Medical Marijuana Clinic Profitability

[deleted795531]

Does anyone know what sort of hourly pay one can expect from giving marijuana recommendations part-time?

Edit: just found a website where you can get a marijuana recommendation for $70 in minutes after filling out whatever documents and getting approved by a doc reading it. how profitable do you think something like that is? seems like a cash cow. what do you think the yearly profit could be minus whatever expenses?

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[Averagemanboy]

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[AlbinoHawk DO]

You might be able to pull it off for a few years if you're willing to relocate since its getting legalized in more places, but the amount of profit is proportional to how you popular your demand is. If I were you, I'd look into more long-term investments like physicians that open dialysis centers.

 

[deleted795531]

You might be able to pull it off for a few years if you're willing to relocate since its getting legalized in more places, but the amount of profit is proportional to how you popular your demand is. If I were you, I'd look into more long-term investments like physicians that open dialysis centers.

there are all sorts of start up, overhead, and otherwise costs associated with opening a center. A website sounds too easy to be true.

 

[VA Hopeful Dr]

You're taking a big, stupid risk doing this. Marijuana is still schedule 1 per the DEA. If the Feds decide to start prosecuting again (and bear in mind, the Democrats are out of power in just over a month), you have literally no defense.

 

[libertyyne]

The local MD charges 500 dollars for the eval and card. Last if I recall almost 10 % of all Medical Marijuana patients in my state had him sign for their cards. There is a probably a crash at some point unless you are offering some other service, or the patients have to get recertified every few years. Why tho?

 

[AlbinoHawk DO]

You're taking a big, stupid risk doing this. Marijuana is still schedule 1 per the DEA. If the Feds decide to start prosecuting again (and bear in mind, the Democrats are out of power in just over a month), you have literally no defense.

Is there, though? All you're writing is a letter saying you believe that this person could benefit from medical marijuana. You're not actually selling the pot or even writing a legal prescription.

 

[VA Hopeful Dr]

Is there, though? All you're writing is a letter saying you believe that this person could benefit from medical marijuana. You're not actually selling the pot or even writing a legal prescription.

So I could also write, on my official office stationary and bearing my signature that a patient could benefit from cocaine. Think that would be OK too?

 

[ChrisMack390]

So I could also write, on my official office stationary and bearing my signature that a patient could benefit from cocaine. Think that would be OK too?

It certainly wouldn't violate possession or distribution laws...

 

[AlbinoHawk DO]

So I could also write, on my official office stationary and bearing my signature that a patient could benefit from cocaine. Think that would be OK too?

Aside from the fact there are instances where cocaine is actually used for treatment, my answer would be yes. From a legal standpoint that is "just like your opinion, man." We have physicians writing books and giving conferences about how they believe PTSD patients can benefit from using MDMA. My understanding is you're legally in trouble if you are using an actual prescription or providing the substance.

 

[Donald Juan]

So I could also write, on my official office stationary and bearing my signature that a patient could benefit from cocaine. Think that would be OK too?

If the patient could reasonably benefit from cocaine...then yes.

 

[VA Hopeful Dr]

It certainly wouldn't violate possession or distribution laws...

Nor did I say it would (nor would any current marijuana docs), try to keep up

 

[VA Hopeful Dr]

Aside from the fact there are instances where cocaine is actually used for treatment, my answer would be yes. From a legal standpoint that is "just like your opinion, man." We have physicians writing books and giving conferences about how they believe PTSD patients can benefit from using MDMA. My understanding is you're legally in trouble if you are using an actual prescription or providing the substance.

A book is quite different from an official statement in my capacity as a patient's treating physician.

In the case of MJ cards in states that allow it, you're basically writing a legal order saying the patient can have it for condition X.

 

[VA Hopeful Dr]

If the patient could reasonably benefit from cocaine...then yes.

Why don't you run that by your local DEA agent and get back with us

 

[Donald Juan]

Why don't you run that by your local DEA agent and get back with us

You do know that cocaine is a schedule II drug, right?

 

[KBorglum]

Does anyone know what sort of hourly pay one can expect from giving marijuana recommendations part-time?

I recently appraised a marijuana-prescribing private medical practice in California, just prior to legalization. The owner was netting approximately the same as a family physician or internist, about $120/hr, $200,000/yr. I appraised the value at zero, because it doesn't earn the owner more than they can earn from similar clinical PCP outpatient services. Also, with recreational legalization on the state ballot looming, few patients would pay for -or renew- a prescription and get registered with the State. On the other hand, getting a prescription would allow for possession of a greater quantity than is allowed without prescription, but few patients would likely comply.

