - from signing the 
marijuana forms. But he says he did it because of a deep-seated 
belief that the drug was a safe and effective treatment.

Medical marijuana, he said, often enabled his patients to get off 
OxyContin, Percocet and other narcotic painkillers, legal 
prescription drugs that claim the lives of hundreds of people across 
Canada every year through overdose, and leave thousands more addicted.

A 2000 Ontario Court of Appeal decision, on the other hand, concluded 
there was no record of anyone ever suffering a fatal pot overdose.

"I felt 'I'm doing the right thing.' I was just surprised that no 
other doctors would do it," he said in an interview. "I never really 
clued in to the money part, because I was so busy."

Ironically, he said he has never been a pot smoker himself, having 
tried it as a young man but was left unimpressed.

In his uniform of faded jeans, T-shirt and a single earring, his long 
grey hair tied in a ponytail, Dr. Kamermans nevertheless looks the 
part of the aging hippie, and has a colourful life story to match.

The son of Dutch immigrants to Canada, he worked in construction as a 
young man and then, after meeting Mary, embarked on a voyage of 
self-discovery that seems almost a cliche of the flower-power era.

Travelling through Canada and the U.S., the couple lived for three 
years out of a "teepee," said Dr. Kamermans, ending up staying and 
doing volunteer work at a Carmelite monastery in California for 
another three years. The nuns, he said, remain "our closest and 
dearest friends." Along the way, they had five children, in addition 
to his two from a previous marriage.

He made the surprising decision in his late thirties to become a 
physician and by 1994, at age 48, had achieved his goal and begun 
practicing. Mary, meanwhile, became a nurse.

After years of working in both the U.S. and Ontario, they set up the 
family practice in eastern Ontario's Coe Hill, about 90 kilometres 
north of Belleville, in 2008.

Largely serving a high-needs, marginalized caseload, the clinic has 
always operated at a loss, said the physician. He took work at 
emergency departments at various nearby hospitals to make up the shortfall.

Under a 2001 federal law, patients wanting medical marijuana first 
had to convince a doctor to sign a form verifying that they suffered 
from one of the qualifying conditions, including cancer, severe 
arthritis, multiple sclerosis and epilepsy. Health Canada, though, 
issued the actual permit that allowed patients to possess and grow the plant.

A recent overhaul of the system puts the onus on physicians to 
essentially prescribe marijuana, with Health Canada regulating only 
licensed marijuana producers.

Long convinced that opioids like OxyContin were a poor way to manage 
pain, and won over by the evidence in favour of cannabis as a safer 
alternative, Dr. Kamermans said he signed a few of the marijuana 
forms in 2009. In 2010, he signed another 100. He told patients not 
to advertise his services, but word nevertheless got around, and in 
2011 "the dam burst," he said, as people from all over Ontario and 
other provinces began making the trip up to the Coe Hill's 
cottage-country location to see the marijuana-approving doctor.

With some of them arriving in wheelchairs or even ambulances, it was 
like a scene from the Lourdes shrine in France, said Barb Shaw, a 
friend and local journalist.

"I was just as shocked as anybody," said Dr. Kamermans.

They were all patients with legitimate pain, he maintains, most of 
them aged 45 to 65, suffering from arthritis or other forms of severe 
pain. Then, as he began to field calls from interested patients from 
outside the province, he decided to take his services on the road, 
seeing as many as 80 patients a day in Halifax.

He said he charged $100 for forms signed in Coe Hill, and $250 when 
he travelled, because of the added costs. That was in addition to the 
standard consultation fees he billed to medicare for patients he saw 
in Ontario. It is common for physicians to charge fees for filling 
out forms and other clerical chores not covered by medicare.

Among those who visited him was Peter Faux, 60, a pig and chicken 
farmer from near Peterborough, Ont., with debilitating arthritis 
pain. He says the pot he now grows is a godsend. He considered Dr. 
Kamermans' fees reasonable, noting that he knows of other physicians 
who charge as much as $1,000.

"You couldn't ask for a better doctor," said Mr. Faux. "It's just 
outrageous what they're doing to him."

Dr. Kamermans receives similarly glowing testimonials on the website 
ratemds.com, where patients post reviews of doctors.

Yet the fees for signing marijuana forms did rankle some of Dr. 
Kamermans' patients. "They seemed exorbitant," said Matt Mernagh, a 
prominent medical-pot activist. "Part of me feels that he's been 
thrown under the bus. Part of me feels, 'You kind of did it to yourself.' "

Earlier this year, meanwhile, the College of Physicians and Surgeons 
found the doctor guilty of misconduct for unrelated matters, 
including inadequate record-keeping, failure to monitor some 
patients' high blood pressure, and not referring one such patient for 
emergency treatment. Dr. Kamermans said the transgressions all stem 
from poor patient charting, a shortcoming he said he is making 
strides to correct.

But while the doctors' college was focused on Dr. Kamermans' 
attentiveness, police were paying increasing attention to Canada's 
medical marijuana program. They publicly warned that it was being 
exploited by criminals who obtained Health Canada permits and then 
grew plants for the street trade.

Dr. Kamermans doesn't believe he was exploited by dealers or 
recreational users, but he concedes that he generally took his 
patients' word for the fact that they were suffering. It is not a 
doctor's role to refute symptoms reported by patients, he said.

Eventually, though, the authorities began looking at his activities. 
Ontario's College of Physicians and Surgeons told him it was 
investigating his marijuana consultations, and he stopped signing the 
forms by the end of 2011. Worse was to come.

On the morning of Jan. 26, 2012, about 20 OPP officers descended on 
the Coe Hill clinic, handcuffing Dr. Kamermans and taking him away 
for hours of interrogation.

Mr. Faux was there that day and said he watched aghast as officers 
leafed through patient files in the waiting room. No charges were 
laid at the time, but police hauled away 4,100 medical charts, 
refusing to return copies of them until months later, said Dr. Kamermans.

It was August of last year when two officers finally came to arrest 
the physician. The charges include six counts of forgery for the 
allegedly bogus marijuana forms, three counts of fraud for allegedly 
billing Ontario's medicare agency for "services not rendered," one of 
possession of the proceeds of crime and one of money laundering.

Police seized $60,000 in cash that Dr. Kamermans said belonged to his 
daughter, and later revoked the physician's bail when he tried to 
transfer money to New Mexico to make mortgage payments on a 
family-owned property there, he said.

The bail breach landed him in jail for three days.

Earlier this year, the college itself laid several disciplinary 
charges related to the marijuana work.

Dr. Kamermans believes he is being prosecuted, essentially, for doing 
the right thing, though he also complains about police tactics that 
he said gratuitously invaded patients' privacy, and needlessly 
endangered Sturgeon Falls residents when his arrest left their 
emergency department without a doctor.

Sgt. Rae said she does not know enough about the circumstances of the 
arrest or photo surveillance of the clinic to comment, but said the 
patient files were seized under a court-approved search warrant and 
that they took considerable time to peruse.

Meanwhile, at an age when most Canadians are looking to retire, Dr. 
Kamermans said he has been cut out of the emergency-department work 
that provided most of his income. He will have to sell the Coe Hill 
clinic buildings. And, along with his wife, he says he is now 
suffering post-traumatic stress.

"Mary is seething with anger most of the time," he said. "It's just 
horrible. They feel they can trash your life."
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