Sandy Brown, MD

Disclosures

June 01, 2007

I had just finished doing a physical on my patient, Simon, a woodworker. I had a few minutes to spare so I thought to ask him about doing some cabinetry for our house. "Doc, I don't do that anymore because of my back. Just can't lift those heavy panels anymore." "So how are you supporting yourself?" I asked him. "You've been my doctor for a long time, so I'm going to tell you." Simon said. "I grow pot."

Surprise! Since proposition 215 passed 10 years ago allowing medical marijuana in California, the ranks of pot growers have swelled. Now, being in possession of a prescription from a physician means that, within guidelines established by the various counties, you can grow marijuana with impunity. Before prop 215, there were great rewards but also great risks; you could lose your property and go to prison. In my county, a medical marijuana card- or prescription holder can now grow as many plants as can fit into a 100 square foot space -- at one time -- without any risk. That means that people who choose to grow indoors can have up to as many as 5 growing seasons! Each harvest can yield as many as 20-30 plants of up to a pound apiece. With a street value ranging from approximately $3000 to $4000 per pound of nontaxable income, it's no wonder that growers drive far nicer cars than doctors in my community.

I have no problem with cancer or AIDS patients using marijuana, but so far no patient with either has asked me for a prescription. Instead, requests come from patients with various aches and pains, fatigue, headaches, colitis, asthma, arthritis, muscle spasms, seizures, and just about anything else you can think of. The prescription allows them to go to a cannabis club and buy the stuff, but 99% of patients want to grow their own and sell what they don't use to cannabis clubs or other buyers. After all, who can smoke 30 pounds of weed in a year without asphyxiating? I tell my patients that I won't do marijuana prescriptions but I will recognize the legitimate use of it as a medicine. "Go and grow a few plants or buy a few ounces," I suggest. "In this county, no one's going to bust you."

For those who must have the prescription there are doctors willing to write them -- for a price. Their patients tell me that these doctors have lines stretching out the door. Patients pay cash up front and fill out a medical history form before spending a few minutes with the doctor, who then prints a boilerplate Rx on his word processor. It's good for a year. Then it's back to the doc for an updated prescription and fee.

What galls me is getting medical records requests from these doctors asking for all of my patients' medical records. I have never objected to sending medical records for free to any physician who is going to use them for my patients' betterment, but these requests are done as more of a CYA maneuver than for any genuine concern for my patients' well-being. "Please send a check for $25 to cover our time and expense," I write back on the records request form. So far, I haven't gotten any richer.

"Does Dr. Brown do 215 cards?" is an occasional question asked by new and some old patients. "No, he doesn't", replies Dalia, my office manager. The more intrepid frequently ask, "Why not?" "Believe me," Dalia says, "You don't want to go there."

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