Medical marijuana is now a legal treatment option in several parts of the country, but physicians who are certified to prescribe it need to make sure to follow the rules, which vary in particulars and enforcement by state.
In Colorado, for example, a 2013 state audit report criticized health authorities for not doing enough to regulate high-volume prescribers, the Associated Press reported.
Joseph Robert Montante is one of a handful of doctors who have faced criminal charges. Montante was initially arrested in 2012 after writing a marijuana recommendation for an undercover police officer who told the doctor he didn't have a medical ailment but "just kinda want[ed] to get legit." Montante was convicted and sentenced to a month in jail plus probation. Separately, he subsequently lost his medical license.
He appealed the ruling, stating that the law that requires a "bona fide doctor-patient relationship" allows prosecutors to challenge medical recommendations from "whichever physicians attract their disfavor."
The Colorado Court of Appeals has maintained Montante's conviction, according to the AP, a decision that could lead the state to scrutinize the number of recommendations a doctor writes more closely.
Meanwhile District of Columbia-based pain specialist Patrick Fasusi, M.D., wrote more than 1,000 cannabis recommendations in 2014, according to an article from the Washington Post. A Department of Health panel audited Fasusi last year; however, the authorities were satisfied with the information he provided about how the program worked and did not ask him to change his prescribing habits, he told the newspaper.
Although residents of D.C., where recreational use of marijuana became legal in February, told the newspaper that getting certified was relatively easy, reporters who visited Fasusi's clinic witnessed doctor-patient consultations and follow-up appointments being made--interactions that can mean the difference between a "certification mill" and legitimate niche practice.
Fasusi also noted that the two consultations were fairly typical, but added that most of his patients have seen other doctors about their medical conditions before they come to him.