Last updated on: 6/5/2008 12:38:00 PM PST
What Are Some of the Suggested Guidelines for Physicians Who Recommend Medical Marijuana?


General Reference (not clearly pro or con)
The California Medical Association (CMA) stated in its July 2003 "Medical Marijuana Guidelines":

"Any physician who recommend the use of marijuana by a patient should have arrived at that decision in accordance with accepted standards of medical responsibility, i.e., history and physical examination of the patient; development of a treatment plan with objectives; provision of informed consent, including discussion of side effects; periodic review of the treatment's efficacy, and, of critical importance, proper record keeping that supports the decision to recommend the use of marijuana.

However, the Board recognizes that these principles may require further elaboration to take into account the factors that may affect the physician-patient relationship in this context."

[Editor's Note: For more information about approved conditions and possession limits, see our page on state medical marijuana laws and guidelines.]

July 2003 - California Medical Association 

David Bearman, MD, Physician and medical marijuana expert, told ProCon.org in a Mar. 1, 2006 phone interview:

"My screening process begins with the initial phone call. We discuss with the caller their condition and make a determination if they qualify for medical marijuana. The condition must be serious enough, and they generally must have documentation.

If someone comes in missing a leg then I don't obviously don't need documentation, but if they claim to be suffering from something such as migraines, I'll want proof of that condition. I'll need to know what other doctors they've seen, how frequently, and what treatment they've attempted. The condition must be serious and the patient must take their condition seriously.

I approach this like a doctor. I see each patient for about an hour, and go over with them all the other things they can do in addition to or in place of marijuana."

Mar. 1, 2006 - David L. Bearman, MD 

Frank Lucido, MD, member of Physicians for Social Responsibility, stated in his article "Implementation of the Compassionate Use Act In a Family Medical Practice," published Spring 2004 in the journal O'Shaughnessy's:

"I have developed (and continue to refine) standards for the recommendation of medical cannabis in my own practice, reflecting my quarter century as a Board certified Family Physician providing primary health care. These are my own standards and should not be construed as criteria for any other physician practicing within the scope of his or her training and license.

General Requirements:

  1. The patient should have a current source of primary care -- a Primary Care Provider (PCP) -- whom he or she sees regularly.

  2. The patient should be seen regularly for the serious illness or symptoms for which medical cannabis is used, by either the PCP or by a specialist, chiropractor, or other health practitioner of the patient's choice. These requirements accomplish two important objectives:
    • Affirming that the patient has access to primary care.

    • Clarifying my role as a consulting physician, and not the primary care practitioner (a common misunderstanding).
Phone Screening

Patients calling for a medical cannabis evaluation are screened by phone to make sure they understand my requirements prior to being given an initial appointment, and to eliminate those who clearly do not qualify.

Pre-Appointment

A 45-minute appointment is schedule for new patients... The patient is mailed a detailed questionnaire, along with release forms...

Appointment

The medical cannabis evaluation is conducted in a face-to-face office visit, which includes the collection of relevant history, problem-specific physical exam, and review of the completed questionnaire and outside medical records...

Pros and cons of medical cannabis use are discussed with the patient, and informed consent documents are reviewed and signed....

Based on all of the above, a decision is reached on whether or not to recommend cannabis to the patient.

Limited approval -- for three months or less -- may be given in cases where there exists some documentation or physical evidence of a serious illness for which cannabis might be beneficial, but more recent records are required and/or expected to arrive.

Follow-Up

Appropriate follow-up appointments are arranged for patients receiving [cannabis] recommendations. Yearly re-evaluation is a minimum."

Spring 2004 - Frank Lucido, MD