Pubdate: Sat, 25 Aug 2001 Source: Register-Guard, The (OR) Copyright: 2001 The Register-Guard Contact: http://www.registerguard.com/ Details: http://www.mapinc.org/media/362 Author: Tim Christie, The Register-Guard Bookmark: http://www.mapinc.org/mmj.htm (Cannabis - Medicinal) STATE, DOCTOR CLASH OVER MEDICAL MARIJUANA State health officials said Friday that they'll ask about 800 patients with pending medical marijuana applications signed by the same physician to waive their privacy rights so it can be confirmed whether they have a legitimate, ongoing relationship with the doctor. State officials say they're simply trying to uphold the state's 2-year-old medical marijuana law, which requires that a doctor who signs a form for a patient be that patient's attending physician. The doctor and his supporters say the state's actions amount to a heavy-handed infringement on doctor-patient confidentiality. They vow to fight the state's tactics, in court if necessary. The controversy stems from the disclosure in July that a single doctor, Molalla osteopath Phillip Leveque, had single-handedly signed for 40 percent of the state's 2,227 medical marijuana card-holders. Leveque has signed for patients all over the state, sometimes consulting with them over the phone. He has defended his aggressive practice by saying it was his "moral obligation" to sign for patients who legitimately qualify under the law, especially when other doctors are reluctant to do so. Two weeks ago, in direct response to Leveque's busy pen, the state adopted a temporary rule that requires physicians who signed medical marijuana cards to have an ongoing relationship with their patients. The rule requires a physician to conduct a physical exam, develop a treatment plan and maintain an active, up-to-date medical chart for any patient he signs for. "That is a pretty reasonable requirement for an attending physician," said Dr. Grant Higginson, the state's public health officer in the Department of Human Services. "From our perspective, if that is not met we do not feel it meets the intent of the law for what is an attending physician." The rule also gave program staff authority to require a physician to provide a copy of the patient's medical file. That provision has been criticized by the Oregon Medical Association, which said it may conflict with federal law protecting patient privacy. To date, the state has asked only one doctor to provide patients' medical charts: Leveque. About 800 pending applications have been signed by Leveque, Higginson said. That's in addition to 935 approved applications he'd signed as of Aug. 8. Leveque's attorney, Marc Blackman of Portland, has sent a letter to the medical marijuana program manager saying Leveque "respectfully but firmly declines your request to examine patient files." "Acquiescing in your request would not only invade patient privacy rights, but Dr. Leveque's ethical, professional and legal duties to his clients," Blackman wrote. In an interview, Leveque said the state's request was "illegal, unethical and extortion." "This is awful. This totally destroys or is an attempt to destroy the doctor-patient confidentiality, which is sacred," he said. That's why on Friday the state began mailing letters to Leveque's patients who have pending applications, asking them to sign releases so state officials can inspect their medical charts, Higginson said. If patients choose not to sign the release forms, that's their right, but they won't get a medical marijuana card, he said. "If we can't review the records, we will be unable to verify a legitimate patient-physician relationship," he said. If the state is unable to confirm such a relationship, then a patient will have 30 days to get a statement signed by an attending physician. If that doesn't happen, their application will be denied and their $150 application fee will be returned. Meanwhile, patients with a pending application are protected from civil and criminal penalties for possessing marijuana, Higginson said. Medical marijuana patients and their advocates complain that the state has allowed a huge backlog of applications to pile up. Higginson confirmed that the state has a large backlog but said most were signed by Leveque. "We have basically taken care of the backlog except for this one physician," he said. "Right now we're unable to process those because we do not have the ability to review those records." Lee Berger, a Portland lawyer who helped draft the state's medical marijuana law and who defends medical marijuana patients, said the state's actions amount to a "witch hunt." "It's improper to promulgate rules and apply them retroactively," he said. He said "it's likely or possible" there will be a legal challenge to the state's actions within the next two weeks. In the meantime, a group calling itself the Oregon Medical Marijuana Coalition plans a rally and news conference Monday morning on the main floor of the State Office Building, 800 N.E. Oregon St. in Portland to protest the way the program is being administered. - --- MAP posted-by: Doc-Hawk