Medical Cannabis Evaluation 101:  The Doctor’s/Patient’s Evaluation Experience

By: Raoul Grant----Healthcare professional specializing in Medical Cannabis.

Published: August 26th, 2010

I’ve been asked to share information about the Medical Cannabis evaluation experience from a doctor’s perspective and offer suggestions for a complete and effective process.  The doctor is sharing his personal standards of patient care, which comply with Colorado state law.  Requirements may vary by state and other doctors may evaluate patients differently than myself, while still complying with the law.  As a patient, you should insist that your evaluation offer the same levels of professionalism and courtesy as you would expect from other doctors.  The MD interviewed has trained and collaborated with leading local and other medical professionals in Washington state and California to raise awareness and understanding for the responsible use of Medical Cannabis.

 The best evaluation is driven by 2 main factors:

1.     A Prepared Patient
2.     A Compassionate and Skilled Diagnostic Doctor with knowledge of medical cannabis

Let me expand upon these in more detail, and discuss unusual circumstances at the end.  The evaluation process is not complicated, yet it is thorough.  Usually the medical cannabis/medical marijuana(MC/MMJ) evaluating doctor (MD/DO) will not be the patient’s primary care doctor or specialist.  The MC/MMJ physician is an evaluator of a patient’s symptoms/conditions to see if they meet the specific state’s criteria for the use of medical cannabis.

Patient Preparation
Step 1 – make your appointment.  please keep your appointment or cancel if you cannot come so that we may serve other patients instead.
Step 2 – the appointment.  Patients will need to fill out several standard information forms, similar to any doctor’s visit, which will enable the evaluating doctor to more fully understand your case.  A detailed, honest history is needed so the evaluating physician can act appropriately.  Incomplete forms can be a roadblock to receiving a MMJ registry card.

Patients should come ready to discuss their medical history and qualifying condition/symptoms in detail.  Your evaluating doctor will want to review the following:

• Medical documentation/medical records from your primary care physician/specialists for the condition for which you are seeking a medical cannabis recommendation.  While chiropractic and physical therapist records are useful, they may be considered as secondary information in many instances. The most meaningful  primary information comes from the present-day or past treating medical doctor(s) (MD) or a doctor of osteopathy (DO). All patients are asked to bring all their medical records to the doctor for review during the evaluation process. Emergency Room records should be included as well.
• List of medications prescribed and taking presently and in the past.   
• Psychiatric history, criminal/legal history, other medical conditions including pregnancy, tobacco use, etc. will be discussed.

What to Expect at the Doctor’s appointment.
During the evaluation, the doctor will do the following:

1. Basic physical exam with focus on the qualifying condition(s) and related symptoms.
2. Review of medical and social history via evaluation of patient information forms and outside medical records; open discussion with the patient.
3. Education: Answer questions about overall health & wellness as well as specifics about use of Medical Cannabis.

In case of minors (under 18 years old in Colorado), a parent/guardian must be present and two doctors approvals are necessary for a MMJ permit in Colorado.  This may vary from state to state. In some instances the MC evaluating physician will communicate with the other treating doctors involved in cases dealing with minors.

Ongoing Patient Preparedness
It is strongly advise patients to keep their own up-to-date medical file in a safe place that is a duplicate of their doctor’s files to be ready for annual MC renewals.  There can never be too much outside medical documentation regarding the qualifying condition including side effects of medication, x-ray reports, lab results,etc..

Unusual Circumstances.
Situations do arise where patients have no medical records due to lack of insurance, lost/missing records, or other circumstances. These patients may be approved for a MMJ card depending on other factors of the applicant’s specific case. Each patient is unique. One size does not always fit all.  The MD/DO will review the patient’s clinical history including the age and prior treatment(s) of the applicant especially in dealing with chronic medical problems, especially the specific qualifying condition for MMJ and its’ cause and other factors that will help the MD/DO make their decision. However, medical documentation by an outside treating physician(s) will usually be needed at some point during the MMJ evaluation process. This information may come to the doctor after the MMJ recommendation is approved and will go into the patient’s file at the MMJ evaluation clinic. The key in these cases is the physicians clinical judgment at the time of examination. The MC evaluation is an art and a science. The MD/DO evaluator reviews,listens, observes, asks questions, examines and then makes a decision----yes, no, or the case is pending depending on more outside medical/other information.

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