As family physicians, we stand at the intersection of patient-centered care, where trust, continuity and a deep understanding of individual health histories converge. This unique position enables us to play a critical role in the safe and effective integration of medical cannabis into patient care when clinically appropriate. Having served both as a Qualified Medical Provider (QMP) and as a member of Utah’s Medical Cannabis Compassionate Use Board*, I have observed firsthand how family physicians are best positioned to guide patients through the complex process of medical cannabis consideration. Why Family Physicians? Family physicians excel at managing complex, chronic conditions through a longitudinal relationship with their patients. This foundation is vital for assessing when conventional therapies are insufficient and exploring alternative options (increasingly popular in our community), such as medical cannabis, in a thoughtful and informed manner. Patients seeking medical cannabis often visit specialized cannabis clinics (I’m sure you can recall various radio ads and billboards for these), which may lack the broader context of the patient’s medical history. In contrast, we as family physicians have a holistic view of our patients’ health, encompassing their physical, emotional and social well-being. This knowledge facilitates: 1. Tailored Care Plans: Family physicians can integrate trials of conventional therapies, monitor their effectiveness, and determine when a shift to alternative treatments, including medical cannabis, might be appropriate. 2. Risk/Benefit Analysis: By understanding the patient as a whole, family physicians can lead nuanced discussions about the potential benefits and risks of medical cannabis, including its interactions with existing therapies and lifestyle factors. 3. Continuity of Care: The longitudinal nature of family medicine allows us to provide ongoing monitoring and adjust treatment plans as needed, ensuring that medical cannabis is used safely and effectively. In contrast, medical cannabis clinics often lead to higher costs for patients and frequently do not include comprehensive evaluations or robust education about medical cannabis. This can result in fragmented care and limited understanding for patients about how medical cannabis fits into their broader treatment plan. Lessons from the Compassionate Use Board Utah’s Compassionate Use Board serves as a safety net for patients who fall outside the state’s qualifying conditions for medical cannabis. This role underscores the importance of thorough documentation and careful consideration of patient cases. Additionally, the Board reviews cases involving patients under 21 years of age, ensuring that this vulnerable population receives careful oversight and guidance. I have been involved with many thoughtful and deep discussions about various patients to best determine the next course of action for them. Some petitions that come from medical cannabis clinics lack the comprehensive information necessary for quality patient care. Family physicians are ideally equipped to navigate this balance. Our comprehensive understanding of a patient’s medical journey ensures that we can present a compelling case for medical cannabis use when conventional therapies have failed. Bridging the Knowledge Gap One of the barriers to greater family physician involvement in medical cannabis prescribing is the knowledge gap. Most of us have not had any training surrounding cannabis. Unlike specialists in cannabis clinics, family physicians may feel less confident navigating this relatively new area of medicine. However, learning about medical cannabis should be no different than learning about any other therapy and I would argue the knowledge gap between family physicians and those clinicians at cannabis clinics is not that large. The Role of Family Physicians in Medical Cannabis Access By Michael Chen, MD, FAAFP 24
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