Calif.'s biggest pot MD may break the rules
SAN FRANCISCO (KGO) -- Medical marijuana has become a huge business in California -- advocates put the number at more than $1 billion a year. With so much money at stake, some pot doctors are being accused of cutting corners to cash in.
The I-Team began looking into California's biggest pot doctor. He has 19 offices up and down the state and some former employees say he is bending, and in some cases, breaking the rules. Critics say that he is authorizing marijuana for patients who do not really need it, and some who could actually be harmed by it.
Dr. Jean Talleyrand left behind his private practice in San Francisco's Mission District after he realized how much money he could make on medical marijuana. In less than five years, his Medicann clinics have grossed at least $10 million.
Talleyrand does not sell pot himself (his patients have to go to a dispensary for that), but for $150, he provides the doctor's recommendation that clears them to smoke marijuana legally under Prop 215.
Passed in 1996, Prop 215 is meant for "seriously ill" Californians with conditions such as cancer, AIDS or glaucoma, but also "any illness for which marijuana provides relief." That phrase gives Talleyrand and other doctors a huge loophole -- one that does not exist in any other state's medical marijuana law.
His internal documents used for diagnosing patients show Talleyrand will recommend marijuana for anything from a headache to a restless leg, nightmares, psoriasis or diarrhea.
"Marijuana tends to slow the gut down, so you will have some easing of your diarrhea," Talleyrand told one patient.
Talleyrand will even authorize marijuana for "cannabis dependence" if the patient smokes too much marijuana.
"If you're overusing cannabis, you shouldn't go to jail for that, you should get proper treatment and that's what we're here for," Talleyrand said.
"Well, that's the first I have ever heard of that; that doesn't make sense to me," California Director of the National Organization for the Reform of Marijuana Laws Dale Gieringer said.
Gieringer was one of the original authors of Prop 215. He says Talleyrand and the other doctors on his staff have a reputation for not spending enough time to properly evaluate their patients.
A schedule from a typical day at the Medicann clinic in Concord shows one or two patients every 10 minutes for a single doctor.
"I think 10 minutes, if I couldn't do a good job in 30 minutes, I don't know what people can do in 10 minutes," medical marijuana supporter Dr. Frank Lucido said.
Lucido heads a group of medical marijuana doctors trying to set industry standards for quality care. He calls a 10 minute medical marijuana exam "a fig leaf" -- it does not cover much.
"I think it's very serious, because you're not only talking about somebody's health, but you're talking about their medical, legal protection," Lucido said.
"I could have a hang nail and say, 'Ow, it hurts,' and you can get it," one former employee said.
Former Medicann employees told the I-Team patients rarely get turned down, no matter how flimsy their medical complaints. Talleyrand and his staff have racked up 130,000 clients, more than any other medical marijuana operation.
Dan Noyes: "Is it all about health or is it about profits?"
Former Employee: "Profits. How could it be about health when you don't examine your patients? When you, when you're just signing it off to get more recommendations. You know, it's a patient mill. It's in and out."
"It would not surprise me that that is happening," Gieringer said. "As I say, 'there's people that cheat on everything.'"
The guidelines from the state medical board are clear, Talleyrand has to "consult with the patient's primary treating physician" or "obtain records to confirm the diagnosis and prior treatment history."
At Medicann, that often does not happen.
Dan Noyes: "Is there a company policy that you can give authorization for marijuana without medical records?"
In fact, Talleyrand's own guide for his 19 doctors says, "Medicann will...accept patients who have no medical records." And in that case, "we must act responsibly in determining a diagnosis."
The guide describes taking vital signs as a basic step that is required by the state medical board for every exam. The I-Team spent the day with Talleyrand at his office in Ukiah and not once did the I-Team see him take vital signs.
The state medical board has questions about Talleyrand's practice.
"Is he following normal standard processes when he is actually recommending these individuals for marijuana? So, is he doing a history and physical on the individual? Is there a treatment plan," Deputy Director of the California Medical Board Kimberly Kirchmeyer asked.
The board has launched an investigation after a complaint from a former Medicann employee.
