MedicateOH:
This is Gabrielle with MedicateOH. We are on site today with Advocare Clinic‘s Steve Davis, MD. Thanks for being here today.

SD:
Thank you so much for coming in and visiting with us as well.

MedicateOH:
Thanks. Could you tell us, what does a patient need to have ready for their first visit to their clinic?

SD:
Well, the first visit to Advocare Clinic is a certification visit which means we have to verify that they have one of 21 qualifying conditions in the state of Ohio for participation that medical marijuana program. That means that they can go online to the Ohio website or to our website and see those 21 conditions. So once they have that condition that they identify that they qualify under, we need to have medical records.

We have to have records that substantiate their medical condition so that we can be confident about placing them in the registry. One of the best ways to do that is to actually be open and forthright with their doctor and communicate what they’re doing and why they want to do it. However, if they don’t feel comfortable going that route, they can still come in with their records. Documenting again, that qualifying condition, that’s really the most important thing.

The other thing that we do is we send out a four-document packet. It’s an intake packet that gathers all the general information, some medical background, social history, any prior use of medical cannabis or cannabis at that point. And we gather some information on our privacy policy. We send them that so they understand all that it’s going to take place while they’re here and visiting with us.

MedicateOH:
One of our writers recently did a story about a patient who had PTSD, but she couldn’t document it. And she was still charged for her visit to one of the medical cannabis doctors. What would happen if a patient didn’t qualify?

SD:
So that’s a that’s another good question. First and foremost, we do everything we can to let them know whether they qualified or not before they come in. We try to get records secured. But there are some patients that will hand-carry records to the practice.

In that scenario, if it was us, we would have asked her first and foremost, “Does she have any records?” PTSD is interesting in that the criteria for the diagnosis are very clear. And we’ve actually created the format of a peer clinic where we can diagnose PTSD, along with some history and a physical and all that sort of thing. However, if at the end of that evaluation, we didn’t feel that confident that she qualified, we would not charge her put her in that registry.

Now back to your question about charging her and not allowing her to qualify, I think that’s more on the practice than the patient. The patient’s coming in as a trust situation. So in my mind, I think that that falls on the practice, and they should have had a better process on the front end to make sure that the patient is going to be okay. On the back end, we don’t want to waste their time. We want to make sure that they get the care and service they need.

MedicateOH:
Tell me about the process from the time that a patient walks in the door.

SD:
So there’s a pre-process and an in-play process. The pre-processes—all those forms, gathering information, some phone calls, maybe emails— are to get everything set up in a queue. And once they come in the front door, we then will get the final payment for their intake visit. There’s a $25 down payment at the time of booking.

And then we’ll go ahead and have them do what we call an in-house informed consent, which is an initial document that goes through all the risk and benefits of medicinal cannabis that has to be gone over with the patient per state requirements. And then it’s signed by both parties.

Then we also make sure that we have records on file since patients will be carrying their records for that first visit. So we will go ahead and get those put into our system. We need to keep those records as part of their diagnosis and recommendation.

From there we take them to a private room. Our intake area is set up to be HIPAA compliant, but then we go right into a private room where a “TCS” (trusted care advocate) will spend some time with that patient, and actually go ahead and start the process of education, putting them in the registry—the general mechanics of that. And then I will come in at that point and do the actual registry final recommendation.

MedicateOH:
Will a patient be given a recommendation for their medical marijuana like a normal prescription? And if so, do they have to stick to that?

SD:
So that’s a very interesting question. A lot of people are confused about how that works. The way it works in Ohio is you make a recommendation. You’re not getting a prescription. What we do is work with the patient based on their symptoms and try to help them look at some of the possible forms as well as concentrations available for their condition. And then they will go to a dispensary where an agent at the dispensary would then help them pick the strains that fit their condition. It’s not a prescription so they’re not held to it. They can change it over time. This is the ultimate physician-led patient-driven self-help program.

