Open Discussion With Potential New Patients Is Harder Than I Anticipated

[Restorium2]

The part that doesn't make sense is when you/they make a caregiver's job so important, and part of the medical treatment, is that a patient doesn't even need one. You don't have to have one. A patient can do it all on their own. But when they simply want someone to grow for them then it has to get so involved. Doesn't make sense. It's rules for the sake of rules, for further restriction. 

 

 

When we enter into this discussion about caregivers always remember they are a non essential part of the equation. So you can't put a lot of undue importance and restriction tied to having a caregiver because all it takes is a form and they are gone. Just like an employee, they can be fired by the real person in charge, The Patient. The patient is always in charge so why pretend like the caregiver is? 

[Restorium2]

Spoken like a true caregiver- one that understands the use of cannabis and how it is tailored to conditions.  Excellent suggestion and strategy.

 

Remember, the take home point must be to be able to explain, clearly and with some authority, what you are doing and why.  Your counter to 'I just gave him what he wanted and could afford and didn't ask questions'.  That will not sell to the court.  Your explanation paints a clear and convincing argument that the cannabis is being used to TREAT a condition, not get someone high as a recreational substance.

 

Just to follow up on that last point, folks like recreational substances and cannabis is clearly one of the safest they can use for fun, but we don't have recreational cannabis laws in this state, and we can't use recreation arguments if we end up in court.  I've never penalized a patient for the use of cannabis in 35 years of practice at various levels, but my tolerance does not equate to the courts' tolerance- an important point to keep in mind.

 

Dr. Bob

Hmm. I'm thinking that I just might not want you to go to court for me. All this time I thought you would be really good in court but now I'm wondering if you do much more harm than good in court. 

[Restorium2]

As a highly functioning patient(pun), I possibly want to buy what I think I need without having to explain why. That's my right. That's what needs to be sold to the courts by my doctor. Not a long story (bunch of pandering BS) to help warp the true meaning of the law into what law enforcement wants it to be to undo restrict us. 

 

The whole 'caregiver in charge' caters to those that think medical marihuana is for a person's end days when they can't take care of themselves anymore. It's only one small segment of real patients that need that kind of help.

[trichcycler]

I am sitting here scratching my head after talking on the phone with a potential new patient that was looking for a caregiver. This is the third time I have had people say something to the effect that I am making this harder than it has to be.  No wonder most of you deal with close friends and family for your patients. I think I am ready to just call it quits as people astonish me with their lack of regard for the legalities on this patient to caregiver relationship.  Can you all give me a way to have a good discussion with a potential new patient?  What are some good questions to lead with? I start out asking about what  their medical needs are and confirm they do in fact have a MMMJ card. Then I try to touch on a bonafide relationship with their Dr. ..as in a follow up at least once ( in regards to making sure that their card is upheld/ validated in court if any problem arises) and that is where people seem to think i am 

a nit picker.... maybe i am not explaining myself in a concise follow along manner......but people dont get where I am going and when I say it could be the difference between me going to jail or not they say something to the effect that I  am worrying more than i should or overthinking, complicating matters which are simple. Are patients not educated? I am just disheartened.  Any suggestions? As with anything I know you should start light and move gradually into more intense questioning/discussions.....how do I have a productive discussion? Thank you.

sorry for any part of the derailing I had.

 

I suggest coming up with some points that are important to you. Maybe like legality, medicine cost etc, starting with the most important aspect of your provisioning/registration. Mine may be age (for example). I ask half of my list in one email, the second half in the next email(interview/meeting etc) If the patient says they're 19, newly released from prison, works at Wendy's..etc,, I don't bother with the next set, and calmly end the interview then, and move on. I try to keep the correspondence quick and short.

 

you could alternatively post of your thoughts, ideals, techniques, with your caregiver advertising, and the patients that repond to you will hopefully already "pre screened" a bit with your prerequisite ideals. (kids(18-25) don't ask me much anymore to be their caregiver, but the few that do, have usually been really good patients, if I registered them.