"If we have from some source a concern that he is providing the adequate care and treatment of his patients, we would definitely want to look into that matter to determine if he was following the standard of care," Kirchmeyer said.
Talleyrand says his practice is different from mainstream doctors. Even before a patient walks in the door, whatever the ailment, he already knows the cure -- marijuana.
"I'm very comfortable with what I'm doing; I'm doing things within the law, and patients are getting better, and that's what I really want for the people out there to see," Talleyrand said.
Talleyrand admits he authorizes marijuana for people in sensitive public safety positions, who are not supposed to smoke pot even in their off hours -- police officers, firefighters, paramedics, even tug boat captains. He also authorized marijuana use for groups critics say could be harmed by it.
Dan Noyes: "Do you authorize marijuana for pregnant women?"
Talleyrand: "Ah, most of the studies on pregnant women are inconclusive. Ah--"
Dan Noyes: "Inconclusive? That smoking marijuana is okay for a pregnant woman?"
Talleyrand: "Well, let me tell you the studies."
In his guide for his physicians, Talleyrand cites anecdotal evidence from a mid-wife in the 1960's and 70's suggesting a healthier placenta among her marijuana using clients."
Dan Noyes: "You're going to quote a mid-wife in the 1960's or 1970's as the justification for you using marijuana for pregnant women?"
Talleyrand: "Well, you have to understand we're coming from a prejudiced group of people. The doctors have been prejudiced."
Talleyrand argues that mainstream doctors and researchers have not taken an honest look at the benefits of medical marijuana.
But, the March of Dimes cites study after study concluding pot use during pregnancy can lead to low birth weight and premature birth.
"It's a preventable birth defect; we know that if women abstain, she has a higher likelihood of having a healthier baby," March of Dimes spokesperson Leslie Kowaleski said.
One of Talleyrand's own doctors butted heads with him over recommending marijuana to pregnant women and others who didn't need it, so she quit Medicann.
"It was very dangerous and very high risk," Dr. Ahimsa Sumchai said. "At times I felt reduced to being a simple, you know, drug dealer. I did feel that way."
Talleyrand also admits authorizing marijuana for children and teens for things like insomnia, anxiety, depression, ADHD, even a 6-year-old's autism.
"The patients, according to their parents, behave a lot better and the parents have an easier time managing their autism," Talleyrand said.
He put the I-Team in contact with Mieko Hester, a Southern California mother of an autistic 9-year-old who received an authorization for medical marijuana from Talleyrand last Friday. She started feeding pot brownies to her son Joey two weeks ago.
"His repetitive behaviors had declined, his appetite had increased, he was calm," Hester said.
Psychiatrists who work with children tell us there's no evidence marijuana can help any mental disorder.
"There are all kinds of new ways of teaching autistic kids that are turning out to be relatively successful, and that is not one of them," child psychiatrist Dr. Lenore Terr said.
In fact, they say it actually can cause depression and psychosis, especially in teens.
"Marijuana is a depressant, so, why give a depressant to a depressed person when you have anti-depressant medication and you also have psychotherapy which is so helpful," Terr said.
Dan Noyes: "Would marijuana help ADD in any way?"
Dr. Stephen Brockway, adolescent psychologist: "Not that I can imagine. Actually, I can't imagine anything worse as a treatment of ADD, because actually marijuana causes problems with attention."
One of Talleyrand's former employees says some parents went to Medicann to get marijuana recommendations for their children, and that it had nothing to do with the kids' health.
"You look at the kids and they're young, they're normal," the employee said. "Their parents aren't giving them weed. They're selling it or they're growing it for profit."
Dan Noyes: "What's your response to that?"
Talleyrand: "I don't think that's happening. I think that, you know, I'm a scientist. I'm a doctor. I look at people and I treat their illnesses."
Talleyrand is not only a doctor, he is also a patient. He says he smokes marijuana to control his anxiety. ABC7 will keep viewers up to date as state watchdogs take a look at his practice, after a former employee filed a formal complaint.
Read Dan Noyes' blog: CA's Biggest Pot Doc
i-team, dan noyes
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