What Doctors Should Know About Recommending Marijuana in Florida
Posted by Glenn Beierle on 06/29/2018 in Doctor Resources
Medical content reviewed by Dr. Richard Koffler, MD, Board Certified Physiatrist
Medical marijuana became legal in Florida on November 8, 2016, when the majority of voters approved Florida’s medical marijuana legalization initiative. Although patients, dispensaries and physicians are obligated to follow certain rules and regulations, eligible Florida residents can now enjoy the health benefits of medical marijuana treatment. Similarly, registered physicians can appeal to more patients and have new opportunities to treat severe conditions.
Unfortunately, there is a shortage of registered physicians in Florida. As of May 2018, there are 114,878 patients in the Medical Marijuana Use Registry (MMUR), and only 1,404 qualified physicians in the state of Florida. Over two-thousand more currently have applications in processing. With only 13 approved medical marijuana treatment centers and 37 approved dispensaries, the demand for medical marijuana professionals is high.
If you are a licensed physician in the state of Florida, your knowledge and experience are needed in the newfound world of legal medical marijuana treatment. To become a registered marijuana doctor, you need to complete a few steps. The process is not too difficult, and it should not take long before you can begin recommending marijuana in Florida.
We’ll explain the process according to the law so you’ll know how to recommend medical marijuana to qualified patients with confidence. Let this be your doctor’s guide to medical cannabis in the Sunshine State.
What Is Medical Cannabis?
According to Section 381.986 of the 2018 Florida Statutes, marijuana is defined as all parts of the cannabis plant including the seeds, resin, mixtures and preparations. Registered patients must purchase marijuana from an approved medical marijuana treatment center (MMTC).
In Florida, marijuana is divided into two categories — low-tetrahydrocannabinol (THC) and medical marijuana. Low-THC cannabis contains less THC, resulting in mild effects and does not create a euphoric high. A physician might recommend low-THC cannabis for a pregnant patient, for example.
Medical marijuana, on the other hand, contains higher levels of THC and can create psychoactive effects. Both types of marijuana products are currently available at MMTCs to help patients with symptom relief.
Medical use refers to obtaining, possessing, using, delivering or administering marijuana under Florida law. In the state of Florida, the medical use of medical marijuana and low-THC cannabis does not include:
- Transfer to a person other than the qualified patient or their registered caregiver
- The use of medical cannabis in public
- Not following doctor’s directions
- Possession or use of marijuana not obtained from an approved MMTC
Smoking is not a healthy way to ingest medical marijuana. Accepted forms of medical marijuana include:
- Topical applications
When you become a registered physician, patients will ask what device they can legally use to administer their medication. Patients cannot use any device they wish. They need to obtain a medical marijuana delivery device from the MMTC they visit. A medical marijuana delivery device includes any object used to prepare, store, ingest or inhale medical cannabis, and is dispensed at the MMTC of choice.
Certifying a Patient Into the Medical Cannabis Program in Florida
You may be wondering what the certification process entails. When you become a registered physician, you treat your patients just as you would your other patients. The greatest difference is you will have to determine that a debilitating condition exists before registering your patient in the MMUR. In general, here is what to expect as a registered physician:
- You do not dispense medical marijuana: You will not dispense marijuana as a certified physician because only approved MMTCs are legally allowed to dispense any medical marijuana products. Your job is only to provide a written document or certification. The patient must seek an MMTC to obtain their medicine.
- You only issue a certification: The certification will state that in your professional opinion, the patient suffers from a debilitating condition, and the benefits of medical marijuana outweigh the risks for the patient. For patients under age 18, a second physician must agree with your decision.
- You certify patients from your practice: You do not need a separate practice for issuing a certification. The certification process can be completed in your regular practice, from the initial examination to submitting electronic forms.
- You are responsible for proper documentation: An important part of the job as a registered physician is recording your reason for issuing a certification, documenting any adverse effects or dependence that a patient experiences and updating all relevant information as needed.
- You will need to examine qualifying patients periodically: You will need to re-examine qualifying patients every 30 weeks before issuing a new certification to determine if the patient still qualifies for medical marijuana treatment.
