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Medical Cannabis Consultants
Improving Patients’ Quality of Life
At Medical Cannabis Consultants we are dedicated to improving the lives of Rhode Island residents seeking alternatives to harmful pharmaceuticals. We do not practice medicine nor are we a medical treatment facility. We are a private, for hire, consulting agency. We work for you directly. We connect potentially qualifying Rhode Island patients with third party Licensed practitioners. We have sought the most knowledgable Rhode Island practitioners in the industry. All of our affiliated practitioners are dedicated to helping you on you’re journey to improve your quality of life.
We will do our best to keep people informed about the latest scientific research while compiling our own in order to better serve the patient.
We care. We want to help.
Medical Cannabis Consultants (MCC) is the leading RI Cannabis Card evaluation and consulting company. We have been consulting in the field of cannabis medicine since 2013. Our staff remains up to date on medical studies and literature and has the extensive experience necessary to assist patients navigating through this newly legal option. We help patients to find the right practitioner. We Do Not Practice Medicine. Cannabis remains a schedule 1 narcotic, and while legal in certain states Doctors are prohibited from “prescribing” medical cannabis. Under Rhode Island law a practitioner must state in their professional opinion that the benefits of cannabis most likely outweigh the risks.
We work with all age groups from pediatrics to the elderly and we find that demographics are constantly changing where our average patient presently is 58 years old and seeking relief without impairment. We will help patients understand onset of action, duration, frequency, side effects, medicating options, THC/CBD ratios, milligrams, terpenes, oils, and even how to cultivate.
MCC would like to assist all those who seek medical cannabis as a therapeutic option. Patients are offered educational packages and allowed to call or revisit throughout the year with questions or concerns at no additional cost.
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Doctors affiliated with Mercy Cedar Rapids and The Iowa Clinic are refusing to sign paperwork their patients need to register for the Iowa Department of Public Health’s medical cannabis program. Iowa law requires applicants to obtain their doctor’s signature attesting that the patient has a “qualifying debilitating medical condition.” But the law stipulates that health care practitioners have “no duty to provide” written confirmation of the patient’s diagnosis.
Mercy Cedar Rapids appears to have instructed its 503 physicians not to sign the IDPH paperwork, according to two sources with qualifying conditions, who receive health care at different facilities in that network. Most if not all of the 250-plus health care providers at The Iowa Clinic, a doctor-owned group in the Des Moines area, are also refusing to sign medical cannabis card applications.
Without cooperation from a primary care provider, Iowans cannot start the process of receiving authorization to use cannabidiol legally. The number of patients affected by their health care group’s policies is unknown but potentially large. Mercy Cedar Rapids handled 451,400 outpatient visits last year at offices around Iowa’s second largest metro area. The Iowa Clinic averages 450,000 visits annually, serving about 148,000 unique patients across its central Iowa locations.
The state’s public health department has approved at least 283 Medical Cannabidiol Registration Cards for patients or their caregivers since a new law went into effect last May. Whereas the previous law applied only to certain seizure disorders, House File 524, passed during the final hours of the legislature’s 2017 session, allows Iowans to obtain cannabidiol if they suffer from any of the following “debilitating medical conditions”:
• Cancer (if the treatment or underlying condition produces severe or chronic pain, nausea or severe vomiting, cachexia or severe wasting)
• multiple sclerosis with severe and persistent muscle spasms
• seizures, including those characteristic of epilepsy
• AIDS or HIV
• Crohn’s disease
• Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease
• any terminal illness with a probable life expectancy of under one year, if the illness or its treatment produces one or more of the following: severe or chronic pain, nausea or severe vomiting; cachexia or severe wasting
• Parkinson’s disease
• untreatable pain, defined as “any pain whose cause cannot be removed and, according to generally accepted medical practice, the full range of pain management modalities appropriate for the patient has been used without adequate result or with intolerable side effects”
“FLATLY TOLD NO MERCY PHYSICIAN IN CEDAR RAPIDS WOULD SIGN OFF”
When one lifelong Mercy Cedar Rapids patient in his 30s took the IDPH form to his primary care provider, he “was flatly told no Mercy physician in Cedar Rapids would sign off on it,” he told me. This source, who preferred not to be identified by name, was frustrated, since “All that my doctor had to do was sign a form stating I have a qualifying diagnosis. They are not being asked to prescribe medical cannabis.”
