Medical marijuana recently became legal this year in Pennsylvania. I have completed the necessary certification requirement and thought that I might have a few patients it could benefit. However, when I checked with my medical malpractice insurance they said that Medical Marijuana services are not covered as marijuana is a Scheduled I substance. I know in Pennsylvania marijuana is not actually prescribed but that patient a patient is certified to have an accepted condition and that it is an opinion that medical marijuana may benefit them. I haven't performed any recommendations or certifications with marijuana until I could be more sure about liability. Does anyone know how to provide some liability coverage if malpractice plans are not covering this? I am sure this has come up in other states. Any input would be greatly appreciated!
Medical Marijuana and Liability
- Thread starter pike73
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I can't speak to PA, but I work in a state that has legalized both medical and recreational marijuana. It's not really an issue for me anymore (I just tell everyone to go to a dispensary and ask them what they would recommend). But when I did certify patients for cards, the state made it very easy. I just filled out a form saying they had one of the (explicitly laid out) conditions for which the state had determined MMJ to be appropriate (I'm an oncologist, cancer was at the top of the list) and that was it. There was no liability issue because I wasn't prescribing anything, or even recommending it. I never brought it up first, I let patients ask me.
I suspect there won't be much in the way of a liability issue for you either since all you're doing is certifying that they have an "appropriate indication". As long as your documentation backs that up, you should be in the clear.
I suspect there won't be much in the way of a liability issue for you either since all you're doing is certifying that they have an "appropriate indication". As long as your documentation backs that up, you should be in the clear.
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I would think if all you do is certify that they have a certain condition, WITHOUT having it state that you think MJ would help, that's a totally different scenario.
Sort of ridiculous to expect you not to certify that a patient has glaucoma when they actually do.
I know this is how it works elsewhere so I don't know specifics elsewhere.
An example is getting a handicap placard. You are actually just signing the patient has X condition that makes Y difficult. That meets the criteria for getting the placard as far as the state is concerned, but that is different than you stating they should have a placard. Makes sense?
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I know one clinic that when those forms were signed, the physician would perform and document a discussion about risks and potential harms from using MMJ if that was what the patient chose to do.
"Some patients find that MMJ has benefits for xyz symptoms. However, there are risks. As a physician I cannot recommended smoking anything, as breathing in the products of combustion (burning stuff up) has been shown to be harmful generally harmful, more or less. It's not clear how much MJ smoke may cause harm. Other methods of administration, may increase or lessen some risks of harm from actual smoke. If you do choose to use MJ, I would recommend a method that avoids combustion with a flame.
I would urge caution as some other popular MJ products can be quite concentrated and may have more SEs, such as edibles or vaping.
I would advise against mixing MJ with other sedating medications. I would advise against driving or other potentially dangerous activities while using MJ.
While MJ is frequently used for nausea, it's possible to develop cyclical vomiting, which sounds like what it is, lots of continual vomiting from MJ use. If this happens the only effective treatment is to stop using MJ.
I was taught to mention that there is a small but real risk of inducing psychosis in some patients that seem susceptible.
I was taught to strongly advise against MJ use in anyone with a history of psychosis, or psychosis in a first degree relative, and not to sign a card in most instances.
I'm not sure I've covered this all perfectly, but it was policy in an otherwise conservative clinic where I know MMJ is done.
It doesn't exactly paint a picture of a physician that is holding a patient's hand down to the dispensary.
"Some patients find that MMJ has benefits for xyz symptoms. However, there are risks. As a physician I cannot recommended smoking anything, as breathing in the products of combustion (burning stuff up) has been shown to be harmful generally harmful, more or less. It's not clear how much MJ smoke may cause harm. Other methods of administration, may increase or lessen some risks of harm from actual smoke. If you do choose to use MJ, I would recommend a method that avoids combustion with a flame.
I would urge caution as some other popular MJ products can be quite concentrated and may have more SEs, such as edibles or vaping.
I would advise against mixing MJ with other sedating medications. I would advise against driving or other potentially dangerous activities while using MJ.
While MJ is frequently used for nausea, it's possible to develop cyclical vomiting, which sounds like what it is, lots of continual vomiting from MJ use. If this happens the only effective treatment is to stop using MJ.
I was taught to mention that there is a small but real risk of inducing psychosis in some patients that seem susceptible.
I was taught to strongly advise against MJ use in anyone with a history of psychosis, or psychosis in a first degree relative, and not to sign a card in most instances.
I'm not sure I've covered this all perfectly, but it was policy in an otherwise conservative clinic where I know MMJ is done.
It doesn't exactly paint a picture of a physician that is holding a patient's hand down to the dispensary.
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weird question, it just popped into my mind....if a physician has a legit reason....can they use medical marijuana and get away with it if a hospital drug tests them? It seems like a debate that may arise with all the legalizing for medical reasons...or is the old, doctors have to be robots deal?
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Even in a state where it is explicitly legal, you can lose your job, license, and DEA certificate if you, as a physician, use marijuana and happen to get drug tested.
The stuff is still illegal on a federal level, and the tests used can't differentiate between acute intoxication and you using it days ago. Additionally, marijuana users are certainly not a protected class, and employers can legally fire you for using in every state I'm aware of (OR and CA have proposed making marijuana use a protected class, but the bills went nowhere).
Basically, as a physician, I'd recommend against it. Even if you're on vacation in CO, OR, etc. Because if you get randomly drug tested by your hospital or employer the week you come back, you have zero recourse.
The odds are good that you won't get tested... But why risk it?
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Oh no im not advocating use...just interested in seeing how it plays out...im sure the issue will arise as more and more states legalize and its accepted medically. its basically seeing whether doctors are able to be patients as well....or since we are doctors we have to be above anything.
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That's not what this is about at all. Marijuana is still illegal at the federal level, regardless of what states say.
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So what.....patients are using it legally at the state level, the government isnt going to come busting down the doors of cancer patients, etc.
Its too profitable of a business for it to stay illegal at any level much longer, and it has absolutely no impact on how well a person performs their job, its a harmless plant.
Its too profitable of a business for it to stay illegal at any level much longer, and it has absolutely no impact on how well a person performs their job, its a harmless plant.
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Hyperbole actually detracts from the strength of your argument.
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At least s/he didn't call it "an herb".
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The "has absolutely no impact on how well a person performs their job" was a great line too.
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Read an article not long ago about a doc who got shafted as a result of his own marijuana use and drug testing. Can't remember where I read it. But doc was applying for a job, in a state where weed was legal, he revealed he was an occasional user. Drug test showed the use, he was referred to treatment, then further referred for more treatment and threatened that if he didn't pay big bucks for this treatment, he'd lose his license. The guy tried to take a stand, saying he wasn't an addict, didn't need treatment and..... he lost his license.
Don't do it. Don't use.
Don't do it. Don't use.
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If a physician had a diagnosis on the list with symptoms so uncontrolled that he has to use medical marijuana to manage, then he is likely unfit to perform his job as a physician involved in the care of other people. He should be on disability and getting his condition undercontrol before he can return to work.
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There are no clear cut answers yet. Federal and state criminal law, labor law, state marijuana laws, as well as state and federal ADA and discrimination laws may apply:
Noffsinger v. SCC Niantic Operating Co.: What Does the Connecticut Ruling Mean for Employers?
https://www.laborandemploymentlawco...plot-twist-for-medical-marijuana-and-the-ada/
