As an experienced MD clinician who is a strong believer in the right of patients to obtain medical marijuana if it may provide relief for their specific medical condition, I was  interested in serving as a medical director for a non-profit that will be successful in obtaining a license to operate a dispensary from DHS later this year.  In addition, I was also looking forward to be able to write certifications for qualifying patients.  However, the language set forth in R9-17-312.E in the second (1/31) draft rules explicitly prohibited a medical director from providing certifications to any qualifying patients:

“A medical director shall not establish a physician-patient relationship or provide a  written certification for medical marijuana for a qualifying patient.”

I suppose DHS felt there might be a conflict of interest if a medical director also provided certifications to patients.  Perhaps the agency was concerned that a director might be tempted to act unprofessionally and provide a certification to an unqualified patient in order to drum up business for the dispensary for which he or she was associated – a very unlikely scenario.

So, you can imagine my delight when I read the final rules that seemed to do away with this unnecessary prohibition.  The corresponding rule, R9-17-313.E, no longer states that a medical director cannot have a physician-patient relationship nor provide certifications for any patients qualifying for marijuana as in the prior draft.  The current rule appears to just prohibit the medical director from writing certifications for qualifying patients who would obtain marijuana from “the dispensary” for which he or she serves as director:

“A medical director for a dispensary shall not provide a written certification for medical marijuana for a qualifying patient obtaining medical marijuana from the dispensary”

But my delight soon turned to confusion when I read this specific answer to one of the FAQ’s on the DHS website:

“What will a dispensary’s medical director do? The duties of a dispensary’s medical director include developing information and training for dispensary agents and customers. A medical director is not permitted by the rules to provide written certifications for medical marijuana.”

Any reasonable interpretation of R-9-17-313.E would conclude that the phrase “the dispensary” means the dispensary for which the medical director works.  For the FAQ to be accurate, the phrase “the dispensary” in the rule would have to mean any dispensary in Arizona.  If, indeed, this were the intention of DHS, then why would it change the language in the second draft rule which was so clear about such a prohibition and left no room for interpretation?

Clearly, this is a matter that needs to be clarified for those physicians, like myself, who would like to serve as a dispensary medical director and also provide written certifications for qualifying patients.

Jason E. Gittman, MD

[email protected]