Indeed, the IDPH application makes clear that the health care provider is not writing a prescription for cannibidiol (see page 4). Providers are simply confirming they have a professional relationship with the applicant and have been involved in diagnosing and treating that patient’s debilitating medical condition. Incomplete forms lacking a physician’s signature “will not be accepted.”
Yet when this patient asked to be referred to another doctor who would sign the paperwork, he “was told no one in the Mercy network would do it.”
Karen Vander Sanden, public relations specialist for Mercy Cedar Rapids, told Bleeding Heartland on February 7,
Mercy has not prohibited its physicians from signing the cards. We have recommended that they wait until further guidance is provided by the state and our physician-led Quality Committee has completed its review and outlined a formal policy and process that will be needed to appropriately address the new law and support our patients.
My source characterized that explanation as a “shell game.” His primary care provider and her nurse assured him that no one in Mercy’s local network would “sign a qualifying conditions form, and that there was no one in Cedar Rapids who would.”
A second source also found the official statement unconvincing. His doctor of more than fourteen years, Dr. Ann Soenen at the Mercy Vernon Village clinic, told him higher-ups had instructed all Mercy Cedar Rapids physicians not to sign the form attesting to a qualifying medical condition. “She asked her director in an e-mail while I was in her office,” he told me. “It’s all because there is no dispensary yet in Iowa. They won’t have a problem with it when at least one opens.” His understanding from his doctor was that the organization doesn’t want patients to commit a federal crime by obtaining medical cannabis from another state.
The first cannibidiol products manufactured in Iowa under the new law “will be available at Department licensed dispensaries only, starting in late 2018,” according to a December 2017 statement from the IDPH.
Note: the dozens of Iowa clinics with the Mercy name outside the Cedar Rapids area are part of the Mercy Health Network, a separate organization based in Des Moines. Janell Pittman, who handles communications for that medical group, told me in September and affirmed last month, “We greatly value the professional expertise of our physicians and their collective ability to make appropriate medical judgments. MHN does not have policies in place restricting physicians’ prescribing of medical cannabidiol to their patients, in accordance with their independent professional medical judgment.”
For the record, no Iowa doctors prescribe cannabis derivatives. Jason Karimi, who runs the Iowa Patients for Medical Marijuana Facebook page, explained, “The word ‘prescribe’ should not be in any discussions. Prescriptions mean FDA approval. Nobody in the country has medical marijuana prescriptions. The laws only allow recommendations. There’s a big difference, and it’s important.”
I have confirmed that some Mercy Health Network primary care providers have signed the IDPH form certifying a qualifying medical condition. I encourage Iowans who have tried to navigate this process with a Mercy physician to contact me confidentially.
“DENYING THE CARDS MAY BE SENDING THE WRONG MESSAGE TO PATIENTS”
Connie Norgart of Urbandale, a retired registered nurse, has advocated for legalizing medical cannabis for years. Due to post-polio syndrome, which causes severe muscle pain, she has been on opioids since 1989. Various pain medications have caused serious side effects, including fatigue, side effects, and bleeding ulcers.
Norgart took her IDPH paperwork to Dr. Melissa Thompson at The Iowa Clinic’s West Des Moines office, she told me during a telephone interview in January. She’s been seeing this family doctor for approximately sixteen years. But Thompson told Norgart she couldn’t sign the application because they “were telling the physicians not to sign them.”
