COVID-19: Telemedicine and Cannabis — Can Telehealth Bridge a Gap? - CRx  Magazine - Summer 2020

Telemedicine has come a long way in the last three years. It existed prior to the COVID pandemic, but it was the pandemic that pushed telemedicine to the forefront. Now that it is here, it poses an interesting question for healthcare professionals: is it appropriate in the medical cannabis realm?, the online arm of a medical organization that helps Utah patients obtain their medical cannabis cards, recently published a fascinating post on this very topic. In the Beehive State, all initial medical cannabis visits must be conducted in-person. Follow-up visits can be conducted virtually when a patient uses the same medical provider.

Some would argue that virtual visits are inappropriate in the medical cannabis arena. They insist, for whatever reason, that medical cannabis patients should always see their medical providers in-person. But why? Does that make sense?

When Telemedicine Is Appropriate

In a much broader sense, the debate over the usefulness of telemedicine boils down to when it is actually appropriate. Few medical professionals would disagree with the assertion that telemedicine isn’t always a better substitute for in-person visits. That is a no-brainer.

Telemedicine isn’t a substitute for the emergency room. It is not a substitute for complex visits requiring diagnostic testing. So when is it appropriate? Telemedicine is an appropriate substitute for any and all medical visits that are conducted solely as conversations between patient and provider.

The easiest way to think of it is in terms of primary care. Though there are exceptions to the rule, most primary care visits with a GP amount to nothing more than conversations. The doctor or nurse practitioner comes in, there is a brief discussion, recommendations are made, and prescriptions are written. That’s it. It is over and done within 10 minutes.

Such conversations can be conducted just as easily via telemedicine. And yes, the discussions can be just as thorough. There is no need for medical provider and patient to meet in-person to have such discussions.

Discussions About Medical Cannabis

Discussions about medical cannabis are no different from discussions about any other prescription medication or the conditions it is used to treat. That being the case, there doesn’t seem to be a legitimate need to require in-person visits when a medical cannabis patient needs to renew their card. The same discussion that would otherwise be had in-person can be had virtually.

You could make a compelling case for requiring in-person visits the first time around. In other words, a patient seeking to get that first medical cannabis recommendation probably should see their medical provider in-person. Why?

Whether it is a doctor, physician assistant, or nurse practitioner, the main objective of that first visit is to evaluate both the patient’s current health and the appropriateness of cannabis as a treatment for a qualifying condition. The word ‘appropriateness’ is key here.

Not Always Appropriate

Medical cannabis is similar to any other prescription medication in the sense that it is not always the most appropriate treatment, even for the qualifying conditions for which it’s available. Just because of patient struggles with PTSD for example does not automatically mean cannabis is the best treatment option.

A medical provider needs to look at the whole picture before deciding whether any given treatment is the most appropriate option. And to do that thoroughly, an in-person visit is usually the best bet. In-person visits allow for a type of interaction that just cannot be had virtually.

For follow-up visits though, telemedicine is appropriate. Medical providers and their patients can have the same medical cannabis discussions virtually as they would have in-person.

By Rehan

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