Medical Marijuana Certifications

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According to the Arizona Department of Health Services, eight doctors have issued nearly half of all medical marijuana certifications in Arizona. DHS Director Will Humble discusses his response to the data.

Ted Simons: Eight doctors are responsible for nearly half of all medical marijuana recommendations in Arizona. That's according to the state department of health. What's DHS doing about it? Here to tell us is Will Humble, director of the Arizona department of health services. Good to see you here. I know one of the things you're doing, you're going to a couple medical boards and saying something doesn't seem right.

Will Humble: Yeah. Last week we looked at the data set, we were up to about 10,000 certifications now, so it's about a third of the year has gone by, we're at the 10,000 mark. So we did a little check on the database a couple weeks ago to see if the high-volume certification doctors are going to the controlled substances database to look at their patient's profile so they can make an informed decision. It turns out that eight out of the 10 were routinely not checking the database, and yet were making attestations on our certification form that they had.

Ted Simons: The database is like a DEA database to show if there was a problem in the past?

Will Humble: It's the board of pharmacy here in the -- in Arizona, it's a state database, whereby folks that get a controlled substance prescription, something like oxycontin, that data gets entered into the database. The idea is the physician should check that database with the patient on their table, they're look at the database to see if that patient has been to a different Doc and maybe got a prescription for something else for the same medical condition. Not that -- just because a patient has a prescription for a narcotic pain killer doesn't disqualify him from a marijuana certification, but that Doc should check.

Ted Simons: You're talking about doctors who maybe have hundreds and hundreds of recommendations, yet by checking and you can check this, may have gone to this database 40 times.

Will Humble: Yeah. Well, we had one physician whose written 1300 certifications, so 13% of all of them have been written by one Doc, and this doctor had only been to the database 50, 60 times. So the majority of the time the physician was not checking. We had three other Docs who had written hundreds of certifications who don't even have a log-in. And yet their attestations say they have.

Ted Simons: And this raises other questions, we were talking about this, because you're saying if they're not doing this, what else are they not doing?

Will Humble: This is one problem. The attestation is incorrect on the certification form, but for me as a public health official, what else aren't they doing? Because we also asked them to look at 12 months worth of medical records before they sign the certification. Well, are they really doing that, or did they just sign the certification? Did they really have a conversation with their patients about the alternatives to marijuana for treating their medical condition? Maybe, maybe not. We don't know, because the suggestion is that if you'll make one attestation that's not right, maybe you'll make a few.

Ted Simons: What happens do these doctors the board will investigate?

Will Humble: We made the referrals to the medical boards, one to the naturopathic board and one to the Arizona medical board, so there were three M.D.s and five naturopathic physicians, and those boards are responsible for the follow-up from here. We'll coordinate activities if they want us to, but it's really in their hands now.

Ted Simons: What happens to the -- let's say the board investigates. And the names get out. And there's disciplinary action. What happens to the patients who were recommended by these doctors?

Will Humble: That's really what this is all about in the end anyway. Making sure that the physicians are acting in their patients' best interest. That's one thing. The other thing is that from the very beginning, way back in November of '10 we talked about our efforts to keep this a medical American program and not let it devolve into a recreational program as is the case in other states. This is one tool we have to keep the Docs honest so they really do full assessments on their patients and the people that end up with certifications actually really have medical conditions that the qualify, and not just oh, my leg.

Ted Simons: Is it still the situation where patients and caregivers, it's still OK for some of these folks to grow their own?

Will Humble: Basically because the dispensary portion of the law is on hold pending the litigation, folks are still getting the qualified patient registration card and if they ask permission to cultivate they can get permission to grow up to 12 plants for their own medical use. Caregivers can have up to five patients, which is 60 plants.

Ted Simons: Where do we stand in this legal situation?

Will Humble: There's about six lawsuits in total of various kinds, the big one is really that issue in federal court sort of, is this against federal law, and if so which portions are against federal law. Once we have an answer with that, we'll be in a better position to make the downstream decisions about what do we do next.

Ted Simons: Are you seeing as many doctors willing to recommend, willing to certify as you thought you would see, and if not, first of all, are you seeing as many as you thought you would see?

Will Humble: I think it's probably about what we thought. These eight Docs we referred to the medical board a couple weeks ago wrote about half the certifications in total. But there are a large number of Docs that have written a handful of certifications. And -- but here's the one thing we are still working on. That is, to get primary care Docs in a better position to have that conversation in their office with their patients, because let's face it. Docs didn't do training in medical school for marijuana, or their residency. So this is a new thing, this conversation, and so we're still working on getting Docs up to speed so they can have an intelligent conversation with their patients.

Ted Simons: I asked the question because there's some who see the -- this information you're giving regarding these certain doctors maybe have a chilling effect on other doctors. Fewer doctors willing to recommend, the fewer options patients have and they see an overall effort on your part specifically, but others as well, in state government to in some way, shape, or form gut this law. How do you respond?

Will Humble: I see -- the newspaper articles come out, you can read the comments, and I read those, oh, god, look, here's the thing. We really are after a couple different things. To make sure that physicians are doing a full assessment of their patients, and they have their patients' best interests in mind and not just revenue. Number two, to try to keep the program as medical as we and can not let it become recreational. Or largely recreational like the other states. So that's -- those are our primary objectives. I know there's a lot of people that see it otherwise. But that's just the truth. And you can believe me Ted or other people can or can't, I can't control that. I can just tell you like it is.

Ted Simons: You're not against the will of the people, is that what you're saying.

Will Humble: That's right.

Ted Simons: Thanks for joining us.

Will Humble: Director of the Arizona Department of Health Services;

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