by Jill Becker, MD

“Every patient deserves a doctor who cares about their health.”
~Jordan Tishler, MD

“I really don’t know what the difference is between a cannabis specialist and a pot doctor.”

So began my conversation with the head of a medical cannabis program in a state that neighbors my home state of Massachusetts.

“I do,” I said.

This was followed by a discussion about his state’s rules and regulations regarding the certification of cannabis for medical use. To be honest, his state has some really great rules in place; rules from which the Massachusetts Medical Cannabis community could likely benefit.

“Okay,” he asked after our discussion, “so what is the difference between a cannabis specialist and a pot doctor?”

My interest in the medical use of marijuana began a few years back. I found myself reading advertisement after advertisement about CBD oil and all of the conditions it was supposed to benefit. My thinking was that if a tiny component of the marijuana plant could heal, the whole thing would likely do a better job. I reached out to a Facebook group, one that my friends are used to hearing me refer to as “the doc/moms.” I figured that this group of then 70,000+ women would be able to point me in the best direction. And of course, they did. Dr. Lori Tishler referred me to her husband, Dr. Jordan Tishler. I don’t recall her exact words but they instantly instilled confidence. I reached out and, as has come to be my consistent experience with him, Jordan was warm and welcoming. One of the first things I learned was that the word marijuana has racist roots. The appropriate term is cannabis.

As fate, synchronicity, or just plain luck may have had it, Dr. Tishler practiced Cannabis Medicine in Cambridge Massachusetts. At the time I was living just outside of Cambridge and traveling to his office was very convenient. I, and a few other interested physicians, were invited to Dr. Tishler’s office to observe his interactions with, and treatment of, patients. 

To be honest, I’m not really sure what I was expecting. That said, I know I wasn’t expecting to walk into a real doctor taking the kind of real histories and doing the kind of real physicals we all learn in medical school. I didn’t expect to meet the quintessential “little old ladies” who were no longer riddled with arthritic pain. Nor did I actually expect to see cancer patients who were receiving their desperately needed relief from the nausea and vomiting often associated with chemotherapy. 

I guess I was expecting to meet a “pot doc.” Instead, I met a Cannabis Specialist.

Over the ensuing months, I had opportunity to learn about Cannabis as Medicine, to attend various lectures, and to learn more about The Association for Cannabis Specialists. I also had a chance to meet other physicians and medical professionals who have studied the endocannabinoid system (the neurology and biology of cannabis and the body) and who have helped their patients navigate the medical cannabis dispensary system – which is confounding at best and shameful at worst. As I became excited about the idea of opening my own Medical Cannabis practice, Dr. Tishler provided helpful advice and experience. 

I also learned about “card mills.” There are many companies out there that guarantee medical cannabis cards for their clients. How, one might ask, can they do that? I asked myself the very same thing. I even signed up with one of them thinking that there must be some medical stop-gap to protect patients, and not really understanding what I was getting myself in to. When I asked questions, I received concerning answers:

“What if I don’t think someone should be certified for a medical cannabis card?” The answer I received was, “We’ll either refund their money or send them to another physician who might certify them. Either way, you don’t get paid for your time.” 

Huh? Physicians are only compensated if they follow the non-medical company’s instructions? That didn’t sound like the practice of medicine as I’d learned it. It also directly violated one of the essential edicts one lives by as a physician, “First, do no harm.”

“What if,” I asked the physician-onboarding specialist at this company, “I feel that a patient should be certified to receive a quantity of cannabis that is less than the limit allowed by the state?” “Well either refund their money or send them to another physician who might certify them for the maximum amount. Either way, you dont get paid for your time.”

Huh? Physicians don’t send patients to the pharmacy with a prescription for a medication without specifying the amount. In fact, no pharmacist would even consider it an authentic prescription.

What about how to take their medicine? Well, according not only to the company I was speaking with but also Massachusetts State Law, physicians can’t prescribe their patients the best modality for their particular condition, they can only suggest it.

An analogy to this would be to send a patient who has asthma to the pharmacy to decide, on their own, if they should take inhaled steroids, steroids by mouth, or intravenous steroids. How would they know what is best without knowing all of the different ways in which their bodies can be effected by such medications? What about the side effects and risks? Serious issues like adrenal gland suppression and osteoporosis? Well, if we’re following my analogy, there would be no pharmacist to ask. Instead, they’d have to ask the cashier what to buy – much like the dispensary “budtenders” that the company I investigated relies on. And, even if they were trained, they’d likely want to sell the patient what they have, not necessarily what’s in their best interest. That is, by definition, a conflict of interest and the reason that physicians generally don’t sell products to patients.

At this point I had become very clear on the difference between a pot doc and a cannabis specialist. Unfortunately the former has given the latter a very bad name and has underscored the public’s perception that what can be a powerful medicine is “just pot.”

Medical Cannabis is a safe and effective treatment for a variety of symptoms. When a patient collaborates with a Cannabis Specialist he/she gets the advice of someone who seeks not only to receive a paycheck, but someone who has studied the science behind the medicine, who knows human disease, and who cares for her/his patients. And, isn’t that what the art and practice of medicine are about? 

Those who are considering using cannabis medicine should consult with our Massachusetts medical cannabis physicians. They have years of experience helping patients use medical cannabis with a variety conditions and can help you determine if medical cannabis is right for you. For more information, or to set up a consultation with the team at InhaleMD, call (617) 477-8886 today.

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