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Conversations with Cannigma: Putting the “Medical” into Medical Cannabis

Leafwell: More Than Just a Medical Marijuana Card

 

Originally published at https://cannigma.com/podcast/more-than-just-a-medical-card/

You can listen to the podcast by following the above link.

Marijuana; cannabis; pot; hemp; green.
Marijuana/cannabis. From https://libreshot.com/marijuana/

There are many questions that are left unanswered when it comes to medical cannabis. “Which product should I use, and how much? How many times a day?” “Can I use cannabis to replace or reduce the intake of other prescription drugs, and are there any negative interactions?” And of course, “How and why should I get a medical marijuana card?

The fact is, these questions are very difficult to answer; and, due to cannabis’s illegal status, carrying out the studies that are needed to answer patients’ queries is almost impossible. Yet, we are dealing with people who are suffering from life-threatening and/or extremely detrimental diseases, illnesses, and injuries. The current standard is not good enough, and we want to put the medical into medical marijuana.

Our doctors at Leafwell, Dr. George Gavrilos and Dr. Steven Salzman, speak to Michael Schaeffer Omer-Man of Cannigma, who are equally as interested in unraveling the mystery (or enigma) behind medical cannabis and how to use it effectively. Oh, and we also talk about what makes Leafwell different from other cannabis clinics in the US.

You can follow the link at the beginning of this article if you would like to listen to the podcast. You can read the full transcript below.

Michael:  Thanks so much for joining us on the podcast. My understanding of Leafwell is that it’s a little bit different than the average medical marijuana or medical cannabis clinic, at least as far as what I or, or most outsiders might think or imagine it to be. Can you tell us what the philosophy is behind it and sort of how it came together and why you started it the way you did?

George:  Absolutely. First and foremost, thanks for having us on. Steven and I are very excited to sort of share our insight and experience starting with the genesis of the practice and, and what our philosophy behind that practice is. When Steven and I decided to change our focus professionally and enter the sort of medical cannabis arena, we did so with the intent of bringing the medical model and our academic backgrounds to the cannabis space.

We quickly realized that patients, from young to old, with a number of complex conditions that I’m sure Steven will touch on really wanted the patient-provider experience, wanted to meet and speak with a professional who could not only evaluate and certify, but educate, and so Leafwell and Leafwell MD was built on the premise that people come first, that, as a community, we have to educate not, not only ourselves, but each other and so we built a platform where patients could easily speak with a like-minded, open, empathetic, compassionate provider, not only to be certified, but to continue cannabis care through the course of their treatment. Our site provides not only access to providers, but access to information and access to the latest in research and focus groups and think tanks, and when you come on to the leafwell.co platform, you get to speak with someone who or a collective of individuals who are more experienced in the cannabis space than we feel like anyone else in the country, if not world.

Michael:  That element of ongoing care, I think, is something that is missing in much of the medical cannabis experience for patients and probably doctors around the country. Why do you think that is, and, and how did you decide to do it differently?

George:  Yeah. I’m going to have Steven take this one, Michael, because for both of us, it was sort of serendipitous in that the patients who, whom we provided care to, really wanted to come back all the time, and so we have a capture rate of patients who, you know, want to get in and schedule for follow-ups, that’s 70, 80%, and Steven can sort of give you his philosophy of care in how he approaches initial verse follow-up visits and, and why we’re finding such real commitment for patients in terms of follow-up and why we feel so passionate about it.

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Steven:  Yeah. I think what George said is very important, was that we applied a medical model to medical cannabis, and, essentially, it’s really more of integrative cannabis medicine because cannabis was the start of getting patients sort of that solid base so that you could begin to implement lifestyle changes and other things that ultimately led to them being significantly improved, but you had to improve certain things first so you could get people back on their feet. One of the things that we laugh about was we didn’t know what our follow-up rate would be, and we were stunned to see, you know, that it was, you know … It was huge. Like George said, 80%. It might even be more. That might actually be on the low side, to be honest.

