By Gene Davis, DENVER DAILY NEWS
The Colorado Medical Society is siding with the Colorado Department of Public Health and Environment in their charge for requiring a stronger bona fide physician-patient relationship before a doctor certifies someone for medical marijuana.
Following the release of data showing that a small minority of doctors is responsible for recommending medical marijuana to a vast majority of patients, the Colorado Department of Public Health and Environment last week called on lawmakers to craft legislation that would crack down on so-called fraud and abuse.
As of last Tuesday, a total of 820 licensed physicians had authorized medical marijuana for 15,800 patients, according to the Medical Marijuana Registry. Of those 820 physicians, only 15 accounted for 73 percent of total patients, and five had authorized 49 percent of all recommendations. There are currently around 29,000 people who have submitted the necessary applications to be included on the state’s medical marijuana.
“It is concerning to us that a handful of physicians have certified the majority of medical marijuana patients, and it seems indicative of the ‘wild west’ nature of the business that has sprung up,” said Edie Sonn, senior director of the Colorado Medical Society.
Sonn said that the Colorado Medical Society, the group that advocates for doctors and patients, is in the process of formulating guiding principles to shape their position on proposed medical marijuana regulation. Sonn said the group is looking at the guiding principles from the standpoint of what’s best to protect patient safety.
“From that basis, then, requiring a bona fide physician-patient relationship before certifying someone as needing medical marijuana is appropriate, logical, and good for patients,” he said.
The Colorado Department of Public Health and Environment (CDPHE) believes that the few doctors providing the majority of medical marijuana recommendations raises concern about the medical care being provided to patients. In turn, the department is pushing to make statutory language changes that would clarify what constitutes a bona fide physician-patient relationship.
“These figures are representative of the concerns we have about whether some physicians really have a bona fide physician-patient relationship, as required in the constitution, with those for whom they are authorizing the use of marijuana,” said a statement last week from Chief Medical Officer Ned Calonge.
Meanwhile, advocates for medical marijuana slammed the CDPHE for taking the wrong approach.
Laura Kriho of the Cannabis Therapy Institute argued that just as doctors in Colorado specialize in niche procedures like brain surgery, others are finding a niche working with medical marijuana patients.
“Why should they be punished for this?” she said.
Additionally, she believes that asking lawmakers to crack down on so-called abuses of the doctor-patient relationship will scare an already hesitant medical community away from providing recommendations for the medicine, leaving patients with few places to turn.
“Ideas like this will only further serve to isolate and alienate patients and to scare physicians into not writing recommendations, so there will be even fewer physicians in the future who will be willing to work with medical marijuana patients,” she said. “It is bad policy and bad medicine.”
Under the CDPHE’s recommendations, a physician would have to have an ongoing relationship with a patient, do a complete assessment of a patient’s medical history and perform follow-up care. A doctor must also be in good standing and not have had their federal Drug Enforcement Administration registration revoked or suspended, and not receive any money from a medical marijuana dispensary of primary caregiver.
If a physician didn’t follow those requirements, they would be referred to the Colorado Board of Medical Examiners for further investigation.
“Many of these requirements parallel federal laws designed to provide protection from economic conflicts of interest that may arise when a physician stands to benefit directly from the sale of a medication or service that he or she prescribes,” said a statement from Calonge.

Distributed by Colorado Capitol Reporters