[imiubu]

Hmm. I'm thinking that I just might not want you to go to court for me. All this time I thought you would be really good in court but now I'm wondering if you do much more harm than good in court. 

 

Ahhh... you get it

 

Give some people enough rope and they will eventually hang themselves.

[Restorium2]

We are talking about "Unauthorized Practice of Medicine" in my opinion.  Where does a caregiver have any right to know any of this(condition, physician etc), or make random suggestions for dosages and such?

 

 Although I understand how the Michigan Republican Courts have been,.. I feel  stating any of those things about dosages etc is outside the realm,  even for physicians in Michigan.

How do you go about informing your doctor that you, the patient, are in charge, and you don't want them bolstering the bad idea of: by just adding a caregiver to grow for you you add a lot of bother for nothing other than undo restrictions in most cases? 

[Dr. Bob]

As a highly functioning patient(pun), I possibly want to buy what I think I need without having to explain why. That's my right. That's what needs to be sold to the courts by my doctor. Not a long story (bunch of pandering BS) to help warp the true meaning of the law into what law enforcement wants it to be to undo restrict us. 

 

The whole 'caregiver in charge' caters to those that think medical marihuana is for a person's end days when they can't take care of themselves anymore. It's only one small segment of real patients that need that kind of help.

 

Won every one of them.  

 

What is actually said in court and what is prepared for if needed are two different things.  I make it a point to have answers for questions, to be used in the event they are asked.  Want to know how much is reasonable?  How much did he have?  yes, that is in line with these guidelines, in fact is well under them.  Know what the federal dose of marijuana is?  How about states that do set limits on how much can be purchased over what period of time (not applicable legally in MI but good to show what is reasonable).  Preparation is key, case by case.

 

Dr. Bob

[Restorium2]

Won every one of them.  

 

What is actually said in court and what is prepared for if needed are two different things.  I make it a point to have answers for questions, to be used in the event they are asked.  Want to know how much is reasonable?  How much did he have?  yes, that is in line with these guidelines, in fact is well under them.  Know what the federal dose of marijuana is?  How about states that do set limits on how much can be purchased over what period of time (not applicable legally in MI but good to show what is reasonable).  Preparation is key, case by case.

 

Dr. Bob

I think consistency of the message you put out is what will serve us in the long term. 

 

If you would counter their claims of the importance of the knowledge the caregiver has about the patient with the fact that the caregiver is not an integral part of the situation and they can be not even used or changed so easily with a form, I would be on board with your message. I would feel a lot more comfortable with it if you stressed that the patient is the boss, not the caregiver.

[+Malamute]

Just because it is not required does not mean that the courts are not requiring the answer.

[Willy]

I think consistency of the message you put out is what will serve us in the long term. 

 

If you would counter their claims of the importance of the knowledge the caregiver has about the patient with the fact that the caregiver is not an integral part of the situation and they can be not even used or changed so easily with a form, I would be on board with your message. I would feel a lot more comfortable with it if you stressed that the patient is the boss, not the caregiver.

I dont think the patient or the caregiver are boss, one over the other,  it should be  a symbiotic relationship. The patients need and the CG's ability to comply. And at the same time , complying with legal issues as best we can. Its ludicrous to demand the patient to confide his/her confidential health situation. But if they wish to share, it can help with suggesting strains,and just encase your  in court, shows your at least vested in the relationship... 

[Restorium2]

Won every one of them.  

 

What is actually said in court and what is prepared for if needed are two different things.  I make it a point to have answers for questions, to be used in the event they are asked.  Want to know how much is reasonable?  How much did he have?  yes, that is in line with these guidelines, in fact is well under them.  Know what the federal dose of marijuana is?  How about states that do set limits on how much can be purchased over what period of time (not applicable legally in MI but good to show what is reasonable).  Preparation is key, case by case.

 

Dr. Bob

Won, or gave ground? Precious ground that is impossible to take back.