- Educate patients: Patients will turn to you for information about medical marijuana. It is important they understand that they are not permitted to drive or operate any vehicle under the influence of marijuana. Also, health insurers are not required to reimburse for costs relating to medical marijuana treatment.
Florida’s Medical Cannabis Program and Legal Risks
Some patients may have already asked you if you are a medical marijuana doctor. Patients want medical cannabis treatment and registered physicians have the chance to provide the best care possible.
Physicians may hesitate to incorporate medical marijuana into their treatment plans for fear of legal risks. Fortunately, the legal risks are minimal. As long as a physician issues a certification with reasonable care to a qualifying patient, they shall not be subject to criminal or civil liabilities under Florida law. You must still continue to meet the standard of care as a qualified physician.
Nevertheless, doctors need to be aware of the prohibitions and expect new laws to change and evolve. Current potential penalties include:
- Disciplinary action if you receive compensation from an MMTC related to the issuance of certification.
- Being charged with a first-degree misdemeanor if you issue a certification to a patient without good reason.
- Being charged with a third-degree felony for possessing or manufacturing a fraudulent registry identification card.
You may also be subject to criminal penalties under Chapter 893, Drug Abuse Prevention and Control.
Part of the certification process involves reviewing your patient’s history with drug abuse to help you determine if medical marijuana treatment is the best option.
How Can a Physician in Florida Participate in the Medical Marijuana Program?
If you are already a licensed physician in Florida, the registration process is simple. Here are the requirements for becoming a registered physician:
- You must have an active and unrestricted license as an osteopathic practitioner or medical doctor in Florida.
- You must take the two-hour course and exam offered by either the Florida Medical Association or Florida Osteopathic Medical Association.
- Is completed online
- Is presented by the Florida Medical Association (FMA)
- Costs $250
- Requires a passing score of at least 80 percent on the post-test
- Takes an estimated two hours to complete
Course objectives include:
- Learn state rules and regulations relating to medical marijuana in Florida
- Learn how to identify qualifying conditions
- Learn how to recognize legal restrictions when certifying patients
- Learn how to decide whether or not to certify eligible patients
If you are concerned about legal risks but have an interest in treating patients with medical marijuana, you can rest assured — your coursework will provide the foundation you need to issue certifications legally.
Not all physicians are eligible to become registered. The following circumstances prohibit a physician’s eligibility in Florida:
- The physician has a restricted license.
- The physician is employed by a marijuana testing laboratory or an MMTC.
- The physician has a direct or indirect financial interest in a marijuana testing laboratory or an MMTC.
How Does a Florida Physician Issue Medical Marijuana Certificates to Patients?
Certification is your authorization for a patient to receive medical marijuana treatment for their qualifying condition. As a registered physician, you may only certify a patient if you:
- Diagnosed the patient with at least one qualifying medical condition
- Determined that the benefits of medical marijuana treatment outweigh the risks
- Evaluated a patient’s risk for addiction by reviewing the patient’s history as documented in a prescription drug monitoring program (PDMP)
- Considered how the side effects of treatment will impair a patient’s ability to operate heavy equipment or drive
- Referred to the MMUR to make sure the patient does not already have an active certification from another qualified doctor
Once you determine your patient will benefit from medical marijuana, you will take the following steps to certify your patient:
- Register as the physician issuing the certification to the patient in the MMUR
- Enter the contents of the certification into the registry
- Obtain a voluntary and informed written consent and keep it with the patient’s medical records
- Write and sign a document stating in your opinion that the patient suffers a severe condition, would benefit from medical marijuana treatment and should use treatment for your recommended amount of time
You will need to enter the following content into the registry:
- The patient’s qualifying condition
- Medical marijuana dosage
- The amount of marijuana authorized for the patient
- The form of the marijuana authorized for the patient
- The methods of administration the patient needs
How do you know if a patient is qualified for treatment? First, they must be either a resident of Florida or a seasonal resident. A seasonal resident means they reside in Florida for at least 31 consecutive days each year and maintain a temporary residence in Florida.
