Nurse practitioners and podiatrists would be able to approve patients for a medical marijuana card in Pennsylvania under proposals awaiting action from the state’s health secretary.
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Nurse practitioners and podiatrists in Pennsylvania may soon be able to approve patients for medical marijuana cards, thanks to new proposals awaiting approval from the state’s health secretary. Right now, only licensed medical doctors and doctors of osteopathic medicine can certify patients for the program, which currently serves hundreds of thousands of people.
If these proposals get the green light, it could expand access to medical marijuana in the state—a move that supporters believe will give patients more options. One cannabis group leader even suggested that this change could help bring down the cost of obtaining a card. However, at least one state official believes that telehealth has already made the program widely accessible.
These recommendations come from Pennsylvania’s Medical Marijuana Advisory Board, as part of a broader effort to make nurse practitioners more independent from physicians, though that effort has faced hurdles. When it comes to approving medical marijuana cards, though, there’s been little public opposition.
It’s not just Pennsylvania considering this change. Nurse practitioners in other states have been able to certify patients for medical marijuana for years. According to Leafwell, a cannabis certification company, more than 20 states already allow nurse practitioners or advanced practice registered nurses to recommend medical marijuana to qualifying patients.
Judy Jenks, a nurse practitioner who runs a medical cannabis clinic in Virginia, shared her thoughts with Spotlight PA, saying, “What is Pennsylvania scared of? Is it the cannabis? Or is it the nurse practitioner?” She continued, “If you’re scared of either one of those, then you don’t understand either one of those.”
Currently in Pennsylvania, nurse practitioners—who receive advanced medical training—can prescribe medications, diagnose conditions, and manage treatment plans, but they must work under agreements with physicians. When lawmakers passed the state’s medical marijuana law in 2016, they left nurse practitioners out of the equation to secure enough support for legalization in the Republican-controlled House.
However, the state’s Medical Marijuana Advisory Board and health secretary were given the power to make changes. In 2018, the board opted not to expand the types of medical professionals who could certify patients but left the door open for future consideration.
The current proposal would also allow podiatrists to certify patients, but only for specific conditions like chronic or severe foot pain. Nurse practitioners, on the other hand, wouldn’t face similar restrictions. The report on the proposal, provided by the state, says that nurse practitioners “treat all disease states” and should have “unrestricted ability to certify.”
While the proposals don’t lay out specific guidelines for how nurse practitioners should work cannabis certifications into their physician agreements, they would still have to register and complete a four-hour training course, just like doctors.
It’s now up to Pennsylvania’s health secretary, Debra Bogen, to decide whether to approve or reject the recommendations. The decision for podiatrists is expected by mid-November, while a ruling on nurse practitioners is due by late January.
State Rep. Dan Frankel, chair of the House Health Committee, supports the move, saying, “It makes enormous sense” to add nurse practitioners and podiatrists as certifying practitioners. “I think they have the expertise in order to do it,” he said.
So, is there a shortage of practitioners in the program? According to Christine Roussel, a member of the Medical Marijuana Advisory Board who presented the nurse practitioner proposal, one of the main goals is to “improve access to care for patients.” However, a recent health department presentation showed that there are nearly 2,000 approved practitioners in Pennsylvania’s medical marijuana program, which is a small fraction compared to the more than 64,000 licensed doctors in the state.
Although some believe telehealth has expanded options for patients, others say there’s still room for improvement. Meredith Buettner Schneider from the Pennsylvania Cannabis Coalition told Spotlight PA that expanding who can certify patients could provide more options and reduce the cost of certification. She also noted that some patients prefer in-person consultations over telehealth.
Other states, like Maryland and Virginia, have seen nurse practitioners play a significant role in their medical marijuana programs. In fact, in Virginia, nurse practitioners and certified nurse midwives outnumber physicians and physician assistants in certifying patients for medical cannabis.
Judy Jenks, who works with nurse practitioners at her Virginia clinic, emphasized that cannabis has been a helpful tool for patients dealing with issues like panic attacks, social anxiety, and chronic pain. She believes that restricting nurse practitioners from certifying patients limits access to care. “Ultimately, this is about the patient,” she said. “This is about the patient having access to a substance that helps them.”
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