Palliative physician visits dispensaries on investigative mission

BY RANDI BELISOMO | randi@lifemattersmedia.org

PALM SPRINGS, Calif. – When chronically or terminally ill patients turn to medical marijuana to take the edge off of their pain, the choice is often not driven by the need to soothe symptom-related suffering. It’s actually about control.

That’s what David Casarett, a Duke University palliative care physician and author of Stoned: A Doctor’s Case for Medical Marijuana, said at this month’s TEDMED conference in Palm Springs. To write his recently published, first-person account of medical marijuana’s potential, Casarret played the part of a patient and visited dispensaries to uncover how these emerging businesses do patient care differently.

“Dispensaries are giving them what they need,” he explained upon finding a hive of interaction and support for new and anxious patients.

Both employees and those in waiting rooms were eager to educate new patients, and some consultations lasted an hour or more. Employees guiding patients through the purchasing process asked about goals, preferences and hopes.

“Patients are seeking it out because of the context in which it is delivered and used gives them control over their own lives,” he said. Casarret cited patients who repeatedly told him some variation of the theme: I felt like that clinic was there for me.

The success of dispensaries and the satisfaction patients find there should serve as a “wake up call” to the health care system, and Casarret offered some lessons learned. The first: patients want more education and thrive when they can learn from each other. These peer-to-peer supports could be particularly valuable in regards to medication and its management.

The second lesson sounds obvious, but it proves more difficult in practice: patients’ needs must be put first. “Patients should not have to wait until they are seeing doctors like me to be asked what they are hoping for,” Casarret said about these questions which are often never voiced or only posed in the throes of end of life care. Medical marijuana users demonstrated that they welcome goals-based planning far earlier.

Casarret’s advice to physicians: swallow some pride, visit a medical marijuana dispensary, and observe interactions there. “We all know we aren’t meeting patients’ needs.”