JEFFERSON CITY — Missouri health officials have said they are not monitoring how many medical marijuana patients doctors have certified. Industry insiders say such tracking is unnecessary, despite other states doing so.
While Missouri doctors fill out a form for each patient they certify, Department of Health and Senior Services employees do not place the doctor’s identifying information in a database, said Lisa Cox, spokeswoman for the department.
The practice runs contrary to regulatory practices in states such as Florida and Illinois.
Legal medical marijuana sales are scheduled to start in Missouri next year. So far, more than 10,000 residents have been certified to use medical cannabis.
“I’m sure, as in every other state, that relatively few doctors will be writing the majority of the qualifying letters,” said Dan Viets, chairman of the Missouri Medical Cannabis Industry Association. “That’s because most hospitals and other corporate entities are reluctant to allow doctors to assign qualifying letters.”
In Illinois, 3,000 physicians certified medical marijuana patients last year, and only 29 of them submitted more than 100 certifications, according to a report by the Illinois Department of Public Health.
Physicians who helped write Florida’s report voiced concern that the certifying habits of doctors could help fuel a public health threat. One physician compared some doctors’ offices to “pill mills” — those that offer easy access to opioid painkillers.
“To me, I look at this data and say this is just another form of a pill mill,” Sarvam TerKonda, a Jacksonville medical doctor and member of the joint review panel, told the News Service of Florida.
“That’s absurd,” Viets said. “There’s no other medication that has such a low potential to do harm. … Just because one doctor is writing more qualifications than another is certainly no basis to question the conduct of that doctor.”
Unlike Florida, Missouri doesn’t require physicians to register with the state if they intend to certify medical marijuana patients. And, Missouri officials haven’t discussed tracking the physician certifications, said Lyndall Fraker, director of Missouri’s medical marijuana program.
“Certainly if something is brought to our attention we’re going to check into it and see what’s going on and then proceed from there,” he said.
Officials said it is possible the state could at some point begin monitoring physician certifications as the program gets off the ground.
The Springfield News-Leader reported on Monday that the Missouri Highway Patrol was investigating whether a “Cannabus” operator, Health City MD, improperly certified patients and then sold them medical-grade pot.
Through Monday, Missouri had received 13,001 patient applications.
Of those, 11,029 had been approved; 94 applications were awaiting revisions by patients, while 227 applications had been denied, according to the health department.
Randy Shaffer, spokesman for Green Health Docs in Creve Coeur said last week the clinic had certified “a few thousand” patients in Missouri, meaning that one company could have certified about a fourth of the applications the state has seen.
Shaffer did not provide the exact number of patients the clinic has certified.
Unlike in other states, Missouri law does not require qualifying patients to have an established relationship with their physicians, meaning it is easier for clinics to operate with the sole purpose of certifying patients.
In North Dakota, a Green Health Docs clinic shut down after the state found it was certifying patients who had no “bona fide” relationship with their doctor.
In Missouri, “there doesn’t have to be a long-term doctor-patient relationship, but that doesn’t mean that the doctor can just pass out qualifying letters like tissue paper,” Viets said. “The doctor has to examine the medical records of the patient.”
He said companies like Green Health Docs perform “an important service” by “bringing patients and independent doctors together.”
“I know that there are some people that certainly want to make a business out of it,” Fraker said of medical marijuana-specific health clinics. “But there again, that’s certainly allowed under the constitution.”
Jack Cardetti, spokesman for the Missouri Medical Cannabis Trade Association, said it was unlikely that a physician would certify a patient who didn’t have a qualifying medical condition.
And, if the doctor did, the state could look up that physician’s information on a patient’s certification form.
“The department knows who the doctors are that are writing these certifications, and if they’re in good standing,” Cardetti said. “State-licensed physicians take their mandate very seriously.”