FacebookTwitterGoogle+RedditEmail

Dr. Jimenez Defends His Practice Methods

Four doctors were named in a complaint to the state medical board earlier this year by the San Diego district attorney’s office in connection with cannabis consultations. The number of doctors investigated by the board for approving cannabis use now stands at 20. Not one of the complaints has come from a bona fide patient.

“SDPD used undercover officers to talk to several doctors and obtain open-ended marijuana recommendations based upon self-reported, vague complaints of ailments,” according to a statement issued by the DA at a July 6 press conference (held jointly with the U.S. attorney). That evening Deputy DA Dana Greisen elaborated to Channel 10 News: “The doctors, because they’re giving it to so many people, are basically legalizing marijuana one doctor and patient at a time… It’s being recommended for insomnia, depression, anxiety… The law is being abused on a massive scale.”

Contrary to the DA’s claim, the law created by Prop 215 in 1996 is being implemented on a very limited scale, given how many Californians are taking corporate antidepressants for which cannabis could be substituted if their doctors were willing to recommend it. The doctors are constrained by lack of training (U.S. medical schools are only just beginning to acknowledge the cannabinoid receptor system) and fear. Every medical board investigation of a pro-cannabis doctor keeps fear alive.

Most outspoken of the San Diego 4 is Jimenez, 43, who grew up in Torrance. He conducts cannabis consultations on the island of Oahu, where he runs a family-practice clinic, as well as in Southern California. The board has subpoenaed two of his patients’ records, one of which he refused to provide after getting a tip that the patient was actually a DEA agent.

“A woman in her 40s presented herself as K.S. back in May 2005,” Jimenez recounts. “She visited with a caregiver. She said she had a diagnosis of chronic insomnia and had been prescribed Lunesta.” Jimenez approved her use of cannabis for six months and requested that she provide confirmation of the diagnosis.

“About a month later I got a call from a dispensary saying, ‘You know that woman that you gave a recommendation for, K.S.? Well, that’s really K.H.’ She had shown her badge when she busted them! Sure enough, several months later I’m on the news, the DA of San Diego and the U.S. attorney are smearing my name all over Southern California.” Jimenez says, “I had no problem sending them one patient’s record as an example of how I do things in my practice. But the second one involved a person whose intention was to do harm. The chart has a name on it that’s not that person’s real name.”

Jiminez describes an unsatisfactory meeting with medical board investigator Nancy Edwards:”I told her I’d be happy to go in front of the board and explain my thinking. She said she was going to fine me a thousand dollars a day for each day I didn’t send the record. I said, ‘You can fine me a million dollars a day, I could care less. But if you continue, I will sue you for slander.” He is represented by Bruce Margolin, an L.A. defense specialist.

Jiminez expects the board to find no fault with the chart he provided them. (The patient has a 37-year history of chronic pain.) He defends his treatment of patient K.S., who did not bring any medical records to show that she had been diagnosed with chronic insomnia. “We know that 40-60% of Californians don’t have adequate medical insurance. We also know that it’s very difficult to obtain medical records, especially from an HMO. It can take months and cost money -some offices charge a dollar a page.” As for not physically examining K.S., Jimenez says, “When someone comes in complaining of chronic insomnia, you’re not going to do labs and a full exam. You ask them questions. You observe them. You try to find out what anxieties are keeping them awake.”

The real-world standard of practice has little to do with the textbook standard, says Jimenez. He once attended a conference on insomnia at Stanford at which an authority in the field described prescribing Ambien for up to two years -although the label advises a maximum of six weeks. “They don’t have any effective drugs for chronic insomnia,” says Jimenez. “Ambien is a very dangerous drug, known to cause bizarre sleepwalking episodes.”

Jimenez and the other doctors about whom the San Diego District Attorney complained will not -cannot, legally- be accused of approving cannabis in the treatment of depression and insomnia, even though that’s what galls the DA, by her own admission. The board will have to come up with a technical reason -a flaw in the history, or the examination, or the treatment plan, or the provision of informed consent, or, likeliest of all, record keeping. Attorneys for the medical board base their definition of a “good faith” examination on a 1983 case, Douglass v. Board of Medical Quality Assurance (as the MBC was then called). The Superior Court based its ruling in Douglass on a section of the Business and Professions Code that states: “Prescribing, dispensing, or furnishing dangerous drugs as defined in section 4022 without a good-faith prior examination … constitutes unprofessional conduct.”

“Philip A. Denney, MD, observes that “cannabis consultants neither prescribe, dispense, nor furnish” cannabis, and that the Douglass precedent is therefore inapplicable. “I would argue that Douglass has absolutely no bearing on discussing the medical use of cannabis with a patient,” says Denney.

