How Many MMJ Cards is Too Many?

How Many is “Too Many” Medical Cannabis Certificates to Write?

As an experienced anesthesiologist who has transitioned into writing medical cannabis certificates, I’ve seen firsthand the importance of combining clinical experience with thoughtful patient care. This journey has prompted me to reflect on a critical question: how many medical cannabis certificates is too many to write?

Drawing from Clinical Experience

Before venturing into the realm of medical cannabis, I spent 35 years in anesthesiology, overseeing a vast number of procedures. Over the course of my career, I estimated that I was involved in around 796,250 surgeries, working in a busy 250-bed community hospital. My role often involved supervising multiple Certified Registered Nurse Anesthetists (CRNAs) during the day and managing cases alone or with a smaller team at night. This breadth of experience not only honed my clinical skills but also deepened my understanding of patient needs and the complexities of medical care.

Throughout those years, I developed a keen ability to assess patients quickly and effectively. I learned how to recognize signs of distress, understand a patient’s fears, and respond appropriately. These skills have proven invaluable in my current role as I evaluate patients seeking medical cannabis therapy. Just as I needed to evaluate the risks and benefits of anesthesia for each patient, I must now do the same for cannabis therapy.

The Value of Familiarity, Education, and Insight

In both anesthesiology and cannabis therapy, familiarity, education, and insight are crucial. My years in the operating room provided me with a solid foundation in patient assessment, risk management, and personalized care.

Familiarity

Familiarity with a range of medical conditions is vital. Over my career, I encountered patients with various ailments, from chronic pain and anxiety to more complex conditions like cancer. Each case required a tailored approach, and I had to be adept at adjusting my strategies based on the patient’s specific needs. This same principle applies to medical cannabis. Familiarity with conditions that cannabis may help treat allows me to recommend appropriate therapies confidently.

Education

Education is another key component of effective patient care. I have committed time to studying the latest research and developments in the field of medical cannabis. Understanding the pharmacology, potential side effects, and interactions with other medications has enhanced my ability to provide informed recommendations. I’ve learned about the various strains of cannabis, their chemical compositions, and how they can be used to target specific symptoms. This ongoing education enables me to discuss treatment options in depth with my patients, ensuring they are well-informed about their choices.

Insight

Finally, insight gained from years of clinical practice allows me to recognize patterns and outcomes that may not be evident from research alone. Having worked with thousands of patients, I have seen how different individuals respond to various treatments. This knowledge is critical when assessing patients for cannabis therapy, as I can draw on past experiences to guide my recommendations.

Writing Over 10,000 Certificates

Together with my associate, Mark Parker NP, we have written over 10,000 medical cannabis certificates. This number reflects our commitment to providing thoughtful and personalized evaluations, rather than simply churning out certificates. It’s crucial to understand that quantity does not equate to quality in medical practice.

In today’s healthcare landscape, “Card Mills” exist—practices that prioritize issuing as many certificates as possible, often without thorough patient evaluation. These operations fall short of what patients truly need. Writing a certificate should never be just a formality; it should be part of a comprehensive assessment that considers each patient’s unique circumstances.

The Dangers of Card Mills

Card Mills, as they are often called, can be detrimental to patient care. These practices focus on volume over quality, leading to several potential issues:

Lack of Personalized Care: When certificates are issued without proper assessments, patients may not receive the specific care they need. This can result in ineffective treatment plans that fail to address the underlying conditions.

Increased Risk of Adverse Effects: Without a thorough understanding of a patient’s medical history, there’s a higher likelihood of negative interactions or side effects from cannabis. Knowledgeable providers should assess each patient’s existing medications and health status to mitigate these risks.

Erosion of Trust: Patients seek recommendations from healthcare providers they trust. If they feel their needs are not being taken seriously or that they’re being treated as just another number, it can erode the patient-provider relationship. Trust is vital for effective treatment, and patients should feel confident that their provider is dedicated to their well-being.

Misleading Information: Card Mills often do not provide adequate education on cannabis, leading to misinformation about its use, effects, and potential risks. Patients may leave these appointments without a clear understanding of what to expect, making them less likely to engage meaningfully in their treatment.

The Importance of Personalized Evaluation

When a patient seeks a medical cannabis recommendation, they deserve more than just a quick consultation and a signature on a certificate. Each evaluation should involve:

In-Depth Patient History: Understanding a patient’s medical background and current conditions is essential. This informs the recommendation and ensures that cannabis therapy is appropriate. I take the time to ask detailed questions about the patient’s history, symptoms, and any treatments they have previously tried.

Discussion of Symptoms and Goals: Every patient has different symptoms and treatment goals. A thorough discussion helps tailor the cannabis recommendation to their specific needs. I often ask patients about their expectations and what they hope to achieve with cannabis therapy, ensuring that I can provide them with realistic options.

Education on Options: It’s important to educate patients about the various strains and delivery methods of cannabis. Many patients are unaware of how different options can affect their treatment outcomes. For example, I explain the differences between THC and CBD, their effects, and how to choose the right strain for their needs.

Follow-Up Care: After a recommendation is made, ongoing support and follow-up are vital. This allows for adjustments based on how patients respond to treatment. I encourage patients to return for check-ins to discuss their experiences, making it a collaborative effort.

The Role of Experience in Care

As I reflect on my journey from anesthesiology to medical cannabis, I recognize that my clinical experience has shaped the way I approach patient care. Having worked in high-pressure environments, I’ve developed a keen ability to stay calm and focused, even when faced with complex situations. This experience translates well to my current practice, where I must navigate the nuances of cannabis therapy.

In anesthesiology, I frequently had to make quick decisions based on a patient’s condition during surgery. This ability to assess situations rapidly and make informed choices is equally important when evaluating patients for cannabis therapy. Each consultation is an opportunity to apply the critical thinking skills I honed in the operating room.

Building Trust Through Care

Trust is the foundation of any successful patient-provider relationship. My goal is to create an environment where patients feel comfortable sharing their concerns and asking questions. I strive to communicate openly and transparently, ensuring that patients understand the rationale behind my recommendations.

By prioritizing patient education, I empower individuals to take an active role in their healthcare. I encourage them to express their preferences and concerns, which helps me tailor the treatment to their unique needs. When patients feel heard and respected, they are more likely to engage in their treatment plan, leading to better outcomes.

Conclusion

The question of how many medical cannabis certificates is too many reduces the importance of thoughtful, personalized care that comes with experience. Being a clinical anesthesiologist for over 35 years has taught me that patient safety and individualized treatment must always come first. Writing over 10,000 Virginia cannabis certificates has also been a rewarding journey, but it’s not about the number—it’s about the quality of care we provide.

As I continue to write medical cannabis certificates, I remain committed to ensuring that every patient receives the careful evaluation and tailored recommendations they deserve. After all, in healthcare, it’s not just about issuing certificates; it’s about making a meaningful difference in patients’ lives. By focusing on quality, education, and personalized care, I strive to contribute positively to the evolving landscape of medical cannabis, helping patients find the relief they seek while ensuring their safety and well-being.

So, is 10,000 Virginia medical cannabis certificates too many to have written? During my anesthesia career, I don’t think a single one of the 796,250 patients I helped then ever thought that number was too many.