The Philadelphia Inquirer announces New Jersey Medical Board suspends the medical license of Anthony Anzalone, M.D. -- Dr. Marijuana. This is the region's first medical license suspension case involving a physician violating newly enacted medical marijuana regulations. My research and blogs reviewing Pennsylvania and New Jersey's Medical Marijuana laws and regulations predicted this type of disciplinary prosecution.Medical Marijuana Research
The factual allegations in these license disciplinary actions are significant but easily proven. The charges focus on the Legislature's basic concerns of legalizing marijuana -- physicians and patients faking medical conditions and diagnosis to get legal pot. That is why, from the legal viewpoint, the laws and regulations were structured the way they were. The laws make it very easy to prove when a medical practitioner fails to comply medical requirements of the Act. The enabling regulations easily exposes medical professionals to disciplinary action if they fake diagnose patients. This is exactly what Dr. Marijunana is accused of doing and for which his medical license is now "Up in Smoke".
Pa and NJ's medical marijuana regulations are very explicit. Each jurisdiction's law requires a complete medical assessment, care and treatment of a patient's debilitating medical condition. A physician must have an existing one-year patient relationship. The physician must continually assess the medical condition on it least four separate visits. Medical records must include a comprehensive medical history, review of all prior medical records, and be updated periodically.
The specific subset of medical conditions allowing for a medical marijuana prescription require both objective and subjective diagnosis prior to a medical marijuana card certification being properly medically certified. The physician's certification must include statements that:
1) The patient is intolerant to conventional medical therapy; and
2) Suffers from at least one if not more of severe chronic pain, severe nausea vomiting, wasting syndrome, HIV and/or aids, MS, ALS, terminal cancer, IBS, Crohn's, a terminal illness with less than 12 months to live, and any other medical condition or treatment approved by the department of health and Senior services by rule.
If a physician certifies as a patient for a medical marijuana card, that physician's identifying information and medical diagnosis must appear on the patient's medical marijuana card. The authorizing physician must have explicit patient conversations regarding the risk benefit analysis of medical marijuana.
The physician's written instructions need include:
1) the physician's personal identifiers,
2) Appointments to see the patient at least once every three months; and
3) Anticipate review of the patient's debilitating medical condition and potential progress of the medical condition.
New Jersey law requires physicians to remain alert for misuse or diversion. The physician must exercise extra care through monitoring, documentation, and consultation with an addiction medical specialist about substance-abuse concerns. The physician may consider patient agreements concerning medical and legal consequences of the misuse of medical marijuana.
The law requires physicians keep accurate and complete records of patient's medical history, physical examination, and diagnosis of the debilitating medical condition in conjunction with symptoms and severity. The patient's history and adverse reaction to conventional medical therapies warranting the use of medical marijuana must be included in the chart. Treatment plan objectives and evidence of informed consent are mandatory and available for periodic public review. This means patients waive their HIPPA rights for public regulatory review.
There is one significant difference between Pennsylvania and New jersey's licensee disciplinary process. In New Jersey it is mandatory for medical professionals to cooperate with a Board investigation. Failure to cooperate is a separate grounds for disciplinary action. This is not the case in Pennsylvania.
New Jersey's Medical Marijuana Act contains a separate and distinct physician duty to comply with Division of Consumer Affairs investigations regarding the certification and issuance of a medical marijuana cards. NJAC 13:45A-33. Failure to cooperate with any medical marijuana and investigation can subject the physician to disciplinary action pursuant to NJSA 45:1-21.
New Jersey's MMA law parallels Pennsylvania's MMA with substantially similar record keeping, certification, and compliance regulations. I have written numerous times about sting operations and Attorney General investigations sending fake patients to targeted doctors. Doctors who fail to comply with the stringent regulatory steps and issue medical marijuana cards willy-nilly are easily discovered and prosecuted.
Dr. Anzalone, who branded himself Dr. Marijuana placed a target on his medical practice. He asked for a state board investigation. He fell into trap the law was specifically designed; to catch stupid doctors exploiting a new revenue stream without a medical basis at the expenses of sick and injured patients. While Dr. Marijuana may have made a little bit of money in the short run, his medical license is now been emergently suspended.