Medical marijuana: CDPHE's Dr. Chris Urbina on physician assistants, patient denials
By mid-January, as many as 4,200 potential medical marijuana patients will be told they are as much to blame for a "fraudulent" MMJ application as the doctor who signed off on a physician assistant's evaluation of that patient. The punishment? Waiting six months before they can apply again for the medication they needed a few months ago when they actually started the process.
In a press release on Friday, the Colorado Department of Public Health and Environment finally addressed growing concern among patients about medical marijuana applications being denied because of issues with physician assistants allegedly performing evaluations.
According to the CDPHE, a denial letter will be sent out to those patients who visited with physician assistants and not doctors, according to the department's interpretation of state law that says patients must have a working relationship with an actual physician.
Keep in mind that while this law currently prevents physician assistants from doing medical marijuana evaluations now, they still can do everything from sewing up a wound to prescribing Oxycontin. As a constant emergency room patient myself, I've been attended to more by PAs than actual doctors. I can completely understand why patients who have spent any time dealing with the health-care system for their debilitating condition wouldn't think twice about seeing a PA for an MMJ evaluation. But apparently the CDPHE doesn't and essentially is saying patients who trusted their doctor and health-care provider to do the right thing should be punished by not getting the meds they need.
I spoke with CDPHE director Dr. Chris Urbina yesterday. He explained the department's reasoning:
Dr. Chris Urbina
"We took this seriously," he says. "We contacted the physicians to find out, first of all, if they had actually seen the patients. That was the important piece, because by constitution, by law, the physician has to have a working relationship with the patient to make a determination of 1) Do they have a debilitating condition that they can apply for a medical marijuana card, and 2) Does the physician then have a long term relationship so that he or she can monitor the patient to make sure their condition is either not getting better, etc. just like a physician-patient relationship you would expect. And finally, do they have some documentation of that. So, in those cases we are reviewing this with the physicians. And those cases where they didn't have a relationship, those cases will be denied."
Again, that sounds like punishing patients for someone else's mistake -- especially considering the CDPHE has the ability to simply reject the applications and allow patients to visit another doctor immediately. As the CDPHE also mentioned in the press release: "Denied applicants must wait six months from the date of denial before reapplying for the registry. Rejected applicants can resubmit a new application without delay and without the additional application processing fee."
But not Urbina, who says the CDPHE is merely following the letter of the law outlined by the constitution and recent legislation.
Page down for more of our interview with Dr. Ubrina.