THE VALUE 0F THE MEDICAL CANNABIS PHYSICIAN IS PRETTY LOW

In any version of a “Medical Cannabis” System, there are three principle components:

1. The Physician who is the “gate keeper” at the present time
2. The grower, who provides the plant material
3. The “Dispensary” which will make some products, but primarily sell the cannabis.

Pretty much all interest revolves around the growing and the dispensaries, and very little around the Physician. Why is this? It is because the physician is valued ONLY as an access point with a valued determined by the market to be around $35, or less than 1/8 of cannabis!

Does this make sense? Why are doctors not valued? Why are all the interest and investments in this industry going into growing and dispensing and virtually none into research and physicians?

I have wondered about this for a number of years and feel I finally have a better understanding. We are a species who loves drama and excitement. We love to watch a crashing plane or car, but don’t want anyone injured. If we are not on the edge, we are taking up too much space. Doctors and medicine with cannabis are boring because we as doctors have not made it very interesting.

As physicians, we are generally scared of losing our licenses – and for good reasons!!

As physicians, we have been told to avoid the plant, working with the plant, testing…

As physicians, we were led to believe that any specific dosing of cannabis or “Treatment Plans” were actually illegal and just not the province of the physician.

Of course, this is now history and it is clear that “Treatment Plans” written by physicians is the only way to move forward. For certain, I feel this way and I give every patient I see a treatment plant.

As Physicians, if we don’t give our patients treatment plants, how can we know what they are taking? Currently, the patient, the physician and the dispensary have no clue whatsoever as to what medicine in what dose or frequency the patient is taking. With this being the case, “follow-up” and adjustment of medicine is just impossible.

So, how do we get doctors to be valued in this industry as they are valued in so many others?

As physicians, we better learn how to use cannabis medicine and it is quite clearly, at least in my opinion, a mg initiative and not “by the gram” initiative.

Growers and Dispensaries are always dealing and measuring grams, ounces and pounds; physicians always work with milligrams.

So, with cannabis, how did our group of scientists and physicians come to low “dose by the mg” cannabis therapy

1. There is much literature using Sativex in many countries and this whole plant extract has been used in hundreds of trials with known dosing
2. The early extracts we created and used 5-6 years ago were not very good. They were perhaps 1-2 mg/ml but still had clinical effects.

So, between the literature and our experience, we learned that a couple of mg of whole plant CBD/THC was a very significant dose. Every time we light a joint or a pipe, we burn more cannabinoids than we need for most diseases for a full day or two

Allow me to give you a few examples of our typical work

1. A patient comes in with pain or anxiety
2. They are started on a specific number of mg of CBD/THC whole plant medicine. This dose is written in the chart and given to the patient. So, the doctor and the patient know precisely what is being taken, just like with any other medication.
3. During the follow up phone call a week later, we can adjust up or down. We can change the ratio and dose of cannabis and then follow up and keep adjusting.

WITHOUT KNOWING WHAT THE PATIENT IS TAKING, WE, AS PHYSICIANS ARE OF LITTLE BENEFIT.

When we can work with the patient and dose by the mg, have normal follow up and medication updates, we will be valued by the industry and regain a balanced role in this industry

Author

Allan Frankel, MD Dr Allan Frankel is one of the few physicians in the US who truly understands Cannabis as a medicine. All treatments suggested have been well studied. Every patient seen by Dr Frankel is given a personally created Treatment Plan created with the patient's specific issues defined. Plant medicine requires "tuning" of the dosing. Dr Frankel works with his patients thru a messaging portal. The use of this portal, allows quick and simple follow up contact with Dr Frankel. Patients are not charged for these messages, as this is how Dr Frankel has learned what he has learned. Follow up appointments in person or by phone/video are also available when needed