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Medical marijuana industry hinges on doctor participation

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A regulatory web governs the critical role physicians will have in Pennsylvania's medical marijuana industry.

Most important is the distinction between a prescription and a recommendation ­— and whether doctors are willing to assume the role the law envisions for them.

Doctors won’t prescribe marijuana to patients in Pennsylvania. They will recommend it — but only if they are registered with the state.

The state’s department of health is still developing a registration process and is eyeing ways to recruit and train physicians, said Corey Coleman, the department’s executive deputy secretary.

The department already has a communication strategy in place to engage doctors.

“It is critically important to have the physicians buy into what the law has dictated and understand what the goals of the law are,” Coleman said.

However, physician advocacy groups such as the Pennsylvania Medical Society argue that little is known about marijuana’s effectiveness in treating medical conditions for which states are allowing people to use it. They want more research, so they have been pushing for marijuana to be reclassified under federal law, which would open the door to further study.

But with the substance approved for use in Pennsylvania, health care providers are starting to prepare.

The Hospital and Healthsystem Association of Pennsylvania, for example, has distributed information about the medical marijuana bill to member hospitals, including a general implementation timeline and federal regulations around controlled substances, said spokeswoman Katie Byrnes.

The association also has encouraged members to discuss the program’s impact on hospitals and patients with their legal counsel.

“Ways in which specific providers and practitioners will plan for and address the new medical marijuana law is a decision to be made by individual hospitals and health systems,” Byrnes said.

Diagnosis required

Under state law, patients must have what is known as a qualifying condition (see box) before they ingest medical marijuana.

That condition has to be diagnosed by a physician registered in the medical marijuana program. Patients also must be under that physician’s continuing care for the qualifying condition.

The registration process imposes several requirements on doctors. Registered physicians can’t have a direct or economic interest in a medical marijuana organization,  and won’t be allowed to advertise their ability to certify patients to receive medical marijuana.

Physicians also will be required to let the department know of any changes in patient status, such as if the patient no longer has a qualifying condition, or if the medical marijuana is no longer a “therapeutic or palliative” option.

Any violation of the rules would be considered unprofessional misconduct, and physicians could receive disciplinary action from the state Board of Medicine or the state Board of Osteopathic Medicine.

It’s unlikely that physicians will face any greater liability than they do with other drugs, according to Justin S. Moriconi, a Philadelphia-based attorney specializing in regulated cannabis.

Discussions among physicians at the medical society rarely touched on concerns about liability, according to Chuck Moran, director of media relations and public affairs for the society.

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