MedicateOH:
I hear that you carry some accessories for patients. What do you carry, and what’s the benefit of getting those here instead of elsewhere?

SD:
What we carry right now are vaporizers and grinders. In the very beginning of the program in Ohio, all that was available was flower or bud, which means you had to have a vaporizer, you have to have a grinder because you can’t process it. You’re not allowed to smoke it; you’re not allowed to convert it.

So because there’s a lot of novices in our programs, we found that there were so many questions we couldn’t answer without something they could see, touch, or feel. So we went to some suppliers and asked for a high-quality, ease-of-use, nice price point vaporizer to be able to sell those and help patients learn while they’re here.

Now they’re not obligated to buy anything here. They’re just simply showing what we have. And if they feel comfortable with it and want to have that, that’s fine. But at the end of the day, the main reason was for educating patients to make sure that they can get off to a good start on the program.

MedicateOH:
That’s such a great benefit for patients. What happens if a patient doesn’t feel like after a patient comes here, they get their card and they go to a dispensary, and they go home and their medical marijuana doesn’t appear to be working for them. What What should they do?

SD:
Well, that’s a great question. The first thing I say they should do is take the notes. They need to know what they’re doing so they can understand what the results are.

But troubleshooting is very part-and-parcel to what we do here. That’s why you need a medical marijuana physician relationship because we help them go through the process of backing up and looking at, “Okay, what strains are you using? What percentages are they? What methods of delivery? What are you eating? How are you supplementing?”

So all those things matter. Are you getting enough omega threes? Are you getting enough exercise, or enough sleep? What’s your mood when you’re using the medication or are you doing it when you’re stressed out? Those types of things all matter, and are important to ensure the success of a patient’s holistic approach to medicinal cannabis care.

MedicateOH:
How often does a patient need to return to Advocare Clinic?

SD:
We usually like to see them back in the first six to eight weeks after they come in and get put in the registry. And then after that it’s once a year unless they are really struggling, at which point we would stick with that patient as long as we needed to. We could bring them back every six weeks, four weeks, whatever it needed to be, for them to make progress in the program and become proficient at taking care of their their symptoms.

MedicateOH:
Why should a patient get their card, both from legal and medicinal standpoint?

SD:
From the legal side, it’s kind of obvious. One of the things is it allows you to carry your medicine in your car or on your person. It allows you to be able to leave the house basically. For some jobs, it does give you some protection, some of the state-based jobs.

It does, however, not protect you beyond what the workplace standards are. So if they say no cannabis, it doesn’t trump their policy. Workplace policy stays. So from a legal standpoint, it doesn’t mean that you can have a card and go out and get cannabis off the street. You have to get it from the dispensary and it has to be in its original container—all those kinds of things. So it’s really just the ability to medicate on the move. I think that’s the biggest the biggest benefit.

From a medical standpoint, I think it’s because you have the opportunity to use strains that are well-defined, well-tested. All the stuff that you can be inhaling—your insecticides, bugs, mold—is tested for.

Then, [getting your card allows for] control over your prescription. If you know that a sativa strain that was 17% THC and 5% CBD worked really well, [the benefit to having your card is] being able to duplicate that and get those ratio right and then also being able to get it again and trying to replicate [those results]. That would be the biggest reasons medically is for consistency in your program.

MedicateOH:
How can patients get in touch and make an appointment with Advocare Clinic?

SD:
They can find us online at AdvocareClinic.com. Or they can give us a call at 1-833-4-Advocare. One of our TCS’s would be more than happy to speak with them!

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All medical marijuana doctors are required to complete specific training in accordance with the Ohio Medical Marijuana Control Board. As of July 2019, there are 214 doctors in Ohio certified to recommend medical marijuana. You can find one here.

Gabrielle Dion Visca has been a writer, editor, and marketing professional for more than 20 years. She currently works as a medical content writer and advocate for legal and responsible marijuana use.