Contact: Richard Gulla
781-434-7101
rgulla@mms.org
Medical conditions, supply, monitoring, certification, registration are among physician concerns
Waltham, Mass. -- April 18, 2013 -- While stating its broad support for many of the Department of Public Health’s proposed regulations governing the use of medical marijuana in the Commonwealth, representatives of the Massachusetts Medical Society will focus on the details of specific regulations in their testimony to be delivered at the DPH’s public hearing on the proposals in Boston on Friday, April 19. (Note: The Boston hearing has been postponed until Monday, April 22.)
The Medical Society, which still advocates that clinical research needs to be conducted to show the safety and effectiveness of marijuana as medicine, commended the DPH for a “thoughtful and responsible job with a difficult task” when proposed regulations were issued in March, saying the regulations took into account many of its concerns.
In its testimony at Friday’s public hearing, the Medical Society, after a detailed examination of the proposed regulations, will share additional concerns related to definitions of medical conditions, supply, monitoring, certification, and registration.
A major concern of the physicians’ group is the definition of “debilitating medical conditions” that would qualify patients to use medical marijuana. The MMS is advocating that a patient must not only have one of the diseases included in the referendum but “also must suffer debilitating symptoms.”
Richard Aghababian, M.D., President of the Massachusetts Medical Society testified that “The MMS policy on this issue establishes a threshold that optimal control of pain and spasticity are not met by conventional methods prior to considering marijuana use. MMS strongly supports adapting the regulations to create a clinical advisory group within the DPH that will review available research and determine appropriate standards for inclusion of diseases and conditions and levels of symptoms that are appropriate for certification. The MMS has concerns that unfettered discretion allowed in the certification process in other states had led to abuses that threaten the integrity of the entire process.”
The issue of a sixty-day supply was another issue cited by the physicians’ group, with Dr. Aghababian, citing organizations such as the American Society of Addiction Medicine that have noted the negative impact on brain function by heavy use of marijuana, stating that a determination that a patient can receive up to ten ounces of marijuana is “unsupported by clinical evidence.
Among other concerns expressed by the Medical Society:
Use of the Prescription Monitoring Program (PMP): MMS supports the mandated use of the PMP prior to certifying a patient, but opposes the apparent intent of the DPH to create a new and free standing data base for medical marijuana. “Integration of marijuana data into the PMP should be straightforward and simple,” the Society maintains.
Written Certification: MMS called attention to the issue of patient privacy in describing particular conditions and symptoms. MMS is concerned that DPH must treat specific diagnostic information with the utmost confidentiality, and that such information be used only to determine a patient’s eligibility for registration. Information should then be inaccessible except for formal reviews by the Board of Registration in Medicine (BRM) when investigating complaints that physicians are certifying patients without a bona fide physician-patient relationship.
Registration Card: Language in the proposed regulations specifies registrations as having a five-year duration, but certification lasts for only one year. MMS said a five-year duration for registration is inconsistent with certification requirements and creates a presumption that all patients will be users for an extended period.
Confidentiality: MMS said the broad language on confidentiality is inconsistent with the integration of patient specific information into the PMP data base. It also recommends that physician participation in the certifying process should be confidential, as “access by the general public to information regarding certifications, underlying diagnoses, and activity by specific physicians may lead to patient doctor shopping or other undesirable results.”
Revocation of Physician Certification: MMS also expressed concern about the process to revoke a physician’s registration as a certifying physician by the DPH. MMS is recommending that separate regulations be created to refer questions about individual physicians to the Board of Registration in Medicine for action. Saying that “any action by the state restricting a physician’s ability to practice medicine is viewed as a disciplinary action by the Board of Registration in Medicine,” the MMS said DPH should modify the regulations to allow for delayed or suspended actions on pending requests until the BRM acts.
The complete testimony of the Massachusetts Medical Society is available at www.massmed.org/testimony
The Massachusetts Medical Society, with nearly 24,000 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes the New England Journal of Medicine, a leading global medical journal and web site, and Journal Watch alerts and newsletters covering 13 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country. For more information please visit www.massmed.org, www.nejm.org or www.jwatch.org.
