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October 2014
In this Issue

  • If You Lie Down with Dogs, You Get Up with Fleas
    Brian S. Zachariah, MD Chief Medical Coordinator Division of Professional Regulation, IDFPR

    This common proverb is often attributed to Benjamin Franklin or to Seneca the Elder. Despite controversies about its origin, there is general agreement as to its meaning: Be careful of the company you keep; their actions and image will attach to you.

    In medicine, perhaps the proverb should say, "If you lie down with unscrupulous businesspeople, you get up with violations of the Medical Practice Act."

    A recently publicized case involving the State's new Compassionate Use of Medical Cannabis Pilot Program Act provides an illustrative example. As covered by several media outlets, the Department recently charged a Chicago physician with violating the Medical Practice Act while attempting to set up a medical cannabis clinic. After the Governor signed the Medical Cannabis Act, but long before the rules for its implementation were developed, a business opened in Chicago charging patients $99 to file medical histories so that an affiliated physician could consider helping them qualify for medical cannabis - but not otherwise be their treating physician - in the future.

    In a formal complaint the Department asserts that this behavior is unprofessional and therefore violates the Medical Practice Act.

    There is a cautionary tale here for any physician interested in certifying patients for the use of medical cannabis under the pilot program. Such physicians are advised to study the act carefully, as it is significantly different from other similar acts recently passed in other states. Highlights of Illinois' Act include the limited number of qualifying medical conditions specified in the Act, the requirement for a bona fide physician-patient relationship and the prohibition against accepting payment for the cannabis certification itself.

    However, there is an even more important and broader lesson in this case of interest for any physician entering into a business relationship with a non-physician. The above-mentioned doctor had partners in his venture. One of them ran a successful medical cannabis clinic in another state and apparently based the operation here on that model - despite the fact that the laws in that state are very different from those in Illinois. These operations are alleged to violate not only the Medical Cannabis Act but the fee-splitting provisions of the Medical Practice Act as well.

    As non-physicians, such partners are not licensed by the Department and our ability to impact their activities is limited. However, the licensed physician involved can be held responsible for their partners' actions in the form of allegations of fee splitting, and aiding and abetting the unlicensed practice of medicine. Last year, the Department investigated 33 complaints of aiding and abetting the unlicensed practice of medicine alone.

    While our medical cannabis clinic challenges may be unique to our state, physicians involved with unscrupulous business people is not just an Illinois problem. The FDA has recently launched their "Know Your Source" campaign, warning physicians of the dangers of purchasing medications from rogue wholesale drug distributors. This is another example of non-physician's actions potentially harming patients as well as the images, reputations and even licenses of the physicians who enter into business relationships with them.

    Whether it's laser hair removal clinics, med spas, or recently and increasingly so-called medical cannabis clinics, etc., the Department frequently deals with complaints involving physicians in business with unlicensed persons. Practicing medicine in this modern era is tough enough. You don't want to be responsible for someone else's ignorance, poor decision making or violations of the Medical Practice Act.

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