Thompson did not return repeated calls seeking comment. The Iowa Clinic’s marketing officer Amy Hilmes provided this statement on February 13:
At this time, The Iowa Clinic does not have a formal policy on the Healthcare Practitioner Certification required on the patient application for a Medical Cannabidiol (CBD) Registration Card. We are awaiting further guidance and development of the program by the State of Iowa. Therefore, most of our physicians are not comfortable proceeding. Once additional information has been received, we will begin the process of studying both CBD and THC (tetrahydrocannabinol) for use in medical therapy.
Norgart told me the same day that in a recent phone call, Thompson explained she was not “comfortable” with signing the IDPH form because of a line stating that the health care provider had educated the patient. That language on the form (page 5) reads as follows: “I have provided this patient with the explanatory information provided by the Iowa Department of Public Health (found on the Department’s website at this web address: https://idph.iowa.gov/Medical- Cannabidiol-Act-Registration-Card-Program/Medical-Cannabidiol-Education-Material) on the therapeutic use of medical cannabidiol and the possible risks, benefits, and side effects of the proposed treatment.”
Asked what further information The Iowa Clinic physicians are seeking, Hilmes pointed to two passages on the Office of Medical Cannabidiol website:
The Iowa Department of Public Health (IDPH) is working to identify tasks and develop timelines to implement chapter 124E, as well as the resources needed to accomplish those tasks. […]
The Iowa Department of Public Health (IDPH) is currently working to develop the rules that govern the implementation of the remainder of the Act.
Hilmes added in the same February 14 e-mail, “The Iowa Clinic physicians and providers are allowed to use their independent medical judgement in the management of their patients. Many providers are awaiting scientific peer-reviewed literature guiding appropriate usage, as is appropriate with any new treatment.”
It’s hard for patients to understand why a longtime, trusted doctor won’t certify a diagnosis. Even if the health care provider has doubts about the value of medical cannabis, whether the patient has one of the qualifying medical conditions is not debatable.
I asked a number of patients who have registered for the state’s program, or unsuccessfully attempted to apply, why they are seeking a medical cannabis card now. Many said they wanted to avoid unnecessary bureaucratic delays once the IDPH licenses a dispensary. “I know it won’t help me until December but I’ll be in line,” was a typical comment.
Others wanted to convey the scope of demand for alternatives to traditional medications: “I wanted to get my card so they could have a better picture of the amount of people that would use this program.” Some expressed concern that policy-makers might draw the wrong conclusions: “If we don’t have anyone getting cards, then politicians who are against this whole thing can point to that and say there isn’t a need.” Many advocates working on this issue hope to persuade state lawmakers to expand the current law to cover more health conditions and more potent cannabis derivatives than CBD oil with 3 percent or less THC.
Norgart acknowledged that Iowans in her situation “can’t get anything” legally yet. “But denying the cards may be sending the wrong message to patients” and others who keep track of medical cannabis registrations, she told me. “A lot of Iowans won’t get the service they should be getting” if their doctors won’t cooperate.
In the Des Moines area, The Iowa Clinic facilities are sometimes confused with UnityPoint Health. That group has hundreds of providers working in about 50 central Iowa locations, along with clinics in a dozen other cities across the state.
Communications staffer Amy Varcoe told me on January 29, “UnityPoint Health, including Blank Children’s Hospital allow each individual provider to make the decision based on each patient.” She denied that the organization discourages physicians from signing IDPH forms. On the other hand, Varcoe asserted that “until the new law is implemented, only seizures are covered.” That’s not accurate; the state has approved medical cannabis cards for scores of Iowans who suffer from one or more of the other qualifying conditions.
The same statement from Varcoe noted, “UnityPoint Health still recognizes medical cannabis is not FDA approved and remains a schedule I drug recognized as drugs with no current accepted medical use and a high potential for abuse.” Karimi of Iowa Patients for Medical Marijuana countered, “since these products are explicitly intrastate only, and not interstate, FDA approval is irrelevant to our state law. […] FDA approval is only required for interstate marketing.” He recommended this November 2017 article by Carl Olsen, a longtime activist who has studied the relevant federal statutes and case law.