[Willy]

Just because it is not required does not mean that the courts are not requiring the answer.

this can also be said about  patients information known to the CG...amount, illness, etc

[Restorium2]

I dont think the patient or the caregiver are boss, one over the other,  it should be  a symbiotic relationship. The patients need and the CG's ability to comply. And at the same time , complying with legal issues as best we can. Its ludicrous to demand the patient to confide his/her confidential health situation. But if they wish to share, it can help with suggesting strains,and just encase your  in court, shows your at least vested in the relationship... 

I need no such thing. None. Nadda. NO CAREGIVER So why does the patient that wants one just to buy from have a different set of standards, more hoops?

[Restorium2]

We patients can legally obtain anywhere we want to. We can buy all we want, up to 2.5, any time we want, from whomever we want. 

 

Having to explain our illness and treatment to the extent suggested here every time is totally ridiculous. 

[+Malamute]

this can also be said about  patients information known to the CG...amount, illness, etc

 

Yep.

 

I 100% believe in no way that any of that required at all,.. but,.. I have specifically seen it make a difference in court even though it shouldn't.

[+Malamute]

Michigan conservative republican dominated courts are insane in Michigan.  They make rulings that go against what other states with same/similar languages do.  Mixture and preparation thereof as one example.

 

Until people actually vote OUT justices who generally run unopposed, things will not change. It can take 20 years to shift a judiciary.

[Restorium2]

How many caregivers are qualified to even understand our illnesses? They surely don't get paid enough to be doctor too. 

 

We have the right to hire a grower to grow for us that has not been to medical school.

[+Malamute]

Agreed Resto.

[Willy]

I need no such thing. None. Nadda. NO CAREGIVER So why does the patient that wants one just to buy from have a different set of standards, more hoops?

 

 

 

 

I guess you would have to ask the MMP an see why they have those standards. and hoops 

I'd like to know what  different set of standards , I as a cg would be putting on a prospective patient , Asking there needs or requirements.

Or maybe just throw them an oz ? Call it even.

Edited March 19, 2016 by Willy

[Jjamh]

As a caregiver I assure you I know more about how each of my strains act or how they "hit" you than just average joe.I always try to tailer my grow to match my patients needs for their specific condition. I don't care to know my patients condition, per say, but if I could just know what symptoms their trying to alleviate, I can work with that, otherwise as a patient would you want me to just give you what I have the most of or just flip a coin?

[medmanmike]

Where does LARA stand with all of this? Do they have "guidelines" for how a CG should interact/understand the pt's medical needs, i.e. Condition, dosage, etc.? If they don't, shouldn't they? They are, after all, the ones approving the licenses.

 

Ive looked through the LARA's site on the MMJ program and can find nothing under "rules" for pt or CGs. The MMMA, Admin guidelines, recent court changes to the Act, etc. are listed, but nothing specific under "licensing" for either pt or CG. Gheez, even a Cosmotologist license requires following a bunch of rules.

http://w3.lara.state.mi.us/orr/Files/AdminCode/1430_2014-100LR_AdminCode.pdf

 

I know the Act and subsequent court rulings have added clarity (right....) to what a pt and CG can/cannot/should do, but one would think LARA, the department doing the licensing, would have a legal interpretation (of the act, new rulings, etc.) and make it available so the licensees would know what is/is not required of them upon obtaining a license.

Edited March 19, 2016 by medmanmike

[+Malamute]

The law does not allow the department to create such ridiculous and burdensome rules.

 

:-)

 

Yay!

 

A cg grows and/or supplies their registered patients with marijuana.  That is it.

 

Anything beyond that is personal preference.  The courts and AG have tried to add more burdensome guidelines, but they simply don't exist.

 

 

Quick story, 

       when I was running the compassion club here in Dickinson County, we used to help patients connect with caregivers.  We had ALOT of caregivers(due to training patients to be Caregivers) and there were 2 patients who we had connected  with 2 different caregivers.

  I actually knew these people and taught them to grow. Both actually grew the same marijuana strains and the quality was the same.

