The most recent update issued by the Florida Department of Health’s Office of Medical Marijuana Use on August 2nd contains some shocking data. Amongst the numbers of dispensaries and cannabis dispensed, every update the Department notes the number of patients that have been entered into the Medical Marijuana Use Registry and the number of patients currently listed as “active”, or having a legal patient identification card.
The state lists 337,082 total patients within the system, but only 251,172 “active” patients. This equates to 85,910 people who went through the trouble of seeing a doctor, becoming qualified within the Registry, but didn’t renew their patient ID cards.
I call these patients “ghosts”, and the growing number points to a major issue within Florida’s medical marijuana industry that no one seems to be talking about.
Growth in Ghosts
While there always has been a certain percentage of patients who ultimately decided to stop participating in Florida’s medical marijuana program (or have, unfortunately, passed away), the marked growth of these “ghost” patients cannot be ignored.
Today, nearly a third of the people who’ve tried medical marijuana in the state have ultimately dropped out of the program. With every update from the OMMU this number continues to rise.
The Devil in the Details
There has been much noise made about Florida’s status as the fastest growing medical marijuana program in the country. Equal amounts of press has been devoted to the sunshine state’s prominence as the second largest program in the United States, behind California.
But as an individual who opened a clinic on January 3, 2017 (the first day Amendment 2 became law) and opened another clinic two years later, the sheer number of patients exiting the program horrifies me.
85,000 people found marijuana too ineffective to justify their continued care with their doctors and pay the $75 annual fee to the state.
Is marijuana really ineffective as a medicine? As both a patient and a practical administrator, I can assure you this is most certainly not the issue. For the answer as to why so many people are leaving the program, you’ve got to look at some painful realities of Florida’s medical marijuana industry.
Ask any patient, doctor pricing is all across the board. While the average cost to see a cannabis recommending physician in Florida is $250, a quick Google search will turn up all kinds of pricing schemes.
Just today we treated a patient within our clinic who’s neurologist recommended she try marijuana. Coincidentally, he was also a recommending physician. When the patient asked about pricing, she was shocked to find the initial visit would cost her $500 cash and follow up visits (that this physician required every 60 days) would also cost $500 each. In a calendar year the patient’s out of pocket cost would be well over $3,000. That’s unreal.
The other side of the pricing spectrum is just as awful. Patients are lured in by shiny new patient discounts, sometimes as low as $49 for initial consultations. In the cases of extraordinarily cheap care, patients often don’t see (or aren’t told) of the fine print. Ridiculous visit requirements (30, 60, 70 day appointments) and/or huge expenses for recertification visits can often be the result of what is thought initially to be extremely affordable care.
Further, there are few practitioners in Florida that appear to value the importance of patient education. Some doctors instruct patients to “go to the dispensary” for their education, setting the individual up for lack luster “corporate talking point” sales presentations where they receive little education and end up spending much more than they need.
Other practices don’t provide any education to patients. You see the doctor, get your information entered into the Registry, and walk out the door without even the knowledge to complete your patient application.
Knowing what I do about patient success (and failure), proper non-biased education of cannabis (including how it interacts with the body, how it can be used to treat individual illnesses, methods of ingestion, and basic products available) is vital to patient success – even for individuals decently cannabis savvy first entering the state’s legal program.
If a physician or clinic is not providing this basic level of education, they are doing their patients a vast disservice. Many patients will not have the education required to become informed consumers, and will end up spending entirely too much money on products that will not work for them.
After a year of spending thousands of dollars in doctors visits and products that don’t give you the relief you’re looking for, I can surmise many patients feel they’ve been taken advantage of by a system that doesn’t mandate a uniform standard of care.
The Legislature found it appropriate to mandate a patient complete a ridiculous informed consent with each visit, but didn’t mandate any particular protocols to ensure patients receive adequate care.
If you’re interested in some tips on finding proper care, you can refer to our prior blog post on this topic by clicking here.
Duped at the Dispensary
As mentioned prior, some physicians instruct patients to head to the closest dispensary for some proper cannabis education. While one would expect dispensary employees to be knowledgeable in all aspects of medical cannabis, sadly that doesn’t seem to be the case in Florida.
Many dispensary employees at the counter are “green” within the world of cannabis. Few have wholistic knowledge of cannabis as a medicine.
The MMTC machine in Florida has one goal – to make money. Therefore many store level employees are only given a narrow education on cannabis as a medicine and are instructed to push the most expensive products to patients, regardless of the patients level of cannabis experience or their individual illnesses.
Also, it’s sadly been my experience that few dispensaries will advise patients of discounts, savings programs, or deals unless they are asked directly. This sets the patient up for some real sticker shock as they’re trying to pay for their first order at the register.
Some patents aren’t even told of the 22 different MMTC’s (dispensary companies) that exist within the state. Shady physicians direct patients to one particular dispensary brand and some go as far as to stipulate only those products can be purchased by the patient. Since Florida’s vertical system means each company that dispenses must grow their own plants, process their own extracts, and allows each their own product lines and pricing, improper or partial dispensary education to the patient also sets them up to fail.
We Can Do Better
Practitioners and MMTC’s in the state must pay attention to the ever increasing number of these “ghost” patients. I have witnessed miracles in my tenure directly helping patients – countless individuals I’ve had the honor of getting to know who have been able to live better due to cannabis. I personally know dozens of people who are now able to walk again, have been able to go back to work; people better able to function in the world because of this natural plant-based medicine.
When I see the number of inactive patients grow week by week, it saddens me deeply. I want to reach out to all of them, offer them some education, and beg them to give it another try.
Until (or if) legal adult use comes to Florida, we all must remember that cannabis is a medically based program. Many patients have found relief from pharmaceutically manufactured medications by utilizing marijuana and it angers me that the big money interests have swooped in and seem to have taken many pages from the big pharma playbook.
Patients deserve better.