Varcoe emphasized in a January 30 message that UnityPoint does not “in any way” discourage providers from doing what they feel is best for the patient.
While I confirmed that at least a few UnityPoint physicians have signed IDPH forms, patients in some communities have reportedly had trouble finding a UnityPoint doctor to certify their diagnosis. I hope to follow up on that soon and encourage Iowans to contact me regarding any relevant experiences with health care providers.
Polly Carver-Kimm, communications director for the IPDH, shared a graphic showing how many Iowans approved for medical cannabis cards suffer from each of the qualifying conditions. I also asked how many physicians from various health care groups had signed the application forms, but Carver-Kimm replied, “We do not collect information that would allow us to identify the certifying health care practitioners by health system, so we are unable to provide that type of detail requested.”
How To Get A Medical Marijuana Card In New York State: A Step-By-Step Guide
For many years I thought my friends with medical marijuana cards were just looking for a legal loophole to get high and goof around—and for the most part I was right. But I had never considered it before. Besides, I was perfectly happy with my stash of relatively low-dose recreational cannabis, which I started taking sometime in 2017 when my lower back pain became untenable.
Then I injured my back (again) during a particularly intense month of contact combat training with fighters twice my size. It had been years since it last happened and I was in a panic. But I’ve been here before: the debilitating pain, the inability to move, and just all-around physical misery. And let me tell you: That kind of excruciating pain is not something anyone would ever want to live through again—or regularly, for that matter.
When I wasn’t hoovering Aleve, CBD gummies and low-dose THC edibles to ease the constant pain, I was seeing a chiropractor, doing physical therapy thrice a week, and slathering myself with CBD topicals. On occasion, I even had to rely on a cane to get around.
Getting a medical marijuana card in New York State is actually quite easy and efficient—as long as . [+] you’re eligible.
Managing this recent bout of pain was also helped by the budtenders I had the pleasure of meeting in Nevada and California: They certainly knew their stuff. But the more I learned about cannabis and how my ailing body responds to it, the more I realized that it was time to see a professional about a medical marijuana card.
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But here’s the thing—I wasn’t looking to get high. And I didn’t want a card just so I could shop locally in Manhattan. So I didn’t go to one of those rent-a-New-York-doctor sites, say the right things for ten minutes, and get a card mailed to me. Instead, I did what I always do whenever I hunt for a new doctor: I asked a good friend in the cannabis industry to recommend a reputable doctor. I did my due diligence and took the medical part of medical marijuana seriously. I gathered whatever pain-related medical documents I had that, just in case they’d be handy.
Once you’ve registered and been approved, you will be issued a temporary medical marijuana card . [+] almost immediately. Simply download and print it.
And I would recommend this approach to anyone. Plus, the entire process was fairly painless—and efficient. My doctor was beyond helpful: Thanks to his recommendations and guidance on dosing, I’ve been experiencing lower pain and fewer flareups. And between medical-grade cannabis (which typically has a higher dosage) and regular mobility drills coupled with core strengthening exercises, I’m already on my way to a (mostly) pain-free life.
And you can do it too. Here’s how.
How to Get a Medical Marijuana Card in New York State
STEP 1: DETERMINE YOUR ELIGIBILITY
Cannabis was partly decriminalized in New York State in mid-2019. But that certainly doesn’t mean that anybody can walk around with joints and go all out at the park. (Public consumption is still illegal, FYI.) Also: New York State has one of the most stringent requirements for its residents to acquire a medical marijuana card—meaning, if you’re not suffering from a debilitating disease, chronic pain, opioid abuse, PTSD, cancer, Parkinson’s diseases, or anything that can seriously affect your wellbeing and ability to function on a day-to-day basis, there’s a good chance you’re not going to be granted the right to use medical marijuana legally. So, if you have one of these qualifying conditions and you think cannabis could greatly improve your quality of life, proceed to step number two.