I mean and of course, part of that is because we are seeing a population that is ill, cancer, seizures, pediatric, adult, older, younger. We see across the board from, you know, infants all the way up to 103-year-old, and so the spectrum of diseases and symptoms that we see literally are innumerable at this point, and so these people need more than just some guidance of, “Try some medical marijuana.” I mean, you know today is, you know, there’s, you know, creams, salves, patches, sprays, suppository, sublinguals. I mean, there are so many products available, and it’s incredibly overwhelming to patients, especially patients who potentially are older or potentially who are sick and already have a lot of stuff going through their mind and anxiety-ridden. So, again, I think a lot of these things play into the whole need for the medical experience, why it’s so successful, why they follow up, and why it’s necessary for them to follow up because the better you feel, Michael, the better you want to feel.

George:  That’s a really good point, Steven, and, and one that I didn’t mention, but I think one of the things we discovered earlier on is that part of the cannabis conversation should, should be what are your goals of care. Right? And so for, for every patient, that’s different. if you see Steven because you’re a terminally ill patient and you want a, you know, a bit more quality of life, a little more clarity, a little less grogginess, a bit more pain relief, you know, your goals of care, at the end of life, are much different than a pediatric patient that Steven will evaluate who is resistant to one or two epileptic regiments and wants to try cannabis or cannabidiol specifically for improvement in that condition.

So, for us, it’s not just a, “Let’s establish care, let’s look at your records, yes, you qualify, see you when you have to re-cert again.” It’s, “Hey, I am now providing care for you. Let’s discuss your goals of care and how over the course of the next period of time, we can achieve them, what we need from you in terms of journaling and feedback and follow-up care and, and where do we go from there,” because a lot of what we do, too, is adjustments to care. So, it’s not just get a card, try something out. It’s come back, let’s talk about it. What worked? What went well? What didn’t go well? What are barriers to care, and what, what can we do to sort of overcome those barriers? So, a lot of people find-

Michael:  So, actually-

George:  Yeah.

Michael:  Yeah. I wanted to ask you specifically about that. In one of our recent episodes, I spoke to somebody who’s been a patient for 10 years. She had fibromyalgia and anxiety that she was treating with cannabis, and she said that it took her a year to find the combination of a strain and, and cannabinoid ratio and delivery methods that worked for her. How do you guide somebody through that, and how much more helpful is it to have a medical team with you in that process?

George:  Yeah. I think the notion of a long time before you find what’s right is not something that is a new concept for us. What I will say, though, is that we get to capitalize on the collective experience of half a decade and thousands of patients and analyze what conditions patients qualified for, what worked in those patient populations based on our follow-up data, and what experiences they’ve shared with Steven. So, Steven, and, Steve, maybe you can discuss this a bit more, has developed over the last half-decade specific protocols for specific conditions that address strain, dose, frequency, and, um, and, and, uh, and, and follow-up care. Steve, maybe you can take this one, too.

Steven:  Yeah. I, I mean, specifically, Michael, I’m sorry, just to follow back up, what was the actual question you wanted answered? Because I know we drifted for a second.

Michael:  I’m asking how do you start with somebody who, …what is the process of finding what works for an individual, and why is it more beneficial to have a medical team guide you through that process? Because, you know, as we know, in a lot of states and probably in Illinois, as well, and we’ll get to the question of recreational versus medical in a second, people are — they’re on their own when they start this.

Steven:  Right. Well, that’s the problem, right? That’s why they need a medical team, but, again, truth be told it is some trial and error, but this is a growing beast that we’re making. So, you know, when we started off, you know, we initially didn’t have a large patient population and a lot of experience, but as the years went on, as the patients grew, what we were able to do is custom-tailor things and see, how do you pull the trigger on something? When do you deliver a dose? How many does it usually work? What is the thing … You know, you start to ca- … It’s just like with the COVID environment, right? Every single day, it’s a new thing because they’re gaining more and more information and testing, testing, testing.

