by James Mc Cready, Managing Director
Arizona Medical Marijuana Medical Directors
The Arizona Department of Health and its director Bill Humble have made a tremendous step forward in the use of Medical Directors to assist in the application process and ongoing management of the Medical Marijuana Dispensaries; to be opened in Arizona, in 2011. Their efforts should ensure the first true “Medical Marijuana” program is established in Arizona.
The Arizona Department of Health has provided a number of important control mechanisms for the Dispensary Applications Process. We believe these steps are necessary to provide a complete and fair mechanism for Dispensary Certification. These measures will ensure the Dispensaries receiving certificates will provide the “Qualifying Patients”, “Designated Caregivers”, the citizens of Arizona, and the State Government of Arizona with the necessary guarantees of Ownership Qualification, Business Operation, Inventory Control, Security, Patient Record Keeping, Education and Support required by the new law.
Medical Directors will be an integral part of the Dispensary Application Process and subsequent Dispensary Operation. For the purposes of our discussion we will focus on the Dispensary Application Process only.
If you are applying for an Arizona Medical Marijuana Dispensary Certificate you will need a Medical Director before you send your application to the Arizona Department of Health. Here are the things you need to know according to Draft 01/31/11 (Remember the Final Draft will be out 3/28/11 and will give us the final word on these requirements):
1. The Medical Director must be an: Medical Doctor, Naturopathic Medical Doctor, Doctor of Osteopathy, or a Homeopathic Medical Doctor with an active Arizona License Number, which you will need to include on your application (Conversation with AZ Dept. of Health).
a. If you are a physician considering becoming a Medical Director. We are recommending to our physicians not to provide their name or license # for application process; UNLESS there is an independent contractor agreement in effect. We are also recommending other specific terms to protect the physician and dispensary, which are outside the scope of this article.
2. The Medical Director can not establish a doctor patient relationship with or provide a written certification for medical marijuana for a qualifying person (R9-17-312 E).
a. If you a re a physician considering becoming a Medical Director. We are recommending to our physicians not to provide a written certification for medical marijuana for any qualifying person. In other words if you are going to become a Medical Director you can not prescribe Medical Marijuana. This is an extremely important consideration. This will have to be a section in your independent contractor agreement. If the Dispensary losses it’s certificate to operate due to your prescription activities. You would be held responsible for the loss of the business. The cost to you would tremendous to you professionally and financially.
3. The Medical Director will need to provide “Policies and procedures that comply with the requirements in this chapter (R9-17-303) for:
a. Qualifying patient recording keeping (for further details see R9-17-312 C and R9-17-312 C)
b. Patient education and support (for further details see R9-17-312 C and R9-17-312 C)
If you a re a physician considering becoming a Medical Director here is what you will need to develop for your Dispensary:
1. Develop and provide training to the dispensary’s dispensary agents at least once every 12 months from the initial date of the dispensary’s registration certificate on the following subjects:
a. Guidelines for providing information to qualifying patients related to risks, benefits, and sides effects associated with medical marijuana.
b. Guidelines for providing support to qualifying patients related to the qualifying patient’s self-assessment of the qualifying patient’s symptoms including a rating scale for pain, cachexia or wasting syndrome, nausea, seizures, muscle spasms, and agitation.
c. Recognizing signs and symptoms for substance abuse.
d. Guidelines for refusing to provide medical marijuana to an individual who appears to be impaired or abusing medical marijuana.
2. Assist in the development and implementation of review and improvement processes for patient education and support provided by the dispensary.
3. Educational materials for qualifying patients and designated caregivers that include:
a. Alternative medical options for the qualifying patient’s debilitating medical condition.
b. Information about possible side effects of and contraindications for medical marijuana including possible impairment with use and operation of a motor vehicle or heavy machinery, when caring for children, or of job performance.
c. Guidelines for notifying the physician who provided the written certification for medical marijuana if side effects or contraindications occur.
d. A description of the potential for differing strengths of medical marijuana strains and products.
e. Information about potential drug-drug interactions, including interactions with alcohol, prescription drugs, non-prescription drugs, and supplements.
f. Techniques for the use of medical marijuana and marijuana paraphernalia.
g. Information about different methods, forms, and routes of medical marijuana administration.
h. Signs and symptoms of substance abuse, including tolerance, dependency, and withdrawal.
i. A listing of substance abuse programs and referral information;
4. A system for a qualifying patient or the qualifying patient’s designated caregiver to document the qualifying patient’s pain, cachexia or wasting syndrome, nausea, seizures, muscle spasms, or agitation that includes:
a. A log book, maintained by the qualifying patient and or the qualifying patient’s designated caregiver, to track the use and effects of specific medical marijuana strains and products.
b. A rating scale for pain, cachexia or wasting syndrome, nausea, seizures, muscles spasms, and agitation.
c. Guidelines for the qualifying patient’s self-assessment or, if applicable, assessment of the qualifying patient by the qualifying patient’s designated caregiver.
d. Guidelines for reporting usage and symptoms to the recommending physician providing the written certification for medical marijuana and any other treating physicians.
5. Policies and procedures for refusing to provide medical marijuana to an individual who appears to be impaired or abusing medical marijuana.
Our next article will deal specifically with the Legal Exposures and problems you will have as an Arizona Medical Marijuana Dispensary Medical Director. We will also discuss some possible solutions. However, as a licensed Physician you know that some challenges in practice are only resolved by a different and larger insurance policy.
If you are considering applying for Medical Marijuana Dispensary Certificate or a Physician looking to become a Medical Director as contact us Arizona Medical Marijuana Medical Directors (AZMMMD) at 602 578-4385. We offer a FREE Consultation to discuss your particular concerns.
James Mc Cready, Managing Director
Arizona Medical Marijuana Medical Directors