In January 2017, when I built my first medical marijuana practice, there was such a palpable feeling of hope behind us. Dozens of patients were excited to begin their journey of treatment with cannabis, so much so that we booked our entire first month of appointment in just 15 minutes. I felt I was doing my life’s work, something morally right.
As the number of patients steadily grew within Florida’s system, the initial feeling of hope and excitement quickly eroded into a sea of vipers looking to take as much money as quickly as possible from the sick. From backroom deals to kickbacks to operating businesses outside of the law, there are many individuals and organizations that continue to place their own personal greed over the wellbeing of the patients they serve.
A recent report issued by the Department of Health’s Physician Certification Pattern Review Panel preliminary report shows the one doctor based in Fort Myers issued 4,203 medical marijuana certifications in a 6 month period (from October 1, 2018 to March 31, 2019), making him the busiest MMJ doctor in the state. In second place, a physician operating in Venice, issued over 2,395 certifications during the same period.
I can tell you with absolute confidence that the only way such an astronomical number of patients could be seen and certified is the physician operating outside of the boundaries of the law.
s. 381.986, Florida Statutes, is clear on the process of what physicians must complete to certify patients for the use of medical cannabis. Amongst the requirement to see patients via face to face examination within the same room, one of the most important legal steps to qualifying a patient is the physician – and only the physician – must enter the patients information into the Medical Marijuana Use Registry and place the accompanying certification and orders within. While recent updates to the MMUR have made this process more streamlined, it takes even the most computer savvy physician 10-15 minutes to complete this important requirement. Further, these updates to the Registry weren’t completed until after the Pattern Review Panel’s preliminary report data had ended (after March 31).
With the working knowledge of the law and the state’s program that I possess, I can assure you that the only way that a single doctor is able to certify so many patients is by having a staff member or team of people to handle the Registry for them – entering patient data, adding certifications, and placing orders for them. This shortcut is illegal, but there are many physicians and clinics within Florida currently operating in this fashion.
When I was building Medicann Clinic, I was resolute in my decision to follow the law exactly. I’ve always said, “the state has given us a sandbox that we must play in”, no matter how ridiculous the requirements.
For every patient seen within our practice, our staff physician, Dr. Kunstman, handles all of the Registry entries and ordering herself. There is no person or people doing this work for her. Because of the time this takes her for every patient she encounters, following the law restricts the amount of patients we are able to see in a clinical day to 14, far less than competing practices.
With so many physicians and practices brazenly flaunting the law with their illegal practices, it has become incredibly hard for us to remain competitive within the clinical space, even while the patient count is ever increasing.
More patients seen equals greater profits, which allows better wages to be paid to physicians and staff, increased growth opportunity by being able to open multiple locations, and a more financially successful business in general. By eliminating the physician’s Registry requirements, the volume of patients able to be seen increases, allowing visit cost to be reduced which further creates a more difficult atmosphere for smaller clinics following the letter of the law to succeed.
Such unscrupulous practice models have been able to survive and thrive due to a complete lack of oversight by the Department of Health. While the Legislature continues to argue about false issues such as THC content in product, patients are being put at risk everyday because the Department will do nothing to protect them. The DOH’s lack of oversight has emboldened these sketchy operators, as they have been able to thrive without interference or accountability.
The Board of Medicine, Board of Osteopathic Medicine, and the Department of Health have the tools and ability to bring enforcement against shady operators and physicians. Registry access can be suspended for up to 180 days for physicians not following the rules. The BOM and BOOM can bring action against physicians for illegal activity, ranging from fines to license suspension or revocation.
Unfortunately, to date, these tools have barely been utilized. Only one medical marijuana physician, Dr. Tommy Louisville, has faced action from the DOH, and this was only because the Pembroke Pines Police Department initiated a sting operation against him first.
Unscrupulous and illegal activities perpetrated by physicians and their staff put patients at risk. The Department eventually will begin to investigate how single practitioners are able to certify so many patients in such a short time, and as their malfeasance catches up to them these physicians will suffer punishment for their actions, leaving patients unable to fulfill their requirements of being seen once each 30 weeks and having their certifications and orders renewed.
For our part, following the law has cost us financially. My business partner and I have invested every dime we have into the business and been able to borrow large sums of money from family.
I have maxed out every credit card, drained my bank account, and as of now haven’t received a paycheck in over a month. We are struggling. My life is more difficult and my future more uncertain than ever before in my life. While our business is growing, other practices in our direct market have cut prices, reduced the amount of time the doctor spends with the patients, and either have eliminated or never instituted educational protocols. Medical marijuana in Florida has become assembly line medicine – get them in and out as quickly as possible so you can take more money from the next person that walks in the door.
When I began building my first clinic in late 2016, I saw the opportunity to be part of the solution in the troubled world of American medicine. Without insurance companies and the rules that come with 3rd party billing, I resolved to treat people with decency and to take a genuine interest in their well being. I knew we had a responsibility to our patients to do things better. When the quality of patient care began to deteriorate at my first practice, I made my concerns known to my physician partner. This resulted in me having my titles stripped and being removed legally from the business.
I licked my wounds, picked myself up, and began Medicann Clinic which launched in mid-January 2019. By being the person in charge and assembling a team of people who shared the same vision and desire to do things the right and legal way, I knew I could finally provide the level of service I felt people deserved.
What I didn’t realize was how corrupt the industry – in particular on the clinical side – had become. While the patient count has increased steadily, our business hasn’t performed as I had hoped or planned, due largely to the fact that the market is filled with unfair and anti competitive practices.
For marijuana doctors and clinics, the free market has resulted in multiple choices for patients. Many people only look at out of pocket expense, which is understandable, however cheaper is not always better – especially in the world of Florida medical marijuana.
There are good practitioners out there, like us. People who care for people, take an interest in their health, provide them the education necessary to allow cannabis to be successful for them, and are responsive enough to answer phone calls and emails. Most importantly, these good actors ensure their patients are never at risk of losing their certifications or orders due to illegal activities perpetrated by themselves or their staff.
Please do you research and please support businesses and organizations like Medicann Clinic. Don’t risk your investment and treatment success on unscrupulous practitioners.