A Michigan physician granted medical marijuana eligibility to more than 11,800 patients in a single year, which amounted to 14% of the total number of people who applied for certification in the state that year, according to an audit released Thursday.
The audit, which argues that the state is not adequately monitoring doctor approvals in its medical marijuana certification system, said that physician certified an average of 45 patients per weekday during the 2014-15 fiscal year, when roughly 84,000 patients applied for a registry card. Twenty-two other doctors certified a total of nearly 47,000, or 56%, of the applicants, which averages out to eight per weekday. The audit did not name the physicians.
In its response to the state audit, the Michigan Medical Marihuana Program said it verifies physician certifications for suspicious applications and, on Sept. 28, began random audits of the certifications.
Auditor General Doug Ringler's audit did not say how many of the 84,000 applicants were new and how many were renewing their cards, which are valid for two years.
But auditors cited research showing most primary care doctors see 11 to 20 patients daily and have caseloads of between 1,200 and 1,900 patients.
Michigan's 2008 voter-approved law lets people legally use marijuana if they have a "debilitating" medical condition such as cancer or a disease with side effects such as seizures or severe and chronic pain. When registering for the program, patients must include a certification signed by a doctor showing a bona fide relationship — that appointments have been held and are reasonably expected to occur again in the future.
More than 224,000 patients registered with the state are growing their own marijuana or obtaining it from 38,000 designated caregivers. The number of patients has jumped by nearly 95,000, or 73%, in three years.
State Sen. Rick Jones, a Grand Ledge Republican, said Thursday it is "unbelievable" that one doctor could endorse so many patients. In 2012, legislators tightened the law to require physicians to assert in writing that they had fully assessed a patient's medical history and current condition, including through an in-person evaluation.
"This just stands out as fraud. I'm hoping that the proper authorities investigate this doctor," he said. "Somebody needs to be held accountable."
The Michigan Department of Licensing and Regulatory Affairs, which is responsible for the marijuana program, declined to say whether it is investigating the physician. Spokesman Michael Loepp said state law prohibits program employees from disclosing information about patients, caregivers and physicians.
They only can verify to law enforcement whether a registry ID card is valid and notify law enforcement about falsified or fraudulently submitted information, he said.
Loepp said the agency "periodically" rejects applications when a doctor confirms in writing that his or her signature has been forged or the physician fails to comply with state procedures used to verify the validity of the doctor's certification. There is no data available on how often such cases occur, he said.
"Clearly, any doctor allegedly abusing their privileges is a concern that we will work to address," Loepp said.
The law protects physicians from criminal prosecution or professional disciplinary action for certifying that a patient will benefit from medical marijuana, unless the licensing board determines a doctor has failed to properly evaluate the patient's medical condition or has otherwise violated the standard of care.
Auditors overall found the state to be moderately effective in administrating the medical marijuana law. They recommended more quickly processing patients' and caregivers' requested changes to their cards and launching an online application process.
The audit said the program received 450 applications and 41 change forms daily between October 2013 and January 2016.
The state said it is securing a new IT system.