 

[VA Hopeful Dr]

You do know that cocaine is a schedule II drug, right?

Yes, and occasionally ENT will still use it but even to us the only available preparation is a topical solution.

But I had assumed (my fault I supposed) that you would be able to make the connection between marijuana for <insert nonspecific condition here> and cocaine for the same condition. If I prescribe cocaine for someone's anxiety, especially if I write it for anything other than that topical solution, the DEA would take interest.

 

[ChrisMack390]

Nor did I say it would (nor would any current marijuana docs), try to keep up

Actually you said exactly that. Try to keep up with yourself.

In any case, my point was that if you are not violating a drug possession or drug distribution law, you aren't violating any drug law. Even for meth, cocaine, heroin - there is no law prohibiting you from telling someone they should go get some. There are laws about having them and selling them.

 

[deleted795531]

I recently appraised a marijuana-prescribing private medical practice in California, just prior to legalization. The owner was netting approximately the same as a family physician or internist, about $120/hr, $200,000/yr. I appraised the value at zero, because it doesn't earn the owner more than they can earn from similar clinical PCP outpatient services. Also, with recreational legalization on the state ballot looming, few patients would pay for -or renew- a prescription and get registered with the State. On the other hand, getting a prescription would allow for possession of a greater quantity than is allowed without prescription, but few patients would likely comply.

Interesting. I'm more curious about these websites, though. It seems like you could have a full time job and still sign off on requests coming in through the website all day, doubling your salary. There must be some catch, beyond having to be legally savvy...

 

[MrChance2]

I recently appraised a marijuana-prescribing private medical practice in California, just prior to legalization. The owner was netting approximately the same as a family physician or internist, about $120/hr, $200,000/yr. I appraised the value at zero, because it doesn't earn the owner more than they can earn from similar clinical PCP outpatient services. Also, with recreational legalization on the state ballot looming, few patients would pay for -or renew- a prescription and get registered with the State. On the other hand, getting a prescription would allow for possession of a greater quantity than is allowed without prescription, but few patients would likely comply.

How do they only make $120/hr when patients pay $100 for a 5 minute visit with maybe 5 minutes of charting.

 

[Manual Disimpaction]

How do they only make $120/hr when patients pay $100 for a 5 minute visit with maybe 5 minutes of charting.

welcome to our healthcare system where you make 8% of the cost

 

[MrChance2]

welcome to our healthcare system where you make 8% of the cost

These guys could literally operate out of a large cardboard box with a laptop, an internet connection, and a good attorney. I get what you're saying but idk here.

 

[VA Hopeful Dr]

Actually you said exactly that. Try to keep up with yourself.

In any case, my point was that if you are not violating a drug possession or drug distribution law, you aren't violating any drug law. Even for meth, cocaine, heroin - there is no law prohibiting you from telling someone they should go get some. There are laws about having them and selling them.

Find where I said anything about possession or distribution. I'll wait.

 

[deleted795531]

welcome to our healthcare system where you make 8% of the cost

A cash business charging 50 bucks per recommendation should be hundreds, not 120

 

[PL198]

So I could also write, on my official office stationary and bearing my signature that a patient could benefit from cocaine. Think that would be OK too?

That's not a very good comparison at all...

 

[VA Hopeful Dr]

That's not a very good comparison at all...

True, as was pointed out cocaine is schedule 2, marijuana is not...

 

[ChrisMack390]

Find where I said anything about possession or distribution. I'll wait.

Then what is this "risk" you are on about? Those are the only laws the federal government has related to marijuana (or any drug).

 

[PL198]

True, as was pointed out cocaine is schedule 2, marijuana is not...

So your stance is that physicians currently prescribing medicinal marijuana are going to be subject to retroactive punishment for prescribing it while it was legal in their state in the event that the DEA decides to supersede state's established marijuana policies? Just making sure I understand.

 

[AlbinoHawk DO]

So your stance is that physicians currently prescribing medicinal marijuana are going to be subject to retroactive punishment for prescribing it while it was legal in their state in the event that the DEA decides to supersede state's established marijuana policies? Just making sure I understand.

It doesn't even count as a prescription for legal purposes in CA. It is a "recommendation" and viewed as your "opinion" on the benefits it may have for a particular person.

 

[ChrisMack390]

So your stance is that physicians currently prescribing medicinal marijuana are going to be subject to retroactive punishment for prescribing it while it was legal in their state in the event that the DEA decides to supersede state's established marijuana policies? Just making sure I understand.