And it’s sort of a similar sort of process being played out on, you know, in Leafwell where you’re getting patients and you’re getting data and we’re getting feedback and we’re retrospectively looking at stuff, we’re prospectively collecting data, and then anecdotally just seeing what’s going on with patients because, you know, I see, what? 20, 30-plus patients a day, and we have meticulous notes, and so there are very specific endpoints that I’m potentially looking at to try to sort of move people along in their phases of care, if you will, but, again, you, you, you know, you have to give the patient some freedom because I tell patients, right, “What works for you might help thousands of other people.”

I’m not so narrow-minded to think I know what I’m talking about because I see so many thousands of people. It’s not. It’s a growing science, and the truth is that our patients are teaching us as much as I’m teaching them, you know, and, and because it’s such a young sort of not well-studied science, it’s important for that follow-up to see what’s happening, to be able to make changes, to grow our protocols, and to sort of narrow spectrums down so that, in several more years, it’s not trial and error. It’s this, this patient has panic attacks, you know? Of the 7,500 patients studied, this, this, and this, and you could see how that data’s much more compelling, and we’re much more apt to put a patient on point a lot quicker than even-

George:  Yeah.

Steven:  … we do, but I tell you, five years ago till now, we’ve gotten a lot, a lot better.

George:  And, and here’s what we are able to do, though. There’s a lot to be discovered, but if you have a good consultation, that, that should cover what your goals of care are as a patient, what you’re comfortable with in terms of consumption methods, what you want to get out of cannabis care when you’re afflicted most with your symptoms or condition, and, though we don’t have the answers for everything, we know that individual products have varying degrees of onset of action, duration of action, and, um, and we know that, for some conditions, um, this combination or ratio of CBD to THC or cannabinoids or terpenes, etc., works better than in this condition. So a thorough consultation with Steven or any one of the other providers in the Leafwell network should result in a clear picture of the qualifying condition of the patient, the patient’s goals of care, their comfortability with different consumption methods when they’re afflicted the most, and all of that information helps us initially give them some guidance.

Now, follow-up care from there, that’s when things get fine-tuned. “Hey Doc, you know, hey, Steven, I journaled.” Right? Steven’s big into journaling. “So, how did you feel before a dose? When did you take the dose? How long after did you get relief? How long did that relief last for? Great. Well, it seems that we need something that has a bit more longer duration of action during this time, or this might have been a little bit too much too soon.” So, so fine, fine-tuning those things is another reason that we so believe in follow-up care.

Steven:  Right, and the ability … Mike, I’m sorry, one more thing. The ability of what George said was he’s really sort of … The only thing he can say is our ability to make moves on the fly. It’s very important, in certain patient populations to be able to really respond. I’ll give you a for-instance, right? Pediatric hospice care where they have sort of like a bone cancer and the pain is crippling, and things have to be changed, and you, it’s just, you know, a lot of times, knowing the patient, understanding all of the things that go into making these decisions. All these things sort of grow in our ability to manage patients effectively and without a lot of guesswork at times.

Michael:  Are there other fields of medicine that you either have personal experience in or, that are out there that require, that have such a dearth of clinical knowledge — or institutional or research knowledge — that you have to make these kind of adjustments constantly, or where there’s a need for clinics like your own to compile it on a patient level instead of the inverse where it comes from clinical studies, and, and you’re just guidance?

George:  Yeah. I, I think we find ourselves in a healthcare environment right now where you see what happens when therapeutic decisions are made on the fly, right? So, every day in, in this pandemic, um, there’s a different approach to care, and it’s almost as if we’re, we’re reactive collecting what data we can, and then making a new decision.

Steven and I always joke that the last half-decade for us has been a fellowship in cannabis medicine, and we strongly believe that the ethos of the practice model, which was a medical model, is one that still holds true today. I wouldn’t go see a cardiologist or an endocrinologist or a pediatrician who didn’t have specific training and a specific knowledge base in the area of medicine that they’re practicing. For us, it is important that every provider in the Leafwell network is well-educated, well-versed, and relatable, empathetic, and kind so that patients who are a bit apprehensive to ask the questions that they really want the answers to, that patients who have been holding off for a long time before getting evaluated, have a safe environment where they can ask questions and get the answers to those questions from a knowledgeable provider.

