Cya Documentation In Light Of Hartwick/tuttle Ruling

[keylan]

Ive had time to digest the recent rulings in Hartwick and Tuttle. Being a nurse this ruling is a lot like what nurses do in their charting - CYA its drilled into us that what we document or fail to document may one day bite us in the donkey in court. Rule one is if it isn't written it didn't happen. Another rule is don't add what is not fact. In light of the rulings I feel it prudent to spend a little time now that one day may save me from jail. Yes its a pain in the butt and shouldn't be necessary, but Im going to do my best to follow what the court seems to want

Some things that I will be doing

1- sending a written note to my certifying MD every 3 months and having this note put in my chart. I will be including in the note the efficacy of the cannabis, a daily amount range and how many times a day I use MM. Lastly I will state to the MD to contact me with and questions or concerns.

In the real world I don't contact my GP that often, for example I just got a Rx renewed for Ultram [the original was for 6 months] I did not have  a face to face with my GP nor did I provide nor was I asked for any information on how the medication was working nor how often I was taking the Ultram. The law has no problem with my GP relationship being "bonified" so by going above and beyond what is customary in a MD / Patient relationship I have laid down written evidence that I have an ongoing relationship with my certifiying MD

 

2 I will also make sure that any tests doctor apt records new dx ect. that I have had done since my apt with my certifying doctor are sent to my certifiying MD. You will have to sign a form requesting that the information go to your certifying Md but they then will send the info over for you. you can just get the info yourself and send it if you don't want them to know your seeing another MD. FYI always double check that the info got to your certifying MD things do get missed!!!!!!The info should be their in 2 or 3 days - they just fax it.

 

3 Notify him of any changes in other medications. [ also make sure he has a list of my current meds and dx for those meds] This is a biggy. in my work I often have to notify the GP of meds another MD has Rxed [ex. Patient sees a Cardilogist and he Rxs a new med or changes meds in some way] This IMO would be a biggy in making sure you have a bonified pt relationship. Its customary in healthcare for this to be done.

 

The above will lay out a papertrail  of your ongoing relationship with your certifying MD. The MD does not need to respond to the information you provide. In the real world they rarely do. I often call MDs torelay info and they don't respond unless their is a problem. An example would be Just calling to let you know Mrs so and so is taking Colace and a calcium supplement she got at Wal mart. now I relay this info to the office nurse she enters it on the computer, the info goes to the MD and he reviews it and if he has no issues its just noted in the chart . but say the patient is on a med that would conflict with one of the over the counter drugs she is taking - he then would contact me or her [ you only get a response if their is a problem - that is customary. Same would be said if I reported a lab test or how well a med is working ect.

 

I am just going to do what I do regularly [as do all healthcare workers]  in the normal course of work. The above are things that are found in any patient chart [actually its more] but since we are looking at courts more is better. These things certainly show an ongoing active relationship. If these things don't show a "bonified " relationship, their is nothing I can think of that would.

[trichcycler]

added;

 

 police have no idea about the last time I contacted my physician, or my knowledge of patient conditions, or even my own.

 

 

1) stay within your plant counts

2) don't sell to anyone outside of your group

3) do not sell cannabis to a dispensary

4) lock your grow room doors at all times

5) do not allow police to search your home or garden without a search warrant

6) do not sell cannabis to a dispensary

7) record expiration dates for patient cards, your own, and cg cards, set reminders for the re up

8) avoid detection

9) do not try to explain anything to an arresting/investigating officer without an attorney present.

10) don't tell other people you grow cannabis

 

Those rules will protect growers from arrest.

[Restorium2]

And the most important, as silly as it may sound; Tell your doctor to write, "In the course of a bonified doctor patient relationship I examined the patient and ......... "

 

The court has made a monkey out of your doctor, like it or not. They have taken the art of medicine out of their hands and made them court appointed attorneys instead (when it comes to cannabis). 

Edited August 4, 2015 by Restorium2