Image of Maria Todd
An expert in managed care and insurance benefits, she teaches healthcare providers across the U.S. how to work with insurers, and insurers how to collaborate with physicians, hospitals and other health service organizations.
Todd is also a certified mediator and health law paralegal, who is called in by healthcare professionals to help resolve benefits and claims disputes.
She is also CEO of the Mercury Advisory group – a consultancy she started in 1983 and that currently has about 100 independent consultants – that works as a referral system on related health care and health tourism issues.
 In Part 1 of this interview, Todd spoke to WeedWorthy about the overall state of the healthcare industry, and the industry’s current approach to cannabis.

Are there any healthcare programs out there right now that are exploring medical marijuana as an option, either as active policy or theoretically? 

I couldn’t name them, but I’ve heard rumblings that they’re out there; that there’s a group of doctors that are really limiting their practice to cannabis consultations. I’ve never met one. 

Some people smirk about doctors who write medical marijuana prescriptions, and say that they’ll give prescriptions for nearly anything, that they’re in it for the money and have poor ethics. Is that your take?

No. The ones I’ve heard of, that are writing prescriptions, are the heads of medical societies; they are Harvard graduates, they are highly respected in the community. They also hold dear the patient confidentiality and privileged communications ethics so they don’t make a big deal of it. 
But I haven’t found any of the wink-wink, nod-nod. Not in Colorado and not in other states where I’m working as a consultant. 

So what does that say to you, when you hear that conservative doctors are saying there’s a place for medical marijuana?

What it says to me is that, within two to three years, we should see an explosion in acceptance for the therapeutic aspect of cannabis in multiple forms.

Then what’s it going to take for these doctors to influence the healthcare system, to convince them that there’s a place for medical marijuana?

Doctors are extremely conservative about ordering or prescribing a regimen of a drug, a therapy – even a physical therapy – without feeling that they have the adequate training to help. Because the mantra (in medicine) is, ‘do no harm.’
I think what it’s going to take is opening-up the training and development, and capacity development, for the physicians to understand that CBDs do this, CBNs do this, THC does this. Right now they know that if they prescribe this antibiotic, it’s for this bacteria and that antibiotic is for that bacteria. So they get training by drug reps, they get training by continuing medical education, by reading in journals, and they can take self-study, directed independent study and other didactic training with others who know more than them. And they get a certificate and a diploma, and they feel a competency. They don’t have that right now (with medical marijuana).

So what’s it going to take?

I don’t know that I have the answer, but I can make some suggestions. The first thing is the University of Mississippi is the only place that is permitted right now to grow marijuana for clinical trials. That has to expand.  The clinic trials need to expand. This is another chicken-and-egg situation in that the IRBs, the institutional review boards, need to build their own capacity in order to oversee the clinical trials, for the clinical trials to make any sense. 
There’s a lot that medical marijuana and corporate marijuana (businesses) can do to help the industry along. And I think that, for a dispensary that is doing well financially, that is corporate-backed – and there’s a lot of them, and there’s all sorts of venture capital out there right now for that – I think that they would love to legitimize their brand by getting behind some of these educational initiatives; providing a limited amount of funding,  where they could incubate some of these valid, well-structured, clinical trials and starting picking off the treatment, the efficacy and the beneficence of this strain. 
If you could (establish) a 30-person study for MS, for shingles, and start to do the first phase clinical trials, they’re not that expensive to do. And not all clinical trials are funded by the manufacturer; some are actually funded by the patients themselves.
So it’s a matter of paying for the IRB, which is less than $10,000, and a clinical trial administrator, probably about $30,000. And then to write up the primary investigative brochure and the paperwork that goes with it is probably about another $15,000, and you’re on your way. 

Where do you see things in five years, in terms of medical marijuana research? 

I think that you’ll open up (Denver-based) Westword or another underground magazine like it, and you will find 15 to 20 different ads for clinical trial recruitment on this strain versus that strain, this edible versus that edible. And I think that it will be very commonplace at that point, in probably a lot more than 23 states.
I think the prices will come down, eliminate the smaller players. I think the quality in five years on the ingredients will be much further matured, and we’ll have product out there with far more consistency than I see now. 

Click Here for Part 1

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