A physician’s greatest responsibility is to provide patients with the best, most appropriate and safest care possible. It is this Hippocratic oath that we recite at medical school graduations, and it’s what you should expect every time you visit your doctor’s office.
Nearly a decade ago, Colorado voters approved a constitutional amendment allowing patients to possess and use limited amounts of marijuana to treat certain conditions. At the time, the Colorado Medical Society opposed the measure. We felt then, as we do today, that research on the use of marijuana for medical purposes was incomplete at best, and that appropriate evidence-based drugs with more accurate dosing are available.
With the amendment now part of our state constitution, however, our focus must be on ensuring that the drug is available only through a program that is regulated, that considers what is right for patients based on the best available scientific evidence, and that protects those patients from harm.
That is why the Colorado Medical Society worked closely with Sen. Chris Romer (D-Denver) and Rep. Tom Massey (R-Eastern Colorado) in crafting Senate Bill 109, legislation that strengthens the current Medical Marijuana program and defines the physician/patient relationship for purposes of this program.
The bill states that to certify a patient for medical marijuana, a physician must have a valid license to practice medicine in Colorado and an established, clinical relationship with the patient.
It would require that the physician perform a personal physical examination and complete a full assessment of the patient’s medical history and current condition. The certifying physician also must offer follow-up care and treatment to determine if the drug is effective.
And, Senate Bill 109 also would create a means for a physician to be referred to our disciplinary body, the Board of Medical Examiners, if he or she is suspected of violating the law. This would allow us to hold our profession accountable to the highest standards of patient safety.
Importantly, Senate Bill 109 does not take away the constitutional right to use marijuana for conditions such as cancer, severe pain and HIV/AIDS. It simply requires the type of physician/patient relationship that good doctors employ for any medical treatment plan.
Many Colorado doctors remain reluctant to certify patients for marijuana use because while the state has declared medical use of marijuana legal, the federal government still outlaws it. Most doctors who do certify patients for medical marijuana do so only after thoughtful discussion and deliberations with patients with whom they are familiar.
But like many Coloradans, we are concerned about the recent spike in the drug’s availability and by accounts of a handful of physicians who seem to certify patients for medical marijuana use without a full evaluation. SB 109 will decrease such abuses.
An established physician/patient relationship is particularly critical when treatment includes a drug such as marijuana. Although we have some scientific evidence about the medical use of marijuana, we don’t have the sound knowledge we’d like of issues such as how the drug will interact with other medications, or its proper dosing.
The Colorado Medical Society believes clinical studies on the efficacy and safety of marijuana should be conducted and evaluated, and that any existing or future policies should be based on study findings. Until that hard information exists, however, patients must rely on their physician’s clinical judgment and knowledge of the available evidence.
As physicians we have an obligation to our patients’ and the public’s health. SB 109 helps up achieve this goal. We thank Colorado’s General Assembly for supporting it.
Mark Laitos, M.D., is a family medicine physician from Longmont and President of the Colorado Medical Society, which represents more than 7,000 physicians and medical students throughout Colorado. EDITOR’S NOTE: This is an online-only column and has not been edited.
