A recent conversation about medical cannabis led to the question of whether any medical clinician can recommend it. As I tried to provide an answer, I realized that doing so was not as easy as I thought it would be. There is a lot to consider here.
The Definition of Recommend
The first challenge I ran into was defining the word ‘recommend’. I suppose any clinician could recommend medical cannabis in the sense of advising a patient to at least consider it. But within the state-legal medical cannabis arena, recommending means something different.
To recommend medical cannabis is to give official approval to a patient wishing to use cannabis medicines. In the state of Utah for example, official recommendations are submitted through what is known as the electronic verification system (EVS). According to the pharmacists at Cedar City’s Zion Medicinal, Utah regulations are very specific about who can issue official recommendations.
Four Types of Clinicians
Utah regulations allow several different types of clinicians to officially recommend medical cannabis. In fact, there are four types – and pharmacists are not among them. They are:
- Medical Doctors (MDs) – Medical doctors are allopathic providers, meaning they utilize traditional diagnostic methods and treatments.
- Osteopathic Doctors (DOs) – Doctors of osteopathic medicine have all the same rights and privileges as MDs. What makes them different is their focus on holistic medicine rather than its allopathic counterpart.
- Advanced Practice Registered Nurses (APRNs) – APRNs are registered nurses who have undergone additional training to be able to provide primary care. Nurse practitioners are among their ranks.
- Physician Assistants (PAs) – A PA has undergone all the same training as an MD. The significant difference is the number of clinical hours he has under his belt.
In all four cases, the clinician must have prescribing authority in the state of Utah to officially recommend medical cannabis. A lack of prescribing authority makes medical cannabis recommendations off limits.
State Licensing Requirements
In addition to clinical licensing requirements, some states require special licensing to recommend medical cannabis. Let us go back to Utah again. Each of the four types of medical conditions mentioned in the previous list require licensing by a state board. So to practice in the state, a Utah family doctor must be licensed by the state to practice internal medicine.
As far as recommending medical cannabis is concerned, Utah used to require that medical providers become Qualified Medical Providers (QMPs) under the state’s medical cannabis statute. In order to do so, a clinician had to undergo additional training to earn a state certification. The certification is essentially another license.
Things have changed in the Beehive State since their medical cannabis program was first enacted. It turns out that there were not enough clinicians willing to become QMPs. As a result, supply did not keep up with demand. State lawmakers stepped in and established the Limited Medical Provider (LMP) program.
Under this program, any clinician in one of the previously mentioned groups (with prescribing authority) can recommend medical cannabis to up to 15 patients. No additional training or licensing is necessary. So why go through the hassles of being certified? Because QMPs can recommend medical cannabis to more than 1,000 patients.
It’s a State Thing
Utah offers a perfect example of why answering the clinician question is not so easy. The truth is that it’s a state thing. States regulate medical cannabis and subsequent recommendations according to their own standards. So what is possible in Utah may not be possible in Oklahoma. If you want to know what is allowed in your state, you’ll have to do some research.