 Anyhow,  both these patients contacted us to complain about their caregivers and that it was just not working out for them.  So, we actually switched the 2 patients to each others caregiver.  Same cannabis. Same prices. Same quality CG's IMO.

 Well, both patients were VErY happy with the switch and remained patients to those Cg's for many years.  Both disliked their previous CG, both loved their new CG's; even though everything was exactly the same, except for the face and personality attached.

 

 

So,... different patients are looking for different things. different caregivers are looking for different things.  Different expectations for all.

 

To the op, keep looking for patients that fit into your scenario or ideals. Relax a little and do not expect every patient to want what you expect or want to give.  Every situation and person is unique and has different expectations.  Start slow, share expectations, don't overburden patients if they don't want it.

[trichcycler]

I have no formal medical training beyond cpr/first aid. I don't have a formal chemistry background. I know so little about the chemical cannabis plant or how it may or may not affect a person on a particular day. But boy oh boy I sure know how to grow a garden indoors though and gladly assist my patients when they decide to have one of their own.  I can grow most vegetables and many fruits year round now.  

 

  I have no idea what prescriptions they take, and even if I could pronounce the words who am I to try to figure what they're for and how they may or may not interact with cannabis. I can tell you that other drugs can and do interact with cannabis negatively (and positively of course) on several levels .  I also know that prescription medication given to a person by a pharmacist prescribed by an MD is experimental. I've seen Rx results all over the map and some tragically end in death, others are a lifetime addiction, chronic illnesses, colon issues, digestive issues and an ever lasting acidic PH(cozy digs for cancer) Cannabis use does not affect my PH, Rx will.

 Trial and error is the game as I see it, nothing new there. It takes one "hit"  for a patient to know if they want/need more or not, it never kills them, they never get addicted either. There teeth don't fall out and nobody is scrambling to take more drugs to cover up the myriad of Rx undesirable effects, commonly known by the endeared "side effects" label.

 

its tiring to attempt a decipher of all the anecdotal mj stories I heard so I decided to accept patients with similar lifestyles as my own, and similar dis-ease too. I grew and sampled hundreds and hundreds of strains, kept notes, revisited the most positive ones, and the negative ones occasionally for a re judge. Win!!  I did win with this notion, and its a keeper. My "patient success" became a regular thing using just that criteria.  Figures, right about the time I'm considering growing only for myself!

 

If I am expected by anybody what has been suggested here..... I will not be growing for anyone else but myself.  whats next , liability insurance? malpractice suits when a strain makes someone paranoid and they freak out?  baloney

[t-pain]

Where does LARA stand with all of this? Do they have "guidelines" for how a CG should interact/understand the pt's medical needs, i.e. Condition, dosage, etc.? If they don't, shouldn't they? They are, after all, the ones approving the licenses.

 

Ive looked through the LARA's site on the MMJ program and can find nothing under "rules" for pt or CGs. The MMMA, Admin guidelines, recent court changes to the Act, etc. are listed, but nothing specific under "licensing" for either pt or CG. Gheez, even a Cosmotologist license requires following a bunch of rules.

http://w3.lara.state.mi.us/orr/Files/AdminCode/1430_2014-100LR_AdminCode.pdf

 

I know the Act and subsequent court rulings have added clarity (right....) to what a pt and CG can/cannot/should do, but one would think LARA, the department doing the licensing, would have a legal interpretation (of the act, new rulings, etc.) and make it available so the licensees would know what is/is not required of them upon obtaining a license.

lara's legal counsel is bill schuette. so lara isnt going to make any legal advice for patients and caregivers. nor are they going to give grow advice etc. many other states dont give grow advice either. its the govt they suck.

 

schuette put out a lot of opinions on the mmma, including some big one right at the start. feel free to follow those rules of his , at least read them and follow as much as possible , even if hes wrong a bunch.

[Norby]

Instead of running out of likes, I like everything said by everyone except Dr. Bob.