State board releases its position on medical marijuana

The Montana Board of Medical Examiners says doctors who staff mass medical marijuana clinics could be disciplined for providing substandard care.

Board members unanimously approved a position paper Thursday that says recommending a course of treatment after a brief consultation and without any follow-up does not meet the standard of care expected of Montana physicians.

The board does not take a position on treating medical disorders with marijuana, but the paper says the board "does have an obligation to protect the public by ensuring that physicians provide medical services via a bona fide physician-patient relationship."

The state has recently seen an influx of "cannabis caravans" — mobile operations that pass through towns and charge people $100 to $150 for a doctor's recommendation to smoke marijuana.

At large clinics in Billings and elsewhere, doctors have churned through as many as 400 people in a day.

The board's new policy "cautions physicians that a mass screening format or group evaluations, whether for student athletes or those desiring medical marijuana, inherently tend towards inadequate standards of care."

The board also discussed at length whether doctors who authorize patients to use marijuana should provide follow-up care.

"We wouldn't say, 'Here, take 400 grams of aspirin and come back in a year,'" said Dr. Arthur Fink.

But the Medical Marijuana Act passed by Montana voters in 2004 says marijuana cards are good for one year, leaving little room for physicians to require patients to come back for followup visits.

The board decided to ask the Legislature to change the law so doctors can authorize marijuana use for periods of time that are less than one year. Board members also will ask lawmakers to allow doctors who have signed authorizations to rescind them.

Fourteen states allow chronically ill people to buy marijuana with permission from a doctor.

But there has been a boom in pot shops only recently after the Obama administration said it wouldn't prosecute medical marijuana users.