Next, they must have a severe medical condition as defined by Section 29 of the Florida Constitution including:
- Crohn’s disease
- Post-traumatic Stress Disorder (PTSD)
- Parkinson’s disease
- Multiple Sclerosis
- Amyotrophic lateral sclerosis (ALS)
- Chronic nonmalignant pain
- Other medical conditions for which a physician believes the risks of medical marijuana use does not outweigh the benefits
You can place no more than three orders for a max of 70 days per order, and afterward, you must issue a new certificate.
How Can Your Patient or Patient’s Caregiver Get Medical Marijuana?
Before a patient or caregiver can visit an MMTC, they need to complete the registration process correctly. To register, patients must:
- Be a Florida resident or seasonal resident
- Be diagnosed with a qualifying condition
- Be entered into the MMUR by a qualified doctor
- Obtain a registry identification card
After you enter a patient into the MMUR, you will provide your patient with a patient ID number. They need this number to apply for their registry identification card.
Patients and caregivers will then apply for their registration identification cards by completing either an electronic or paper application. Once their identification cards have been approved, they can contact an MMTC to fill an order. Even if a patient does not have an MMTC in their home city, they can still contact an MMTC and arrange a delivery. Currently, the approved MMTCs are:
- 3 Boys Farm
- Keith St. Germain Nursery Farms
- Knox Medical
- Liberty Health Sciences
- Remeny Wellness
- Surterra Therapeutics
- The Green Solution
Your patient may require the assistance of a caregiver to help monitor and administer their medical marijuana. In Florida, a caregiver is defined as a person who has agreed to assist a qualified patient’s use of medical marijuana. A caregiver must:
- Be a resident of Florida
- Be at least 21 years old
- Agree to assist a qualified patient in writing
- Apply and be approved for a registry identification card
- Meet all requirements under Florida law
- Be registered in the MMUR as a caregiver
Caregivers may not:
- Be a qualified physician
- Be employed by an MMTC or marijuana testing laboratory
- Have a financial interest in an MMTC or marijuana testing laboratory
- Receive compensation for any services provided to the qualified patient outside of actual expenses
- Consume medical marijuana obtained for the qualifying patient
Medical Marijuana Identification Cards
To receive a registry identification card, patients and caregivers must:
- Be entered into the MMUR by a qualified physician
- Complete a paper or electronic application using login credentials sent by the physician to the provided email address
- Accurately complete the application and submit a $75 application fee
The application processing time is 30 days from receipt. Patients and caregivers show their cards at MMTCs to obtain medical marijuana.
Primary Benefits of Acquiring a Florida Medical Marijuana Card
A Florida marijuana card will keep your patients out of jail while possessing medical marijuana. However, it is important they understand the rules and regulations. They need to know that even with a card it is illegal to drive under the influence of medical marijuana. With a marijuana card, patients will enjoy:
- Access to the best dispensaries
- The legal right to obtain and possess the approved amount and type of medical marijuana
- Medical marijuana treatment under their physician’s care
- Dosage and treatment designed to help specific symptoms
- Monitoring of symptoms and side effects
What a Florida Doctor Can and Cannot Do When Issuing a Medical Marijuana Certificate to a Patient
In general, as a registered physician you can:
- Examine and diagnose patients with a qualifying condition
- Monitor a patient’s side effects and progress
- Document any changes
- Suggest dosage and treatment types
- Enter qualified patients into the registry
- Accept compensation from an MMTC
- Certify a patient who does not need it
- Benefit from an MMTC or medical marijuana testing laboratory
- Dispense medical marijuana
Register as a Medical Marijuana Doctor Today
If you have doubts about the effectiveness of medical marijuana treatment, you still may want to consider offering treatment options for your patients. Patients are demanding cannabis treatment to cope with severe pain. With an open mind, you can attract new patients to your practice and retain regular patients with additional services. Patients will turn to you as a source they can trust, rather than seek relief from less credible entities or obtain marijuana illegally.
If you are ready to join the growing and exciting field of medical cannabis, let us be your go-to source for the latest information and to connect you with patients. Every day, thousands of patients search for registered physicians in their state. Our site connects doctors to patients who are seeking help.
If you register with us, you’ll enjoy greater exposure and draw more patients to your practice. We notify you of patients’ appointment requests securely and conveniently in your email inbox.