Finding the best medical marijuana doctor for you is a lot like looking for the best primary care physician. You may prefer an office with highly-personalized or concierge care, or easy access may be a top priority.
While there is no one-size-fits-all approach to finding the best cannabis physician, here are a few questions to ask as you begin using cannabis as part of your healthcare regimen.
What is the physician's educational background?
Most states require medical cannabis practitioners to have an MD, DO, or advanced nurse practitioner/physician assistant degree. They must have experience practicing medicine prior to becoming qualified to certify patients for medical marijuana cards. The practitioner needs to be familiar with a variety of medical conditions in order to assess the treatments the patient has already tried before determining next steps.
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For example, patients will often seek a medical marijuana card for anxiety. To best assess that patient, the practitioner needs to understand other psychotropic medications, drug interactions, how to integrate cannabis into an existing regimen, and how to help the patient withdraw from other medications safely. This type of guidance, while typical for most medications, does not necessarily occur for cannabis.
Dr. Melanie Bone, a board-certified OB-GYN and cannabis specialist, explained,
"Cannabis is perceived to be so safe that adding it to what the patient is already doing does not seem risky. Not so. Also, the fact that most doctors do not know enough about cannabis to recommend it means that the patient's regular doctor is not involved. It is common for them to send the patient to a known cannabis practice, without asking for or getting feedback until that patient's next annual visit. A lot of patients then perceive cannabis as alternative medicine and don't want any information to be sent back to their other doctors for fear it will become an unwanted part of their medical record. We must work to make cannabinoid medicine mainstream to integrate it safely and effectively into a comprehensive plan for the patient."
For now, cannabis medicine is not mainstream and patients need to exercise caution and do their homework before selecting a medical marijuana doctor. According to Dr. Bone,
"Sadly, some cannabis practitioners do not always have a lot of education or experience with cannabinoid medicine either. There is a patchwork of basic educational requirements and re-certification laws that vary from state to state. You can become a certifying practitioner in some states for a few hundred dollars and a few hours of basic cannabis education. For this reason, becoming a practitioner is not hard to do and can be lucrative in the same way 'pill mills' were. Less educated or motivated practitioners may instruct a patient to 'try a few things' and then have them back to see what worked and what did not. There is some truth to the need for a trial and error approach, but it should be predicated on good basic guidance."
Can I get medical advice at dispensaries?
As a result of the often hands-off approach, cannabis patients end up asking the budtenders at a dispensary to guide them, according to Dr. Bone. Most dispensaries train their employees to understand the endocannabinoid system and the role that cannabinoids play. However, budtenders may not be schooled in physiology, pharmacology, endocrinology, psychiatry, pain management, and the other specialized areas that physicians have devoted years to studying.
Dr. Bone continued, "They also are not privy to a patient's comorbidities. I can't tell you the number of times I have suggested that a patient start with a certain product for a variety of reasons, such as their use of opiates, alcohol, antidepressants, and blood thinners, and then get a call about side effects within a day or two of starting their cannabis. More often than not, these folks left the paper I gave them suggesting how to use recommended cannabis (e.g. sublingual drops or topical cream) at home and relied on the advice of the budtender who suggested something else, usually higher in THC, which caused panic or rapid heartbeat."
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In many cases, these issues can be resolved by modifying product, dose, and interval. But it is important to remember that dispensaries are businesses with incentives for selling. Employees of a dispensary have policies and metrics to meet, while patient care is the primary concern of the cannabis practitioner. Therefore, you should seek medical advice only from a licensed practitioner.
What are red flags to look for in a medical marijuana doctor?
As you conduct your search for a qualified cannabis physician, these things may mean you should look elsewhere:
- Limited years of experience. It may be prudent to seek a physician with at least two years of clinical experience.
- Any medical board sanctions for improper or unethical behavior.
- Tight scheduling, or booking new patient consultations every 15 minutes and only spending a few minutes on each appointment.
- Large numbers of negative online reviews or a glut of suspiciously glowing reviews.
- Unconventional advertising, such as posting flyers in the neighborhood.
Patients experienced with cannabis may feel like they can skip state requirements, especially if cost is a factor. But making such a decision can be dangerous, Dr. Bone warned, and patients should beware of fly-by-night operations that do not adhere to state and local standards. Ultimately, the medical marijuana doctor you choose should ask for access to your medical records and only recommend cannabis for qualifying medical conditions in your state.
Choosing the best medical marijuana doctor
Many patients can benefit from consulting with a cannabis expert to learn about their specific disease and how to manage it with an integrative approach. Making cannabis a frontline treatment option remains crucial as, in Dr. Bone's words, "The only way cannabis medicine will become more mainstream is if we develop best care delivery models, and the only way to do that is to collect data from diligent practitioners. Ultimately, this process may then inform using cannabinoids as a part of everyday health and wellness in addition to treating ailments, such as severe epilepsy, for which we use it now."