Pubdate: Sun, 29 Nov 2015
Source: Chico Enterprise-Record (CA)
Copyright: 2015 Chico Enterprise-Record
Note: Letters from newspaper's circulation area receive publishing priority
Author: Carla K. Johnson, Associated Press Medical Writer


Chicago (AP) - The green-typeface slogan "WE'ED like to be your 
doctor!" - unmistakably weed-friendly - has attracted hundreds of 
medical marijuana patients in less than a year to Dr. Bodo 
Schneider's clinics in southern Illinois and suburban Chicago.

In New Jersey, Dr. Anthony Anzalone has a similar following at his 
three clinics, marketed online with a marijuana leaf logo and a 
"DrMarijuanaNJ" web address.

The two marijuana-friendly doctors in states with similar laws face 
starkly different treatment by government regulators. When it comes 
to oversight of boundary-pushing doctors, enforcement practices vary 
in the 23 states allowing medical cannabis.

Illinois has taken a tough posture. Schneider, a former emergency 
room doctor, may get his license revoked in a medical board case 
getting underway Tuesday. Accused of charging patients for marijuana 
recommendations without a legitimate doctor-patient relationship, 
he's the third Illinois physician to face punishment related to 
medical marijuana in a state where legal sales only started this month.

"I understand why they don't want everybody and their uncle opening 
up a marijuana stand," said Schneider's attorney, Luke Baumstark. 
"But I think the regulators have gone after a very high percentage of 
the people who have tried to use this law at all. It's over-aggressive."

New Jersey has taken no disciplinary action against Anzalone, a 
gynecologist, or any other doctor related to medical marijuana since 
sales started three years ago, according to Jeff Lamm, spokesman for 
the state's Board of Medical Examiners.

"The state's been very good to me," Anzalone said in a phone 
interview. "We're complying with the law as best we can. ... All I'm 
doing is the job other doctors don't want to do."

Indeed, pot doctors fill a void left by physicians unfamiliar with 
marijuana's health benefits and fearful of endorsing what the federal 
government regards as a controlled substance, cannabis advocates say.

Schneider is a "godsend to patients" in southern Illinois, where two 
major health care organizations actively prevent their doctors from 
recommending marijuana, said Dan Linn of the Illinois chapter of the 
National Organization for the Reform of Marijuana Laws.

Writing a law to restrict how doctors recommend marijuana is tricky. 
Lawmakers in Illinois, New Jersey and other states have tried to 
avoid California's drop-in, instant exams by attempting to define in 
legislation a legitimate doctor-patient relationship. Laws commonly 
call for a "bona fide" relationship with a physical exam and review 
of medical records. New Jersey doctors must register in a publicly 
viewable database and take courses in addiction medicine and pain management.

Even in two more tolerant states - Colorado and California - how 
governments oversee pot doctors has become an issue.

In Colorado, where medical marijuana has been legal since 2000, more 
than 115,000 people hold medical recommendations because they're 
either too young to buy recreational pot or because they prefer a 
lower tax rate and higher possession limits. Colorado health 
authorities have grappled for years with ways to curb suspect pot 

Colorado physicians are barred from working out of dispensaries or 
having any financial stake in the marijuana business. As in other 
states, they're required to examine patients in person once a year.

The Colorado Medical Board says it has sanctioned at least six 
physicians since 2009 for violating pot regulations, though details 
of those cases aren't public. In 2013, one physician received three 
years' probation after being convicted of making an improper pot 
recommendation to an undercover police officer.

In notoriously permissive California, a "Get Baked Sale" of marijuana 
food products in June had doctors on hand to provide on-the-spot 
patient recommendations. The state, which was the first to legalize 
medical cannabis, has disciplined only eight doctors in 20 years for 
improper marijuana recommendations.

California's laid-back approach may change. The state recently 
enacted legislation to require the Medical Board to crack down on 
doctors who write recommendations without a proper patient exam or 
valid medical reason.

In Illinois, regulators alerted doctors soon after the medical 
marijuana law passed in 2013 that one doctor shouldn't set up shop to 
treat all the eligible medical conditions, which range from glaucoma 
to HIV and cancer.

"The Department will continue to closely scrutinize instances where a 
physician's practice exists solely to offer medical cannabis 
certifications," said Terry Horstman, spokesman for the Illinois 
Department of Financial and Professional Regulation.

Supporters fear that Illinois' harsh stance discourages mainstream 
doctors from participating and that this pushes patients into the 
arms of a few pot doctors who may be unmotivated to follow up on 
patients' overall health concerns.

Said Chris Lindsey of the Marijuana Policy Project, a national group 
that supports legally regulated marijuana: "Having a few well-known 
clinics in the state that clearly follow the rules can be a valuable 
resource, both to patients who otherwise have few options, and for 
doctors who would prefer to make a referral."
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MAP posted-by: Jay Bergstrom