This is such a bad opinion. The only people breaking a federal law are those that actually have any marijuana in their possession.

 

[VA Hopeful Dr]

Then what is this "risk" you are on about? Those are the only laws the federal government has related to marijuana (or any drug).

Losing your DEA license, which for most physicians makes you unemployable.

https://www.deadiversion.usdoj.gov/pubs/manuals/pract/section2.htm

Under the CSA, DEA has the authority to deny, suspend, or revoke a DEA registration upon a finding that the registrant has:

1. Materially falsified any application filed
2. Been convicted of a felony relating to a controlled substance or a List I chemical
3. Had their state license or registration suspended, revoked, or denied
4. Committed an act which would render the DEA registration inconsistent with the public interest
5. Been excluded from participation in a Medicaid or Medicare program

It would not be difficult to argue that giving a legally binding recommendation to a patient that allows that patient to obtain a schedule I substance is against the public interest, should the DEA change positions with the new administration.

 

[VA Hopeful Dr]

So your stance is that physicians currently prescribing medicinal marijuana are going to be subject to retroactive punishment for prescribing it while it was legal in their state in the event that the DEA decides to supersede state's established marijuana policies? Just making sure I understand.

Its possible. Just because a state makes something legal doesn't mean the DEA has to be OK with it. They can't take away your California license if you're running a marijuana clinic there, but they can absolutely take away your DEA registration at any time.

I'm not even saying this is particularly likely, but I'm not sure its worth even the small risk.

 

[PL198]

Its possible. Just because a state makes something legal doesn't mean the DEA has to be OK with it. They can't take away your California license if you're running a marijuana clinic there, but they can absolutely take away your DEA registration at any time.

I'm not even saying this is particularly likely, but I'm not sure its worth even the small risk.

It's hard to say something is impossible but I'm blanking trying to come up with a time that the federal government issued retroactive punishment for things legal in state at time. I have a hard time believing a) that the medicinal marijuana tide would ever turn the other way b) in the event that it does, previous prescribers would be subject to any penalties.

To be fair you said it's not likely

 

[VA Hopeful Dr]

It's hard to say something is impossible but I'm blanking trying to come up with a time that the federal government issued retroactive punishment for things legal in state at time. I have a hard time believing a) that the medicinal marijuana tide would ever turn the other way b) in the event that it does, previous prescribers would be subject to any penalties.

To be fair you said it's not likely

I agree, it's not all that likely. The thing is, it's not like we doctors have trouble finding jobs. Opening a medical MJ clinic given that just seems kinda stupid.

 

[sazerac]

It's hard to say something is impossible but I'm blanking trying to come up with a time that the federal government issued retroactive punishment for things legal in state at time. I have a hard time believing a) that the medicinal marijuana tide would ever turn the other way b) in the event that it does, previous prescribers would be subject to any penalties.

To be fair you said it's not likely

From http://www.nbcnews.com/news/us-news/why-montana-going-backward-medical-marijuana-n410081

One morning in March 2011, Mark and Valerie Sigler, the husband and wife owners of Big Sky Patient Care, one of the largest medical marijuana providers in the state, pulled up to their facility near Bozeman to check on things.

But the "Open" sign was off. The parking lot was empty.

Stepping inside, the couple was found rifle-wielding, federal agents in riot gear, standing watch over a handful of employees handcuffed on the ground. The Siglers had walked into a raid.

"I'd probably have been shot today, because I was in their faces screaming at them, telling them that we were state-compliant," said Valerie Sigler, shaking as she described it more than four years later. "So what were they doing there?"

The Siglers' business was one of dozens across Montana raided by federal authorities that day.

Many providers were charged, and almost all accepted probation or house arrest to avoid jail. The Siglers got house arrest plus five years of probation, which they're still serving. And becoming felons was just the beginning.

=====

From https://cannabisnow.com/breaking-dea-raiding-montanas-biggest-medical-marijuana-dispensary/

May 2016

Agents from the Drug Enforcement Administration and local law enforcement from around Bozeman, Montana are raiding one of the battleground state’s largest medical cannabis providers this morning.

Witnesses at the raid at Montana Buds in Four Corners, MT report six members of law enforcement taking items out of the dispensary and placing them in a storage trailer. One women was seen hand-cuffed and sitting on the sidewalk.

=====

These were both in a medicinal marijuana state. The articles don't describe any punishments for the prescribers, but medicinal marijuana is indeed a tide that ebbs and flows, and the federal government is quite happy to issue retroactive punishment for things that were legal in the state at the time.