The board’s expert witness in Douglass opined that a physician should spend 20-30 minutes personally examining a patient on his or her initial visit, and that the exam should include, among many other specified procedures, “a rectal examination and a pelvic examination for women and prostate examination for men.”

Denney comments, “This is not the real world. It’s not clear how this opinion of a single board consultant has led to the definition of what a ‘good faith prior examination’ means. If, in fact, not doing one on the patient’s initial visit constitutes negligence, then 99 percent of the doctors in California could be accused. Been to Kaiser lately?”

FRED GARDNER is a former Public Information Officer for the District Attorney of San Francisco. He can be reached at fred@plebesite.com

 

 

More articles by:

Fred Gardner is the managing editor of O’Shaughnessy’s. He can be reached at fred@plebesite.com

June 18, 2018
Paul Street
Denuclearize the United States? An Unthinkable Thought
John Pilger
Bring Julian Assange Home
Conn Hallinan
The Spanish Labyrinth
Patrick Cockburn
Attacking Hodeidah is a Deliberate Act of Cruelty by the Trump Administration
Gary Leupp
Trump Gives Bibi Whatever He Wants
Thomas Knapp
Child Abductions: A Conversation It’s Hard to Believe We’re Even Having
Robert Fisk
I Spoke to Palestinians Who Still Hold the Keys to Homes They Fled Decades Ago – Many are Still Determined to Return
Steve Early
Requiem for a Steelworker: Mon Valley Memories of Oil Can Eddie
Jim Scheff
Protect Our National Forests From an Increase in Logging
Adam Parsons
Reclaiming the UN’s Radical Vision of Global Economic Justice
Dean Baker
Manufacturing Production Falls in May and No One Notices
Laura Flanders
Bottom-Up Wins in Virginia’s Primaries
Binoy Kampmark
The Anguish for Lost Buildings: Embers and Death at the Victoria Park Hotel
Weekend Edition
June 15, 2018
Friday - Sunday
Dan Kovalik
The US & Nicaragua: a Case Study in Historical Amnesia & Blindness
Jeremy Kuzmarov
Yellow Journalism and the New Cold War
Charles Pierson
The Day the US Became an Empire
Jonathan Cook
How the Corporate Media Enslave Us to a World of Illusions
Ajamu Baraka
North Korea Issue is Not De-nuclearization But De-Colonization
Andrew Levine
Midterms Coming: Antinomy Ahead
Louisa Willcox
New Information on 2017 Yellowstone Grizzly Bear Deaths Should Nix Trophy Hunting in Core Habitat
Jeffrey St. Clair
Roaming Charges: Singapore Fling
Ron Jacobs
What’s So Bad About Peace, Man?
Robert Hunziker
State of the Climate – It’s Alarming!
L. Michael Hager
Acts and Omissions: The NYT’s Flawed Coverage of the Gaza Protest
Dave Lindorff
However Tenuous and Whatever His Motives, Trump’s Summit Agreement with Kim is Praiseworthy
Robert Fantina
Palestine, the United Nations and the Right of Return
Brian Cloughley
Sabre-Rattling With Russia
Chris Wright
To Be or Not to Be? That’s the Question
David Rosen
Why Do Establishment Feminists Hate Sex Workers?
Victor Grossman
A Key Congress in Leipzig
John Eskow
“It’s All Kinderspiel!” Trump, MSNBC, and the 24/7 Horseshit Roundelay
Paul Buhle
The Russians are Coming!
Joyce Nelson
The NED’s Useful Idiots
Lindsay Koshgarian
Trump’s Giving Diplomacy a Chance. His Critics Should, Too
Louis Proyect
American Nativism: From the Chinese Exclusion Act to Trump
Stan Malinowitz
On the Elections in Colombia
Camilo Mejia
Open Letter to Amnesty International on Nicaragua From a Former Amnesty International Prisoner of Conscience
David Krieger
An Assessment of the Trump-Kim Singapore Summit
Jonah Raskin
Cannabis in California: a Report From Sacramento
Josh Hoxie
Just How Rich Are the Ultra Rich?
CJ Hopkins
Awaiting the Putin-Nazi Apocalypse
Mona Younis
We’re the Wealthiest Country on Earth, But Over 40 Percent of Us Live in or Near Poverty
Dean Baker
Not Everything Trump Says on Trade is Wrong
James Munson
Trading Places: the Other 1% and the .001% Who Won’t Save Them
Rivera Sun
Stop Crony Capitalism: Protect the Net!
FacebookTwitterGoogle+RedditEmail