In mid-March as cases of COVID-19, the illness caused by the novel coronavirus, started to ramp up and social-distancing measures became commonplace, the Florida Department of Health issued an emergency rule to allow physicians to see patients for follow-up appointments and prescribe treatments remotely.

But the emergency telehealth rule, which applies to all doctors, physician assistants and advanced practice registered nurses who prescribe controlled substances like cannabis, wasn’t extended until 6 p.m. on Wednesday, the day it was supposed to end, leaving the state’s 333,625 medical marijuana patients and 2,537 qualified physicians in a lurch until the last minute.

The order was extended until May 8.

On a call Tuesday night with Department of Health and Agency for Healthcare Administration officials, doctors asked when they will know how to proceed with seeing patients.

Cassandra Pasley, director of medical quality assurance under the state’s health department, said she is “aware of the expiration” and that any action is “under consideration.” She could not provide doctors with a time line.

“We’ve all been left hanging,” said Dr. Lorri Ryan, a Volusia County anesthesiologist who doubles as a medical marijuana doctor.

On Wednesday night she cheered.

“We got extended, woohoo!” she wrote in a Facebook message.

Her clientele averages at around “60-plus,” and have transitioned surprisingly well to using the technology, she said. She hopes the state sees the value in extending the emergency order or at least providing some guidance.

“They’re putting so many people at risk if they don’t [extend],” said Dr. Michelle Weiner, a Hollywood-based pain management doctor and marijuana specialist said before the extension. “When it comes down to practical, common sense and global public health ... I’m pretty sure they will extend this if they are watching what’s going on.”

Social-distancing appointments

Weiner said the alternative to virtual appointments is spacing her patients out in 30-minute intervals so that no one sits in the waiting room and the space can be cleaned between each visit. The appointments she schedules through Zoom help her keep a full schedule and gives patients piece of mind without leaving their homes, she said.

Medical marijuana patients are mandated by law to visit their doctors every 210 days in order to keep their active status as a qualified patient. These visits often consist of doctors educating their patients on new products and tweaking their orders to fulfill the patients’ changing needs. There isn’t as much hands-on activity as there might be with her chronic pain patients, for example, Weiner said.

“It’s not like I’m doing a bad job by doing telemedicine,” she said. “The patients are so grateful. It’s the same exact visit except they don’t have to wait in a waiting room.”

In addition to the emergency order, the state has addressed medical marijuana from a commercial side. Dispensaries are staying open during the statewide “stay-a-home,” order and delivery drivers carry a letter signed by Florida Surgeon General Scott Rivkees that says the business “performs a critical role in providing healthcare delivery services” and authorizes drivers to “travel outside of established curfews during the declared State of Emergency related to COVID-19.”

Easier for some patients

Elijah Joyce, a marijuana patient from Fort Myers, said if the state considered medical marijuana to be essential, it should maintain virtual appointments as well.

The hour-long commute to his doctor is grueling, he said, and the virtual appointments have made things much easier as he practices social-distancing measures.

Joyce, 29, had his first telehealth appointment March 31, which he said was “the same as going into the office.” He hopes it even becomes a permanent option for patients even after the risk of COVID-19 diminishes.

“The visits at doctors ‘offices are difficult to do while maintaining social distancing. Many of the offices are in cramped spaces, and the telehealth option allows a needed buffer for the patients,” he said. “It also takes away a bit of the financial burden for the cost to travel to these appointments.”

Brad Taylor, 41, of Cape Coral, said his appointment with his North Fort Myers doctor took about 10 minutes over a video call, and saved him the drive from Cape Coral and risk of coming into the office. He said his doctor’s office is small, and that in order to keep a six-food distance from others, there could only be two patients in the waiting room at a time.

“Even the doctor and I would need masks since we’re sitting just across the desk from one another,” he said.

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