 

[Entadus]

I agree, it's not all that likely. The thing is, it's not like we doctors have trouble finding jobs. Opening a medical MJ clinic given that just seems kinda stupid.

How do you propose MMJ patients get their cannabis if no doctors write recommendations? Somebody has to do it

 

[michaelrack]

How do you propose MMJ patients get their cannabis if no doctors write recommendations? Somebody has to do it

Maybe they shouldn't get their cannabis?

Alternatively, states can make cannabis OTC.

 

[VA Hopeful Dr]

How do you propose MMJ patients get their cannabis if no doctors write recommendations? Somebody has to do it

No, somebody does not "have to do it". Outside of maybe cancer patients, there isn't much good data about medical marijuana's value.

Truthfully, I wish it was just legal and they'd leave us out of it.

 

[Dr. Death]

No, somebody does not "have to do it". Outside of maybe cancer patients, there isn't much good data about medical marijuana's value.

Truthfully, I wish it was just legal and they'd leave us out of it.

Couldn't you say this about opioids or almost any other pain killer?

 

[VA Hopeful Dr]

Couldn't you say this about opioids or almost any other pain killer?

You could, and that's why fewer and fewer of us prescribe opioids for chronic pain. I personally have exactly 3 patients on chronic opioids, and they all take at most 1 norco/day.

 

[tatsuchi]

Usually respect your opinions, @VA Hopeful Dr, but it seems in this case you have more of a political stake rather than a medical one.

Could it be risky running a marijuana clinic in a marijuana-legal state? Sure, it's not one of the most sound business options I've come across, nor would I personally ever entertain the idea.

But it's not illegal. In this thread you started with scaring people about the legal threats of having such a practice, associating it with writing prescriptions for illegal substances, and then scare tactics with the DEA possibly taking away one's registration essentially because of "the change in political winds."


I get you are against the substance, but it would further your arguments to be a bit more rational about it. People make it enough of a murky issue without being honest with all the facts as it is.

 

[michaelrack]

But it's not illegal. In this thread you started with scaring people about the legal threats of having such a practice, associating it with writing prescriptions for illegal substances, and then scare tactics with the DEA possibly taking away one's registration essentially because of "the change in political winds."

.

I am sure a federal prosecutor could find some law to prosecute a doc writing a recommendation/scrip for medical marijuana, especially if he is running a "marijuana clinic".

 

[VA Hopeful Dr]

Usually respect your opinions, @VA Hopeful Dr, but it seems in this case you have more of a political stake rather than a medical one.

Could it be risky running a marijuana clinic in a marijuana-legal state? Sure, it's not one of the most sound business options I've come across, nor would I personally ever entertain the idea.

But it's not illegal. In this thread you started with scaring people about the legal threats of having such a practice, associating it with writing prescriptions for illegal substances, and then scare tactics with the DEA possibly taking away one's registration essentially because of "the change in political winds."


I get you are against the substance, but it would further your arguments to be a bit more rational about it. People make it enough of a murky issue without being honest with all the facts as it is.

Uhh, you are completely off base with this. I am 100% behind full legalization of marijuana. Full stop. I'm against medical marijuana because I think its unwise to put doctors in the middle of this, but that's not the point.

I'll distill this down for you very quickly...

I think being a marijuana physician is stupid because if the DEA wanted to, they could, at minimum, revoke your ability of prescribe controlled substances. The only reason they aren't going after doctors who do this is because they were told not to by the President (the DEA is, after all, under his authority). If our new President decides in January to change that policy, your only defense is "Obama promised not to prosecute". That seems a fairly weak defense in my eyes.

 

[Entadus]

No, somebody does not "have to do it". Outside of maybe cancer patients, there isn't much good data about medical marijuana's value.

Truthfully, I wish it was just legal and they'd leave us out of it.

Perhaps this is because it's a schedule I substance, and thus there is a massive amount of red tape to deal with for anyone trying to do research on cannabis

Maybe they shouldn't get their cannabis?

Go back to 1950. Lol

 

[VA Hopeful Dr]

Perhaps this is because it's a schedule I substance, and thus there is a massive amount of red tape to deal with for anyone trying to do research on cannabis

Go back to 1950. Lol

Why don't you PubMed this and get back to us.

Hint: there is actually quite a bit of research, it's just not impressive

 

[Taddy Mason]

...it's just not impressive

Hmmmm, I wonder why....