A prominent cannabis pediatrician in Massachusetts is retiring, and that could put his patients in ‘crisis’ – masslive.comApril 10, 2021
Parents whose children benefit from medical marijuana to deal with debilitating medical problems have long turned to Dr. Eric Ruby for help accessing the drug. But come Oct. 30, the 73-year-old Ruby has said he will retire, potentially throwing the state’s already cumbersome pediatric medical marijuana program into short-term chaos.
Ruby’s now cares for the vast majority of pediatric cannabis patients in the state. He’s the primary pediatrician for almost 60 pediatric patients in the medical marijuana program. As of mid-September, there were 54 active pediatric registrations in the state’s Medical Use of Marijuana online system, according to the Cannabis Control Commission. In June there were 93.
His retirement means that children who need cannabis will have to seek out an entire new team of doctors to get it. But while the state has thousands of doctors, just a handful seek the certification to prescribe medical marijuana, given federal illegalities that could threaten hospital research dollars and reimbursements.
“What needs to happen is the doctors (caring for the patient’s underlying condition) need to be certified (to recommend marijuana),” Ruby said. “The doctors know their patients are taking this medication, so those doctors need to push the agenda that they should be able to take care of a medical need.”
Cannabis regulators require that every pediatric patient seeking a medical marijuana card in Massachusetts must receive a “recommendation” for cannabis from two physicians certified by the state. For kids, one of those physicians must specialize in pediatrics.
Regulators are now in the process of enacting new regulations that would expand the number of certified cannabis providers able to work with children from 15 to 79. Those new regulations, set to be voted on by the Cannabis Control Commission at the end of October, would allow a pediatric sub-specialist, oncologist, neurologist, or family physician to qualify as their ” pediatric recommendation.
Currently, the Cannabis Control Commission says there are 12 physicians and three nurse practitioners registered with the state who say they specialize in pediatrics. Changing the language would allow an additional eight oncologists, 22 neurologists, and 49 family care physicians currently certified by the state to also work with children.
Though not all those physicians might be willing to work with children, it would conceivably increase the caregivers who are able to work with kids.
The state says it’s required by law to keep the names of those providers confidential.
“Caregivers or patients with concerns about future access to the Medical Use of Marijuana Program should consult with their certifying healthcare provider or active patient advocacy organizations in the Commonwealth about resources for pursuing recommendations for medical grade cannabis,” said Maryalice Curley, a spokeswoman for the Cannabis Control Commission.
But Ruby says he’s unable to refer patients to new providers because he doesn’t know what other certified providers are working with children. Patients themselves struggle to find a provider, with Ruby saying he often hears that patients have been looking for a pediatrician willing to recommend cannabis for a year before finding him.
Even if parents are able to find a new physician, they are likely to come with a higher price tag. Parent Rachel Butze, for instance, said after struggling to find Ruby for several months, she recently located two new pediatricians willing to recommend cannabis to her 16-year-old son, who had been diagnosed with anxiety, a mood disorder, PTSD, ADHD, a pervasive developmental disorder and depression.
But unlike Ruby, who charged $75 a visit, the new physicians she has found are charging $200-$300 a visit. Further check-ins are required by the doctor anywhere from every three months to every six.
All told, Butze said she might have to pay $1,000 a year just for the physician visits.
“This is already an extreme burden on families that are struggling,” Butze said. “Why should it continue to put them in a position where they have to choose medicine or food for their children?”
Ruby says that despite the burdens his retirement will put on patients, coronavirus has put a financial strain on his practice. PPP loans from the federal government are running out. At 73-years-old, with underlying respiratory problems, he also worries about his health. Already this summer, he’s had to close the office several times due to coronavirus scares.
Yet he worries that for those desperate enough for medical cannabis, and unable to navigate the hurdles to come, he also worries parents will turn to more accessible products on the illegal market.
“The whole reason to have medicinal cannabis is so it is clean, monitored, so we know it’s not impure. This is why my retirement puts it in crisis mode,” Ruby said.
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