Telemedicine & the Bona Fide Relationship in the New Jersey Medical Cannabis Program (NJ MCP)
The only requirement for an NJ MCP provider is to have a current DEA license and a physical practice in NJ. If multistate operators connect NJ patients to NJ physicians by Telemedicine, they are quite within their rights. It is not a violation of the MCP. If the physician/provider does not have a physical practice in NJ, then that is a violation of the program rules. However, the distinction that only NJ physicians may admit NJ residents into the NJ MCP is arbitrary and unnecessary. Patients in NJ are free to cross the river into NY and PA to obtain medical treatment from providers in those states. The prescriptions and other treatments from out-of-state providers are perfectly legal here in NJ. There is nothing special about NJ physicians that make only them eligible to admit patients into the NJ MCP.
Only about 1000 NJ physicians have bothered to join the MCP out of the 28,000 or so in the state. Even many of the physicians who joined the MCP are not committed to marijuana therapy, but they do it out of courtesy for their patients. There is precious little education about the Endocannabinoid System (ECS) in the physician community. When the Department of Health appointed the Medical Marijuana Review Panel, they published the curriculum vitae of the members. None of the members on that panel had any documented education, publications, or experience with cannabis, or the ECS. Admittedly, the Review Panel did an excellent job in the end, but their lack of education and experience going into that task was concerning.
Patients have told me some of the most shocking statements from NJ physicians. For example, numerous physicians have belittled, laughed at, or simply ignored patients’ requests for cannabis therapy. One NJ physician told an impoverished, dying Hospice patient that if he wants medical marijuana, he should find another physician.
The bona fide relationship that is necessary for the MCP between a patient and a provider is an artificial construct. The original medical marijuana bill said that all a physician had to do to admit a patient into the MCP was attest that the patient had a condition that qualified to join the program. This could even be done by a review of the patient’s records, without the physician seeing the patient at all.
The bona fide patient relationship is phony. When I go to see a doctor for medication or treatment, whether it's a GP or a specialist, I do not have to see that doctor more than once for treatment. I certainly do not have to see a doctor four times, or for any arbitrary length of time, before I can be treated. Moreover, with medical marijuana, these physician visits are almost exclusively cash out-of-pocket for the patient. A great many patients have been impoverished by their illnesses or injuries. Spending $400 a year on physician visits, in cash, just for the opportunity to purchase a medical marijuana card, and then purchase very expensive medical marijuana, certainly strains the resources of many patients, and denies access to many more.
Many patients were greatly relieved when visits for maintaining an ID card in the MCP were reduced, at the discretion of the provider, to once a year.
Please join my call to require education on the ECS for all health care providers in NJ as a condition for continued licensure.
I also hope you will support the bills currently in the NJ Legislature that create insurance coverage for medical cannabis, S3799/A5760 and A1708/S3406.
Cannabis Regulatory Commission Testimony, 12/7/21
Ken Wolski, RN, MPAExecutive Director, Coalition for Medical Marijuana--New Jersey, Inc.