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Doc prescribes pot over Skype as chill settles over medical community

Canadian doctors who prescribe medical marijuana are feeling a chill, as health officials apply pressure on them to not prescribe a drug they know little about.

A doctor in Toronto was willing to go on the record with Metro to talk about the stigma surrounding medical pot and the benefits patients derive from the drug. But when he heard several colleagues are being scrutinized by the College of Physicians and Surgeons, he backed out.

“Patients' doctors do not want to prescribe and they think that the college has said that you cannot prescribe,” said the doctor, who we agreed to keep anonymous. “It’s uncomfortable and there is a stigma behind it.”

The physician has started seeing patients via Skype — who are connected with him through a private firm for a $300 fee — as more and more patients are finding it tough to find a doctor willing to sign off on a pot prescription. He says telemedicine is sufficient for such consultations and the patients provide him and the firm government issued identification and their medical records.

“I just don’t sit there and openly sign prescriptions for somebody. I see them, assess them, get some information from them about what treatments they have had," he said, adding his patients are not “stoners," but business people, lawyers, even other doctors.

“If it’s a young kid who wants to do it just to make it legal, I don’t see those kind of people," The doctor told Metro. "But if it’s someone with cancer that can’t eat, that has no appetite, that is nauseous all the time and they find that when they take this it gets rid of their nausea and they can eat— if you are that patient’s physician, how can you not prescribe it, I just don’t understand.”

He said the problem is the fact there is no scientific data for doctors to reference when considering prescribing pot to patients with multiple sclerosis, cancer and various chronic pain conditions.

“Physicians receive no training,” he said. “The average physician would have no idea how to prescribe it. They don’t know what a gram is, or three grams, they don’t know.”

Sandy Daviau, spent more than a decade looking for a doctor to prescribe the drug for his multiple sclerosis. He said with the recent changes to Health Canada’s medical pot program, which makes doctors the ultimate gatekeepers of the drug, more and more patients are finding it hard to access the drug

“It’s worse than before,” said Daviau, whose initial physician Dr. Rob Kamermans was ordered to close his Coe Hill clinic and was charged with fraud, forgery and money laundering after he signed off on 4,000 pot prescriptions over the course of a year. It’s stories like these that have doctors worried they will get nabbed for trying to help patients “There is a clampdown going on right now. There is a political war going on out there behind the scenes and we are the pawns right now. It’s wrong, but they are doing it.”

The College of Physicians and Surgeons of Ontario told Metro the federal pot program changes provide “significant concern,” as doctors are expected to prescribe a drug that has no clinical studies linked to it.

In Quebec, the college is deeply concerned with doctors prescribing pot, especially though telemedicine or Skype consultations, which is actually illegal in the province.

Spokesperson Dr. Yves Robert said that all forms of E-health are under review right now.

“The basic principle here, considering cannabis or not, is the fact that prescribing is a medical act that requires an appropriate evaluation of the patient’s condition and that can’t be done if you do not see the patient,” he said. Currently, doctors registered in Quebec are forbidden from using telemedicine, but doctors from elsewhere can still see Quebec patients via Skype. That will soon change, he says.

“We are working right now to update this data and probably in the future, physicians who prescribes to a patient in Quebec will have to be registered in Quebec.”

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