STEP 2: FIND A LICENSED PRACTITIONER WHO PARTICIPATES IN NEW YORK STATE’S MEDICAL MARIJUANA PROGRAM
Decades ago, there was such a stigma surrounding cannabis use. The word “stoner” carried with it visions of unkempt misfits unbothered by ambition, the business of life, the rat race, or “the establishment.” But no longer. These days, more and more people are taking cannabis as a means to improve their health—not to get zonked. After all, the plant is known for its anti-inflammatory and neuroprotective properties. According to BDSA, an analytics firm that focuses on the cannabis industry, “the worldwide [cannabis] market will more than triple from $14.8 billion in 2019 to $46.8 billion in 2025.” A staggering growth projection. And for New York residents, finding a professional couldn’t be easier: The New York State Medical Marijuana Program lists a robust number of registered participating healthcare professionals in all 62 counties—many of whom are not just doctors, but nurse practitioners and physician’s assistants as well.
STEP 3: SCHEDULE A CONSULTATION WITH A DOCTOR OF YOUR CHOOSING
Choosing a doctor for the purposes of learning how to treat your condition with the help of medical marijuana is very much like picking a therapist: You’ve got to have rapport. And as a patient, you need to feel that you’re in good hands. Once you’ve picked a physician from New York’s list, schedule an appointment and talk about whatever it is that ails you. (In my case, I emailed my doctor my lumbosacral MRI and X-ray results shortly before our appointment to help move things along—and to give him a good idea of what he’s dealing with.) During the consultation be as detailed as possible, especially when answering questions related to your symptoms, medical history, and general lifestyle. This will help the doctor “prescribe” a suitable cannabis product for you. And by “prescribe,” the physician will help determine the starting dose you need, the best delivery method for your body, and the frequency with which you ought to be partaking. The whole process typically doesn’t last an hour if you’re an obvious candidate—and once the appointment is over, your doctor will then prepare your medical marijuana patient certification, which will be emailed to you in PDF form. And of course, this is where you pay your doctor’s professional fee.
STEP 4: WAIT FOR YOUR CANNABIS CERTIFICATE BY WAY OF EMAIL
It won’t take long for the certificate to reach your inbox. (Mine showed up in three days.) As soon as it’s in your hands double check each field on the form—there’s no room for any sort of error, so if you find one, ask your doctor to make the necessary corrections. The certificate should contain important personal information: the medical condition that qualifies you to be part of the state’s medical marijuana program, your patient certification number, your doctor’s DEA registration number and New York State practitioner number, your dosing recommendation, and the expiration date (which is exactly one year from the issue date). I recommend printing at least two copies: One to keep on file and one to have with you at all times, since you need to present your certificate in addition to your medical marijuana card when visiting a dispensary.
STEP 5: SIGN UP FOR A NEW YORK STATE GOVERNMENT ACCOUNT
This bit is very important and I cannot stress this enough. Having an NYS ID will make all the difference when applying for a medical marijuana card. So if you don’t already have one, get yourself a personal New York State government account via the state’s official NY.gov ID site and keep your username and password safe. Remember, this is the exact same login credential that allows you sign up for a multitude of state services across the board: educational programs, health resources, DMV services, tax assistance, and a whole lot more. So if you’ve lived in New York for long enough and have a driver’s license or state ID, there’s a good chance you already have an account. Plus, if you’ve ever applied for unemployment insurance, you certainly have one—because there’s no way you can certify claims without a MY NY account. So double (and triple) check to make sure you don’t sign up twice. Go over your data to validate its accuracy, otherwise it could cause delays or complicate your application and registration. Beyond that, it’s just good idea for every New Yorker to have a singular account you can use to easily access your personal data and process whatever you need to get done on the state level—your my.ny.gov account is not solely meant to authorize cannabis for legal medical use.
