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In 2000, a neighboring doctor started making money prescribing pot. Denney joined their practice, having voted for Proposition 215, but said, "It became obvious they were playing fast and loose and it wasn't for me. I wanted to do things like take blood pressure and listen to the lungs. I thought it was obvious that the more controversial the practice, the closer you have to go by the book."
In 2004, he started three cannabis clinics in Orange County, Redding, and Sacramento with another doctor, and was semi-retired, working three days a week. "It was great," he said. "The patients are happy to see you. No one's dying in the lobby. No one's puking on your shoes. They pay on time."
Denney said he remembers first meeting Assad at a gathering of cannabis clinicians in Oakland where Assad's reputation as a loose cannon preceded him. Denney didn't see the doctor again until he testified on his behalf. "I had no intention of buying his practice when I testified," Denney said. But a Los Angeles buyer later approached him about a joint venture to purchase NorCal Healthcare and he agreed to buy the practice for $1.2 million (the company's annual net revenue).
Denney had given up the Redding and Orange County clinics to relax. But he got bored and said he saw NorCal as a chance to do right by Assad's 40,000 patients, who were left holding a recommendation from a discredited physician. He also likes testifying on his patients' behalf at court dates, parole hearings, Child Protective Services hearings, and union tribunals.
He intended to spend four months fixing Assad's practice, but said, "We're three months in and not even close. A conservative estimate is it's going to take till June. My role here is going to be limited to getting it up to the standards and functions of a physical plant I can be proud of."
He has let go of some NorCal staff, raised the standards of care, and brought in new medical professionals. Atop his to-do list: moving the Oakland office. "It's a pit," he said. "It's literally subterranean. It's dirty, stuffy, and we have to have a better space."
Denney said he intends to develop the premier cannabis practice in the state, rivaling its large peer MediCann. "We mean to practice excellence," he said. "We mean to be a model for physical evaluations of cannabis patients in the state. We understand we have to do a better job. We have to be exemplary. We have to be above reproach."
Denney said he sees about thirty patients a day now. Even Dr. Neyhart, the physician whose testimony was pivotal in Assad losing his license, agrees a good clinician can work that fast with the help of physician assistants and nurses doing much of the intake. "We focus the practice very narrowly," Denney said. "We determine the answer to a single question: Does this patient have a medical condition that could benefit from cannabis?"
Denney acknowledged that script mills exist, and if patients can't get a recommendation from him, they can just walk down the street to a less serious physician. "Such people give reputable physicians a bad name," he said. "They make this seem like a scam and they play into the hands of those who are opposed to this by doing things in a loose and unprofessional way."
But Denney said that fact belies an important distinction: Using pot is still safer than prescribing aspirin. "If this were a dangerous drug it would be a big issue," he noted.
Denney is the former president of the Society of Cannabis Clinicians, a trade group for pot doctors that had an open-door policy to people like Assad. The current president, Dr. Jeffrey Hergenrather of Sebastopol, said there's a rift in the clinicians' world between those who want to shun bad doctors like Assad and those who don't. The rift is so deep, in fact, that a splinter group has arisen called the American Academy of Cannabinoid Medicine, touting actual standards for clinical practice.
Hergenrather said consumers who see a shady pot doctor do themselves a disservice, because going to a place that keeps records, does physicals, takes blood pressure, looks at case history, and affords ample time with a doctor can save lives. He said he has often caught head and neck cancers in people who were coming in for a simple pot script. The fact that the California Medical Board did not permanently revoke the license of Assad after earlier misconduct indicates much bigger issues with doctors in the state than prescribing a harmless plant, Hergenrather argued.
Denney advises any of Assad's former patients with questions to call him and come in for a re-examination if necessary. And the issue of script mills may disappear all on its own this November if the Tax Cannabis 2010 initiative legalizes pot for personal consumption. If so, Denney estimates he'll lose 75 percent of his business and "fade into the woodwork."
Correction: An earlier version of this story misstakenly attributed the estimate that there are 600,000 to 700,000 people with pot recommendations from a doctor out of perhaps 4 million California marijuana smokers to Fred Gardner, editor of the cannabis medicine journal, O'Shaughnessy's. It should have been attributed to Dr. Philip A. Denney. In addition, an ealier version mistakenly said that a Los Angeles buyer had purchased NorCal Healthcare for $1.2 million, when in fact, it was Dr. Denney.