Medical marijuana doctors "need to come out of the closet and be part of the solution," says CannaMed medical director
Attorney Rob Corry has significant issues with Senator Chris Romer's legislation concerning the relationship between doctors and medical marijuana patients.
Less critical is Dr. Paul Bregman, the medical director of the CannaMed USA doctor referral service. Bregman actually believes the senator "is on the right track" even though the doc's a comparatively high-volume prescriber of the sort who's drawn criticism from both Romer and Ned Calonge, Colorado's chief medical officer. Moreover, he encourages other doctors working in this specialty area to "come out of the closet and be part of the solution."
Most medical marijuana physicians are laying low right now, but Bregman, a trained radiologist who's been involved in the prescribing of medical marijuana for around three years, is open to speaking with the press -- although he's not always happy with the results. In today's Denver Post article about Romer's bill, he complains about being misquoted: "They used the word 'ridiculous,' and I didn't say the word 'ridiculous.' I said 'outside the law,'" he maintains.
He also quibbles with some numbers in the report. The Post stated that he's written about 1,500 medical marijuana prescriptions since 2007 but only about 35 of them were for patients under age 21 -- an area of particular interest for Romer, who sees strong evidence of fraudulent diagnoses among 18-to-21-year-old patients. Bregman says the 1,500 patient figure is correct, with the number of younger patients adding up to between 5 and 10 percent of that total.
Still, he feels it's important to speak honestly about medical marijuana -- even if it doesn't always reflect positively on each of his peers.
"Yes, there are rogue doctors," he allows. "But through technology, I think you can identify a rogue medical marijuana doctor just like you can identify a rogue doctor writing too many prescriptions for Vicodin and Percocet. I think we need a sane policy as it applies to physician monitoring."
Bregman emphasizes that "I don't want to throw out what works with traditional medicine. I'm not a renegade. I believe in good medicine -- the best medicine for patients." With that in mind, he advocates greater communication between medical marijuana patients and their primary-care physicians. Ideally, he likes to see records of patients who've been taking heavy pharmaceuticals prescribed by their regular doctor -- and then send them back to that caregiver with new information about how medical marijuana may be able to help.
At this point, someone is needed in his role, he believes, because many old-school doctors "are scared of medical marijuana because it's listed as a schedule one drug, like heroin, and they're not taught in school about it. There's fear and a lack of knowledge." In his experience, however, "more and more doctors are open to it" -- and once word spreads about the substance's positive effects, a middle man may no longer be necessary. "I see that happening in the future," he says. "But I think it's going to take a while."
Because he's working in conjunction with other doctors, Bregman feels he doesn't need to examine patients over a period of years -- the sort of relationship advocated by officials like Calonge.
"I can see people in ten or fifteen minutes," he says, "and because of my expertise, I can evaluate 99 percent of them and feel good about it, because I'm not missing a thing. I can listen to the stories people are telling me and make sense of them medically and then advise them to tell their doctors what they're doing with medical marijuana. I can go from A to Z with a patient because I'm a good doctor, a trained doctor who understands the law and practicing the art of medical marijuana."
Regarding Romer, Bregman would like the senator to sit down with doctors like him, as well as other stakeholders, to hammer out a workable solution that would keep patients' needs in the forefront. Likewise, he'd like all parties to revisit the regulations three-to-six months down the line to determine if tweaks would make them more effective.
Whatever proposals eventually emerge, Bregman wants legislators to beware of addressing problems in a way that destroys the entire system.
"Let's say there are 30,000 registration cards out there, and 25 percent of them are questionable," he says, by way of example. "That means 75 percent of them represent patients who are being helped. That's a lot of people."
Together, he believes, "we can mediate and negotiate and come up with a sane policy that works."
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