Medical marijuana: Physician assistants the cause of delayed applications?
The Colorado Department of Public Health and Environment announced last week that as many as 4,000 medical marijuana patient applications and renewals were being held up in order "to ensure patients and physicians are within guidelines." Despite the CDPHE's vagueness, we've learned that many the applications are being scrutinized because they were apparently completed by a physician's assistant and only signed off on by a doctor.
According to Carol Goddard, executive director of the Colorado Academy of Physician Assistants, physician assistants cannot recommend Schedule 1 drugs such as medical mariuana or even evaluate a patient for a recommendation for a Schedule 1 drug. Interestingly, however, they can prescribe Schedule 2 drugs like Oxycontin and even cocaine with DEA approval or the co-sign of a doctor,.
Vincent Palazzotto, director of the Medical Marijuana Assistance Program of America, says one of the docs associated with the MMAPA affiliate organization Mobile Doctors of America (MDARX) used physician assistants to perform the evaluations on about 800 patients for whom he subsequently signed recommendations -- a practice that was permitted at the time by the CDPHE, he maintains. But since then, the CDPHE has reversed that decision. "It's important to remember that this is a CDPHE thing," Palazzotto says, noting that the MDARX has letters from several professional medical groups that encourage the use of physician assistants on these evaluations.
Palazzotto says that MDARX has begun contacting patients who were evaluated by physician assistants and are experiencing delays in their application. But there's no need to wait for a call; patients can also phone MDARX at 1-855-632-7987 and set up a time to see a doctor again for free.
Unfortunately, not all doctors' groups are being as open about what is going on.
We've received numerous e-mails from patients who went to Well Docs, where they were evaluated by physician assistants before a doctor signed the recommendation. One patient who has been waiting over sixty days for his medical marijuana card says he was told by Well Docs that he would have an answer by December 15; the Well Docs rep advised him to call around that time to make sure.
The patient says he moved to Colorado a few months ago specifically to get a medical marijuana card for neurological pain issues. Because he's new to the area and didn't know any compassionate caregivers, he says he's stuck in a pretty rough spot. "For right now, no dispensaries will serve me because my papers are expired... Colorado is currently testing my will to go on. I am stuck at home and in pain constantly."
In answer to the complaints, Benjamin Einhorn sent a message to me from the Well Docs Facebook account last week: It read: "yes some of our liscences [sic] are on hold and any that are denied because of our doctor we are fixing for free when this whole thing comes down." But since then, the Facebook page for Well Docs has been shut down and I have been unable to reach Einhorn or any other representative at the numbers listed for their Denver and Boulder locations.
No word from the CDPHE when the issues may be resolved.
Editor's note: After the publication of this post, we received a note from MMAPA board member Betty Aldworth, who writes:
MMAPA does not conduct physician evaluations for MMJ, and does not facilitate those evaluations. MDARX (Mobile Doctors of America) is the company referred to in your piece. While MMAPA and MDARX do partner on a number of projects, they are separate entities with separate missions. MMAPA has a distinct board of directors with no control over MDARX, and as a member of that board it's important to me that the distinction between the organizations is clear.
The references have been altered in the text above to reflect Aldworth's information. We regret the error.