Two doctors account for more than a third of the patients on Colorado's medical-marijuana registry, and five doctors account for more than 50 percent of the patients, according to statistics from the state health department.
In all, of the 10,000 medical-marijuana patients on the state's registry, 75 percent of those received their recommendations from one of only 15 doctors.
The clustering of so many patients on the registry from so few doctors has raised the suspicions of state officials.
"It's a cause for concern," said Jim Martin, executive director of the state Department of Public Health and Environment. "At least in any other area like this, we would want to be sure that the physicians are meeting the standards of care."
State Attorney General John Suthers went a step further, suggesting the state Board of Medical Examiners investigate the top pot-recommending docs.
"The Health Department can question whether it's proper medicine to issue hundreds of certifications in one day and perhaps make some referrals to the medical board," Suthers said, referencing a statement by the state's chief medical officer during a recent hearing that one doctor signed for 200 patients in a single day.
But cannabis advocates said the clustering is perfectly understandable, the result of doctors who specialize in a particular area. Medical-marijuana attorney Rob Corry said the doctors are "compassionate professionals" whose specialty naturally attracts patients seeking alternative forms of medicine.
"I'm very concerned about the climate of fear that the Colorado attorney general has created in the minds of physicians who are just trying to help people," Corry said.
Under state confidentiality laws, the names of the top pot-recommending doctors are not released. But the doctors are almost certainly affiliated with one of a handful of large medical-marijuana referral clinics in the state.
The founder of one such clinic, The Hemp and Cannabis Foundation in Wheat Ridge, said his doctors put patients through a rigorous screening process and have turned away numerous patients who are not qualified.
"A lot of doctors don't know anything about medical marijuana," said Paul Stanford, the Portland, Ore.-based founder of the clinic, which has offices in eight states.
Under Colorado law, patients can receive medical marijuana only for a "debilitating medical condition," such as cancer or severe nausea. The greatest number of patients are on the registry for chronic pain.
Stanford said the recommendation process at his clinic starts by pre-screening patients in phone calls and ensuring they have medical documentation of their ailments. After that, an appointment is made and the clinic's doctor or other staff members spend a couple hours examining and counseling the patient.
But Stanford acknowledges other clinics might not hold as high a standard. Several clinics that advertise in the local alternative magazine Westword tout "no prior medical history needed" policies. Others are connected to marijuana dispensaries, linking the diagnosis of a problem with the sale of a cure.
Suthers said the legal language of Amendment 20 — the voter-approved initiative that legalized medical marijuana — ultimately restricts how much he or any other official can address the concerns.
"There's not much that can be done about it," he said. "And frankly I think it's all by design."
By John Ingold
August 30, 2009