Pubdate: Sat, 04 Jun 2016
Source: Boston Globe (MA)
Copyright: 2016 Globe Newspaper Company
Contact: http://services.bostonglobe.com/news/opeds/letter.aspx?id=6340
Website: http://bostonglobe.com/
Details: http://www.mapinc.org/media/52
Author: Felice J. Freyer, Globe Staff

MEDICAL MARIJUANA DOCTOR LOSES LICENSE TO PRACTICE

The state has pulled the license of Dr. Tyrone S. Cushing, accusing 
him of recommending medical marijuana in 2013 for a visibly pregnant 
woman with a history of substance abuse.

Cushing, who worked at CannaMed, a medical marijuana consultant 
service in Framingham, is the second doctor in recent days to have 
his license summarily suspended for improperly certifying patients as 
eligible to receive medical marijuana.

In its summary suspension order Thursday, the Board of Registration 
in Medicine described Cushing as the state's "third-highest provider 
of medical marijuana certificates," having issued 4,649 certificates 
as of May 20 while working only two days a week. Cushing acknowledged 
he did not conduct any physical examination or obtain vital signs of 
any patients, and may have certified many pregnant women, according 
to the order.

Last week, the board summarily suspended the license of Dr. John C. 
Nadolny, saying he had signed 5,792 certificates without having a 
physician-patient relationship with the patients, as required by 
state law, and often delegated the work to nurse practitioners.

In a summary suspension, the board suspends a license without a 
hearing after finding that the doctor poses an immediate and serious 
threat to the public health, safety, and welfare. Suspended doctors 
must stop practicing but may request a hearing.

Cushing and Nadolny work in medical practices with the sole purpose 
of providing certificates that permit people to possess marijuana for 
medical purposes. Nadolny was medical director of Canna Care Docs, 
which has offices in seven states, including eight in Massachusetts.

CannaMed, where Cushing worked, has an office in Framingham and three 
in California.

In order to sign a medical marijuana certificate, a doctor must 
conduct a clinical visit, obtain medical history, explain the 
potential benefits and risks, and have a role in the continuing care 
of the patient, according to the state Department of Public Health.

The board's action against Cushing focused on a case that resulted 
from a complaint from a Department of Children and Families 
caseworker in August 2013. Asked why the board did not act sooner, 
Dr. Candace Lapidus Sloane, board chairwoman, said she could not 
comment because it is an active investigation.

According to the order, Cushing signed a one-year certificate for a 
patient who was seven months pregnant and who had received treatment 
for opioid addiction. The order stated that he failed to discuss 
treatment alternatives, the risks associated with using marijuana 
along with other drugs, her use of opioids and Prozac, her "admitted 
prior use of recreational marijuana," or the risks of marijuana use 
during or after pregnancy. He did not follow up with her 
obstetrician, her primary care doctor, her mental health provider, or 
her substance abuse treatment provider, according to the order.

Cushing did not reply to a voicemail message left at his home. A man 
who answered the phone at CannaMed but who would not identify himself 
said that "nobody's commenting right now."
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MAP posted-by: Jay Bergstrom