“The future of MMJ treatment is dependent on several issues: physicians must establish legitimate, bona fide, physician/patient relationships, patients must have a method of determining the best medication for their unique symptoms, and clinical outcomes for ongoing treatment must be obtained to validate the field of medical marijuana. These are the three areas our company focuses on.” (C. Croan)

The anti-medical marijuana lobby is effective so let’s recognize how they are effectively undermining the medical marijuana industry:

 They have raised the issue of whether MMJ dr/pt relationships are valid, legitimate or even professional.
 The MMJ “evaluation” does not employ “MMJ care” it only uses “MMJ evaluation” in other words “care” or “treatment” is missing in the MMJ treatment model.
 Anti-mmj legislators have adroitly maneuvered MMJ physicians into performing evaluations only – with no follow up care. The MMJ docs thought they were winning a major point and they would cash in on evaluations. This robs the MMJ industry from obtaining positive clinical outcomes.
 Currently there is no vehicle to use aggregate data to indicate whether MMJ actually works as a treatment. “Pharma” trials do that but MMJ has entered the market essentially untested.

The current MMJ care model dooms the field.

In regard to physician/patient relationships the state legislators the author is familiar with intended only for a physician to perform the MMJ evaluation. It is clearly specified that a physician’s assistant or other professional may not perform the evaluation and have the doctor sign off – it’s flirting with disaster to operate against the legislative intent and administrative policy. We don’t need people in the field who cut corners. But they won’t be around long without licenses or clinics as we are seeing.

If a clinic takes your money for an evaluation…shouldn’t they reimburse your money if they dropped the ball about an aspect of their compliance and you were NOT provided a legitimate evaluation? Should you have received a refund from the clinic? This makes some clinics, or organizations look, pretty…mercenary.

Oh, and to the physician who related to the author, “Since PTSD is psychic pain I’m going to recommend that condition for MMJ because technically it’s chronic pain and PTSD isn’t authorized”. Bullshit, that’s dishonest.

Anyone cutting legal corners in the MMJ field is doing EVERYONE a disservice.

Failure to follow up in medicine is contradictory to the mainstream medical care model which is called “evidence based medicine”. After all – who would recommend a Schedule I substance and not follow up on the effect for treatment?

In every Medical Practice Act, in every state where MMJ is authorized, there lies the seed of one of the next regulations. Ever physician is actually required, now, to follow up with the patient about the medical intervention (the MMJ recommendation). Our prediction at Enigami is that legitimate follow up will be increasingly enforced by the regulatory agencies. At the time of this writing four states mandate follow up.

But what is it the regulatory agencies are going to require? Evidence based medicine. Wikipedia defines it like this: “Evidence based medicine aims to apply the best available evidence gained from the scientific method to clinical decision making.” In other words there needs to be some type of legitimate method to “follow up” or to monitor whether the medical intervention actually works. Okay, that’s just good medicine and good for the consumer.

Currently, in those states where there is no follow up care – we obtain no clinical evidence of whether MMJ actually is effective. Grrrrr.

The Colorado Medical Practice Act is pretty typical of the different States and partially relies on case law. Colorado’s Act quotes case law defining medical practice as not being a discrete single event. Yet in the MMJ care model it stops at a single event – evaluation. It’s true that in many areas of medicine consumers may go to a specialist who evaluates us and refers us on for ongoing needs – and therein is the key – MMJ evaluators have no viable follow up referrals because they don’t exist. How many primary care doctors will perform the follow up? There are a few MMJ doctors who perform minimal follow up and still more physicians who are concerned about the question of having a legitimate physician/patient relationship. Follow up care would go a long way to enhancing the MMJ care model. In fact performing follow up care, “evidence based medicine”, will help patients determine the best medication.

But there’s another great benefit to follow up care besides just practicing legitimate medicine. It can provide clinical outcomes which legitimize the entire field of medical marijuana. The “evaluation only model” was considered a win by physicians in legislation. So I say, “Congratulations, you’ve robbed the field of MMJ from establishing itself as legitimate by not being able to show hard research outcomes!”

Help is on the way though. Pioneering MMJ legislators are making legitimate follow up mandatory. It’ll be a short step to collecting those outcomes and being able to quote hard data instead of relying on anecdotal success stories. Instead of saying, “it MIGHT shrink tumors” we’ll get to say, “in an multi-year study involving 350,000 MMJ patients – those with such and such tumors showed reduction in size (etc.)”

The lack of a legitimate medical marijuana care model concerns us so here is what we did.

We created Enigami Systems, Inc., to uses outbound email inquiries (or other methods of media communication) to follow up and inquire about a client’s unique symptoms and how they are responding to a specific MMJ medication which we also track. The information, helps determine which medication is the best used to diminish, or contain, distressing symptoms. The outbound inquiries come from our online portal where the individual’s personal health record exists. We can monitor with whatever frequency is desired which makes a heckuva medical record but after all is said and done it beats the pants off of ANY mainstream medicine follow up.

Oh, our aggregate “outcomes” legitimize the MMJ field’s effectiveness

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