Physicians are gatekeepers for entry into the state medical marijuana program. Patients wishing to use medical cannabis to treat the symptoms of disease or debilitating condition must obtain a recommendation from a physician — this is not subject to review or second-guessing. It may not be overridden by any government agency.

Naturally, there is confusion and concern about how this is supposed to work. Doctors are unsure what constitutes a legitimate recommendation; they worry about liability when recommending a drug not approved by the Food and Drug Administration. And how do you ensure consistency in dosage, purity and strength?

The Michigan Medical Marijuana Act stipulates doctors shall not be subject to sanction for writing medical cannabis recommendations. In Conant v. Walters (2003), the U.S. Supreme Court ruled doctor-patient privacy rights protect discussions of medical marijuana and that recommendations are protected free speech. The confidentiality provisions contained in the state law protect doctors as well as patients; the state maintains no list of doctors writing recommendations. Physicians cannot lose their license to prescribe medications for writing medical marijuana recommendations.

Finding physicians willing to assess patients for a medical marijuana recommendation is turning out to be difficult for many patients. Almost daily I hear from patients with the same question, “Where do I find a doctor that will evaluate me for a medical cannabis recommendation?” Thus far, only one clinic in the state is openly accepting new patient referrals for medical marijuana assessments: the THC-F clinic in Southfield.

A few family doctors have begun quietly writing recommendations for old patients. Most, however, are either refusing or taking a wait-and-see attitude. Many erroneously believe that the law, which actually took effect Dec. 5, is on hold until the state publishes final rules in April.

The most troubling reports concern patients being dismissed from practices for simply asking their physicians about medical marijuana. While rare, it is happening. Recently, I spoke with a woman in Antrim County with epilepsy; on another day it was a man in Grand Rapids with heart disease. Each had asked their doctor about medical marijuana and both were dismissed just for asking. This is unconscionable and unethical but apparently legal.

For up to date information visit our Web site, www.MichiganMedicalMarijuana.org. Appointments with the THC-F clinic may be scheduled at: www.thc-foundation.org