STEP 6: REGISTER ONLINE AS A MEDICAL MARIJUANA PATIENT WITH NEW YORK STATE’S MEDICAL MARIJUANA PROGRAM
From here on out, everything is going to be easier than surviving the disaster that was 2020—including the four years we had to endure with our twice-impeached former president. Anyway, enough about that: Now that you have your New York ID, whether it’s a driver’s license or a non-driver ID card, simply visit my.ny.gov and log in. Just make sure you do not use Safari, which is incompatible with New York State’s platform. (I used Chrome.) From there, consult the second section of your NYS Medical Marijuana Program patient certification and follow every single directive accurately on page three. And make sure there are no typos: Your name, date of birth, address, and patient certification number all have to tally up with the information on your doctor-provided paperwork. Errors and falsifications will cause major delays—it could take weeks or it could take a few months, depending on whatever discrepancies there may be. You’ll notice that there’s a section called “Supporting Documentation,” which allows you to upload paperwork. But you can ignore it for as long as you have your NYS identification number: That particular field is meant for individuals who reside in New York but need to show proof of residency, mainly because their state ID is from somewhere else—or they simply do not have the required ID.
Those who are too Ill may designate a caregiver after they process their own registration.
So there’s no need to upload any of your medical documents, your patient certification, your license, or even your photograph. (The powers that be will use the existing image it has on file from your ID.) So it’s important to note that you must enter your nine-digit NYS ID without dashes or spaces. And once you’ve done that you’ve essentially completed your registration. NB: If your condition is so severe that you’re not always able to go to the dispensary yourself, you can designate a caregiver after your registration is approved.
STEP 7: SAVE AND PRINT YOUR TEMPORARY MEDICAL MARIJUANA CARD
If all goes well (no typos were made; your nine-digit NYS ID was successfully verified) you’ll have your temporary card almost immediately after registration. A prompt will appear at the very end of the process and it will enable you to download the card, which will be valid for a month. Print a few copies and have one with you at all times (in addition to the medical marijuana certificate with your doctor’s signature), in case you need to visit a dispensary immediately. Again, you need both the card and the certificate to enter a dispensary.
STEP 8: WAIT FOR YOUR MEDICAL MARIJUANA CARD IN THE MAIL
It should take you no time at all to receive your “real” medical marijuana card in the mail. More often than not, it takes less than two weeks. Personally, mine arrived exactly one week after the day I registered. Note that the card only lasts a year and you will a few need periodic follow-ups with your doctor to see how your treatment is going—and whether your dose needs to be calibrated further. To renew it, give your doctor ample time and schedule a renewal appointment at least a month before your medical marijuana card expires.
Step 9: MAKE YOUR FIRST MEDICAL MARIJUANA PURCHASE
There are less than 20 medical marijuana dispensaries in New York City. But there are more in other counties, which you can find here. Do your research and pick one that suits you—in terms of what they carry and what your physician recommended you take. For instance, if you were advised to try sublinguals go to dispensary that carries a number of them so you’re able to enjoy a number of options. Remember: Take both your card and certificate. You will not be able to purchase medical cannabis in New York without both. One good thing to remember is that while your doctor may recommend certain methods of THC delivery via the certificate (such as edibles, sublinguals, or buccal sprays), the dispensary’s “pharmacist” or budtender may (and can) ultimately recommend something completely different. All this is legal. If you’re not comfortable with whatever the dispensary recommends, most doctors will let you call them right there and then—so you don’t end up spending money on something that could be too strong or too weak for you. Cannabis isn’t cheap, so it’s always good to proceed with good advice.
STEP 10: IN THE EVENT OF UNAVOIDABLE TRAVEL, FAMILIARIZE YOURSELF WITH STATE RECIPROCITY LAWS
In some instances, even in the middle of a pandemic, travel may just be unavoidable. And the last thing you need is to be without pain relief in a distant city. Here’s a helpful list that explains where you can purchase medical marijuana with a New York State card—and just what the parameters are. Many will let you make purchases, while others will only allow for you be in possession of what you already have. Each state is obviously different. Hawaii, for instance, will let out-of-state qualified visitors register online up to three months in advance. But whatever you do, make sure to never fly with cannabis on you.