FAQs – Physicians
Do physicians have a state and federal
constitutional defense to any interference from federal authorities for
advising patients about medical marijuana?
Yes. A federal appellate court, in a ruling left standing by the Supreme Court in 2002, enjoined the federal government from either revoking a physician's license to prescribe controlled substances or conducting an investigation of a physician that might lead to such revocation, where the basis for the government's action is solely the physician's professional recommendations of the use of medical marijuana. - Conant v. Walters, 309 F. 3d 629, 633-634 (9 Cir. 2002), cert. denied, 540 U.S. 946 (2003). As per federal constitutional law, doctor-patient consultations are absolutely protected from federal or state interference or punishment as a matter of the fundamental right to free speech.
What are my responsibilities to my patients
who want medical cannabis?
physician’s professional obligations to prospective medical cannabis patients
are no different from those for any other patient. The physician is expected to
assess a patient’s medical history and medical condition, and recommend
treatment that they think is appropriate.
What must I do to register with the
must register in the Physician’s Registry on the Commission’s website and renew every two years. Physicians
who register are called “certifying physicians” because they can issue written
certifications to their patients to obtain and use medical cannabis. You will
need to specify the conditions or diseases that you plan to treat, and any
criteria for including or excluding patients.
What are the general legal standards for
determining if a patient qualifies for medical cannabis?
and the patient must have a “bona fide physician-patient relationship.” The
patient’s condition must be severe, other medical treatments have been ineffective,
and the symptoms reasonably can be expected to be relieved by the medical use
What is a “bona fide physician-patient
law defines this term. Essentially it is a treatment or counseling relationship
between a physician and patient in which the physician reviews the patient’s
relevant medical records, completes an in person assessment of the patient’s
medical history and current medical condition, creates and maintains medically
standardized records, expects to monitor patient program and takes any
medically indicated action to follow up.
Are there conditions that qualify for
treatment with medical cannabis?
if the patient has a chronic or debilitating disease or medical condition that
results in being admitted into hospice or receiving palliative care.
the patient has a chronic or debilitating disease or medical condition that
causes (or is receiving treatment for a chronic or debilitating disease or
medication condition that causes): cachexia, anorexia, wasting syndrome, severe
or chronic pain, severe nausea, seizures, or severe or persistent muscle
the patient has glaucoma or post-traumatic stress disorder (PTSD).
If I have a patient I think would benefit from
medical cannabis, what do I do?
you determine that your patient’s treatment, disease, or medical condition
qualifies him or her for medical cannabis, you or your staff will go to the
Commission website to issue your patient a “written certification.”
What information will be contained on the
name, address, date of birth, physician’s name, the date of patient
qualification, and medical condition(s). How often should a physician follow-up
with a patient? A Physician should direct a patient to follow-up as you think
is medically appropriate. At minimum,
the physician must perform an in-person, evaluation once every 365 days,
with additional evaluation to be performed at the discretion of the physician,
to continue to issue a written certification to the patient.
Can a physician revoke a patient’s
a physician may amend or revoke a certification on any medical grounds, if the
patient no longer meets the physician’s inclusion criteria, or the patient now
meets the physician’s exclusion criteria.
Two examples of exclusion criteria are that the physician suspects that
the patient is abusing cannabis or the patient is diverting cannabis to others.
Will the Commission make a list of certifying
physicians available to the public?
At this time, the Commission does not have plans to post a list of certifying physicians to the website.
Are the Physician registry and Patient
the MMCC database system links the physician and patient registries through the
written certifications. Each patient may only have one written certification
and one certifying physician at a time. After 30 days, a patient may seek
renewal of the written certification; the renewal certification supersedes the
previous written certification. A certifying physician may terminate a written
Does the physician have to be registered as a
certifying physician before the patient visit in order to provide a written
certification for the patient?
physician must be registered as a certifying physician before providing a
qualifying patient with a written certification. The process for a physician
registering with MMCC as a certifying physician can be accomplished on-line in a matter of minutes. The physician will be
asked to complete an on-line application with basic information, including
name, social security number, business address, e-mail address, telephone
number, Maryland Board of Physician (MBP) license number, and controlled
dangerous substance (CDS) permit number. The MMCC database system will
immediately verify the information submitted and, if the application is
complete and the data matches the MBP and CDS records, an e-mail will be sent
to the physician. Once the physician responds to the e-mail the registration
process is complete.
Does the patient need to be registered before
the patient visit in order to obtain a written certification for the patient?
the patient must register in the Commission’s Patient Registry in order to
register before a physician can provide a written certification for the
patient. The application process to register with MMCC can be completed
on-line. The patient must provide basic information, including name, address,
date of birth, an image of a government ID, and a recent picture for ID
purposes. MMCC staff will review the application and notify the patient of
their unique 25-digit ID registration number
My physician says he won’t register with the
Maryland Medical Cannabis Commission to provide me with a written certification
because he is afraid he may lose his DEA registration or even be criminally
of doctors around the nation have been writing recommendations to their
patients to use medical cannabis pursuant to state laws since 1996, and have
not been prosecuted. Beginning in 2009,
the U.S. Department of Justice directed federal prosecutors not to prosecute
physicians and patients who were complying with state law. In addition, in
December 2014, Congress specifically barred the Department of Justice from
spending any funds that interfere in the implementation of various states
medical cannabis programs, and specifically included Maryland. Finally, in the
only ruling by a high-level federal court regarding physicians recommending
medical use of cannabis, the United States Court of Appeals for the Ninth
Circuit affirmed an injunction blocking the government from interfering with
the First Amendment rights of doctors and patients to speak to each other about
medical cannabis, and for a doctor to recommend medical cannabis to their
Are there limits to “the reasons the physician
may deny issuing a written certification of medical cannabis” (10.62.03.01A
reason that the physician may deny issuing a written certification is that the
condition with which the patient presents is outside the field of practice and
specialty of the physician. A reason that a physician may specify as an
exclusion criterion, and terminate a written certification is that the physician
has, in the course of his education and research, determined that the patient
is not an appropriate patient for medical cannabis. A physician is free to
define his or her exclusion criteria as narrowly or broadly as they think may
be appropriate for their practice.
Can the Maryland Board of Physicians take
action against my Maryland medical license if I become a certifying physician
and recommend medical cannabis for patients?
No, the MBOP cannot take any such action and is prohibited by law from doing so as long as the certifying physician is practicing with the parameters outlined under the State's Medical Cannabis Program.