Today marks the beginning of a multi-week series I’ll be having on how to best serve dispensary patrons using cannabis for medical purposes. As the lines of healthcare in the cannabis space continue to establish itself, there are best-practices current dispensaries can be utilizing by simply understanding a patient’s journey from where they’ve begun to the time they arrive at the doors of your facility.
To begin comprehending the patient’s perspective, we need to first take a step back and look at the existing health paradigm and understand what traditional consumer expectations are. Let’s start with our patient Meg.
- Meg has been experiencing signs of depression and anxiety due to the global COVID-19 pandemic. She contacts her lifelong family healthcare physician who proceeds to give a full clinical evaluation, establish a diagnosis with corresponding ICD-10 code, and then prescribe anti-depressant medications. Meg’s visit is fully covered by her health insurance as a preventative service with no out-of-pocket expenses.
- Meg brings the prescription to her local pharmacy where her pharmacist will transcribe and precisely dispense the physicians orders including product, strength, dosage form, and frequency of use. Along the way, the pharmacist will evaluate her full medication profile for drug-drug interactions, assess for duplicate therapies, and counsel on common side effects. The pharmacy bills Meg’s prescription insurance and charges her a reduced co-pay for her medication.
- Meg takes her medication as prescribed for 2-3 weeks with no visible changes and some unintended side effects. She reaches out to her physician who will reevaluate and make readjustments based on standardized protocols and years of practical experience. The process then repeats with new medications or a modified dose of her current therapy.
The educational foundation is set by the physician and pharmacist with years to decades of institutionalized learning and practical experience. All prescription medications have universal prescribing guidelines and patient information readily available based on clinical research conducted by globally-renowned, multi-billion dollar pharmaceutical companies. Literature and data points are available from large-scale randomized double blind placebo-controlled studies, aka the “gold standard” in intervention based studies. There are systems of checks and balances as well as established protocols for Meg every step of her journey in an attempt to treat her medical condition.
Now let’s take a look at the process of what medical cannabis patients might be experiencing today:
- Meg’s condition has not improved, but because of negative side effects from her prescription medications, she wants to try a natural approach in treating her depression and anxiety. She speaks with a brand new physician via 30 minute tele-health session and is enrolled into a medical cannabis program which, depending on the state she lives in, has complex registration requirements, a patch-work of rules and regulations, as well as and unknown amount of products/potencies available. Cannabis is still federally designated as a Schedule I controlled substance so the consultation is not covered under her health insurance and she has to pay out of pocket.
- Meg receives her medical card and arrives at a medical (or adult-use depending on the state) dispensary where there may or probably not be a registered pharmacist or healthcare professional anywhere on site. The tele-health physician has not dictated precisely what product, strength, dosage form, or frequency of use beyond “sativa” for day and “indica” for night so she speaks with a “budtender” who recommends their personal favorite cultivar “Ninja Turtle Platinum Kush” at 29.8% THCa and 0.2% CBDa because that’s what helps them after years of experience with cannabis. This cultivar with the same name harbors a completely different cannabinoid and terpene profile in the next state over, but don’t worry, the chemical constituents that are required to be lab tested in that state won’t uniformly match Meg’s product anyway so don’t bother comparing. Oh yeah, cannabis is not covered by her prescription insurance either, so again, she must pay out of pocket for a product that may or may not work for her.
- Meg goes home and begins to use her cannabis. She’s still uncomfortable with the lack of guidance, so she joins her local Facebook or Reddit community of medical cannabis patients in hopes of finding the best recommendations available. u/Princess_Nugmaster recommends the newest cross of Bob Saget OG X Green Crack because it’s “fire”. Since costs are constraining, u/XxX_tomatoes_69 recommends that Meg purchases an ounce of the least expensive bottom-shelf flower and to manufacture her own edible cannabis products at home in the comfort of her own kitchen that she shares with her grandparents, parents, and siblings. Meg has full autonomy over the products she purchases from the dispensary, so her next readjustment is completely self-initiated and self-guided as well.
Do you see the stark and dire contrast in what is considered “medical” care in the cannabis industry at this point?
The cannabis industry is still in its infancy when it comes to standardized medical practices and protocols. There are numerous big-ticket regulatory hurdles to cross on both individual state levels in addition to federal reform needed in order to begin streamlining cannabis into modern healthcare conversations, but movement is progressing. The overlying, resounding issue is that cannabis can be used as medicine. There’s no reason why the industry can’t take meaningful steps in getting in there starting with the consumer experience.
For patients incorporating cannabis into their current healthcare regimen, it’s crucial to have their expectations laid out and clearly defined. The core objective in using cannabis as medicine is self-discovery guided by multiple facets and personnel. Dispensaries have an opportunity to serve patients on the front-line in a fashion more comparable to a neighborhood pharmacy rather than the corner liquor store. Most importantly, this journey must be rooted in a solid foundation of continuous education as the industry evolves and a strong focus centered on the patient.
Over the next few weeks, I’ll be discussing my experience working in the retail cannabis industry as a healthcare professional and how I envision laying the foundation to build a patient-focused dispensary. I hope you follow along with this conversation, and together, we can develop an industry where cannabis and healthcare collide.