Companies blanket Pa. with ads on how to get a medical marijuana card, but doctors are silenced

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By contrast, doctors working alone or in small practices can face stiff penalties for taking a similar approach — or even for simply noting on websites that they are among the state-licensed doctors who can certify patients for medical marijuana cards.

The advertising restriction on physicians in Pennsylvania is rare, according to several medical cannabis law and policy experts. Among Pennsylvania’s neighbors, only West Virginia has a similar advertising ban for medical professionals, a Spotlight PA review found, and regulators there have a more lenient take on what certifying physicians are. allowed to say online.

“It’s a terrible disadvantage for local doctors,” said Jeff Riedy, executive director of the Lehigh Valley chapter of the National Organization for Marijuana Law Reform.

Companies frequently promote a $125 to $225 fee for an initial certification, a document that allows a patient to receive a state medical marijuana card and shop at dispensaries. Riedy worries that “quick fix doctors” will ask leading questions and rush through the process. Friends of his received endorsements from certifying society doctors – then turned to Riedy with questions he said a doctor should have covered.

“It’s not necessarily legitimate and it leaves patients unsure of what’s going on,” he said, later adding, “I think it’s mostly a monetary incentive for them to get people’s money. They really aren’t that concerned with pointing people in the right direction.

A previous Spotlight PA investigation found that two companies that offer to help patients qualify for medical marijuana cards — Releaf Specialists and Compassionate Certification Centers — made claims on their websites that several experts in health policy and addiction treatment have called it misleading, incorrect, or possibly dangerous. Both companies defended the language they used when interviewed by Spotlight PA, but the research they provided did not support their claims.

One such company, Compassionate Certification Centers, had a media kit on their website that touted their large online audience: “OVER 150,000 medical cannabis patients who regularly visit our website!” The same 2020 media kit says, “We own the first page for the majority of all search engine searches.

The practices of certification companies vary, and in interviews and public statements, some operators have said they are driven by a desire to help people, not just make a profit. They described the convenience they provide to customers, the steps they take to verify that patients qualify, and the care they provide throughout the process. And regardless of how physicians connect with patients, physicians always have a responsibility to meet the requirements of Pennsylvania’s medical marijuana law.

Yet in the competition to attract potential medical marijuana patients, it’s not a level playing field.

The state’s medical marijuana law does not mention certifying companies, and a Department of Health spokesperson previously told Spotlight PA that the agency has “no regulatory authority” over them.

But the department has power over doctors who certify patients. In addition to being licensed by a state board to practice medicine, these physicians must also be approved by the Department of Health to certify patients for medical marijuana. The agency has threatened to expel some practitioners from the medical marijuana program for alleged publicity violations, documents obtained through right-to-know requests reveal.

And in at least one case, the department told a doctor she could face even more serious consequences, hinting at the potential suspension or revocation of her license in a warning letter. If she did not remove “prohibited marketing items” from a website, the Health Department wrote, one of the state’s medical boards could take disciplinary action against her license.

“I was shocked,” MaryFrances Koester, the doctor who received the warning, told Spotlight PA. “Honestly, I was scared. And I was angry because I didn’t think I had done anything wrong.

Unequal rules

Koester is an emergency physician who decided to start her own cannabis-related telehealth business in Lackawanna County in 2020. She sees cannabis as a life-changing treatment option for many patients suffering from chronic pain, anxiety , post-traumatic stress disorder and other conditions.

In a letter dated May 2021, the department told Koester that she violated state rules due to statements on the Cannabis Care Consultants website. A video embedded in a blog post and information on a second page “advertise your services as a practitioner who can certify that a patient will receive medical marijuana products,” the department said.

Lackawanna County physician MaryFrances Koester started a cannabis telemedicine practice in 2020. (Photo by TribLIVE’s Kristina Serafini for Spotlight PA)

Koester updated the website. But in a response to the Department of Health, Koester disputed that what she did was advertising.

“Patients want to know which practice/doctor they choose, at least legitimate patients who are genuinely seeking medical help,” Koester wrote. She told the department that her medical marijuana practice was “tiny” and that she could see five patients a week.

“I would work less, make more money, and not have the director of medical marijuana write me threatening letters if I worked for one of these big companies,” she wrote in the same email. “But I believe these organizations undermine the legitimacy of medical marijuana and threaten the program.”

Her changes have resolved the department’s concerns, she remains a registered practitioner in the state program, and she has never been disciplined on her license, as recent public filings and responses to queries show. open case requests.

Over a period of about four years, the Department of Health sent a dozen letters to doctors, including Koester, for alleged violations of medical marijuana advertising, according to documents provided in response to requests. right to know. One of these letters threatened to take disciplinary action against several doctors.

In some cases, doctors or website managers have responded by removing all references to medical marijuana and certifications from their websites. Other times — such as when alleged Department of Health websites identified practitioners as “medical marijuana doctors” or as “certifying physicians” — they removed specific information.

Although the state has cautioned a small fraction of the roughly 1,800 licensed medical marijuana practitioners in the state, the advertising ban is having a broad impact, limiting how doctors communicate and creating additional barriers for patients.

“It’s very, very restrictive to the success of the program,” said Lauren Vrabel, an Allegheny County cannabis pharmacist and member of the national group Doctors for Cannabis Regulation.

The advertising ban doesn’t affect pharmacists like Vrabel — in Pennsylvania, only physicians and MDs of osteopathic medicine can certify patients for medical cannabis. But Vrabel doesn’t think cannabis-certifying doctors should be treated any differently than surgeons, dermatologists and other practitioners who can describe the services they provide.

Medical marijuana specialists and other certifying companies are permitted to advertise in Pennsylvania. But individual doctors can face stiff penalties for taking a similar approach. (photo by TribLIVE’s Kristina Serafini for Spotlight PA)

In other states, advertising restrictions would be less significant because there is less uncertainty about which doctors can approve patients for medical marijuana. In Michigan, for example, any licensed physician or Doctor of Osteopathic Medicine can do this.

But to certify patients in Pennsylvania, doctors must register with the state, complete four hours of training, and then receive final approval from the Department of Health. The vast majority of doctors here have not gone through this process, which means they cannot certify patients for medical marijuana.

“By creating the registry and discouraging mainstream doctors, what we’ve seen popping up to fill that space is a bunch of what I would consider to be sort of gray market operators,” said Chris Goldstein, a regional organizer for National Reform Organization. marijuana laws.

The Pennsylvania Department of Health maintains a public list of licensed medical marijuana practitioners that includes their county, name, location, and specialty. However, it does not provide phone numbers or websites, and it does not specify whether doctors are accepting new patients.

Meanwhile, doctors trying to make themselves easier for patients to find may be in trouble.

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