Cannabis medicine is medicine for us, and, and we’ve created a practice where the focus is patient care, education, and continued growth of our knowledge base via research and follow-up care. So yeah, I believe that our practice should be like every practice or every practice should be like our practice. Yeah.

Steven:  And everything wrapped up into one nice word called communication-

Michael:  Yeah.

George:  Yep.

Steven:  Everything together.

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Michael:  Can you tell me about the research side of things? What, what kinds of … What are you looking to build a knowledge base around, and how do you go about it? Do all the patients participate?

George:  So, about a year or two into practice, uh, we realized that patients more and more wanted to share their stories and experiences, right? The cannabis community is one of sharing knowledge, experience, and growing together, and so you know, Steven had a light bulb moment and it took me a, you know, it took me a while to get on board, but he was like, “Listen, George. We, we can share the collective experience of thousands of patients via looking at data. We have the data. Let’s hire a bio-statistician. Let’s look through the data that patients have, you know, signed off on sharing with, others, and let’s put some stuff out there.”

So about a year or two ago, we, you know, we took a deep dive, and are retrospectively looking at all the patients that we’ve certified for specific endpoints, primary and secondary, and moving forward in the digital age, yeah, Steve and I were a bit, were a bit slow to the process, but now that we have a telemedicine solution and a platform that can do a lot of the pen-to-paper tasks that we did in the past were prospectively also collecting data looking at specific endpoints.

What do I mean by that? Um, we’re looking at pre and post cannabis care and how that’s affected presenting symptoms, qualifying conditions, quality of life, sleep, anxiety, depression scales, um, self-improvement scales, range of motion for those afflicted with orthopedic injuries and so we’re also taking the approach of looking at cannabis and how it affects current prescription medications or current therapies patients are on. Are we able to wean off of or cut doses of opiates, anxiolytics, benzodiazepines, sleep aids, etc., by using cannabis.

The initial data pool that we have is quite impressive and something that Steven and I are really excited to share with the medical community, but, anecdotally, I will tell you that patients sleep better, patients feel better, patients are off or on reduced doses of medications that they were on coming in, and there’s not a day that Steven isn’t in clinic when somebody tells him that he’s changed their life, and, Steve, I want you to fill in, though, because I think your approach to care is very unique, and it is tiered, and, you know, I think that that’s the right approach, and I think people would be interested in, in hearing your philosophy.

Author: Bokske; source: https://commons.wikimedia.org/wiki/File:FemaleCannabisCluster.jpg

Steven:  Well, yeah, I’ll Reader’s Digest it for the audience, but, basically, everybody who came in, it didn’t matter what was wrong with them, back pain, neck pain, cancer, ALS, rheumatoid arthritis, PTSD, didn’t matter. Every single patient had some form or another of insomnia, anxiety, depression, and when we went through, it was immediately obvious how and why things needed to be done.

Phase one was sleep. When we got patients sleeping six to seven-plus hours a night, we reset their biorhythms and Circadian rhythms, their response, and perception of pain, the logic, the critical and reasoning senses of the brain.

Stress hormones were kept in check, and it bled into phase two, symptom management, pain, anxiety, tremors. People started feeling better, and it was clear that those phases were intimately linked.

I also realized there was a phase three, and if I was going do things correctly, that’s where you had to dive all in, and I called it the take back your life phase because everybody had it, but it was unique to everybody. You had five knee surgeries, physical therapy. Veteran PTSD, you psychotherapy. In that was diet, weight management, exercise, getting patients off narcotics and benzos and sleep meds and antidepressants and psychotics, and all that was in there.

And so in a tiered approach, we were able to get patients sleeping, get patients feeling better, get a massive anti-inflammatory response using CBD, and then marrying those concepts together, building a strong base, and then sort of rebuilding them. In the end, cannabis led off to what the ultimate thing it turned out to be was building a 2.0 version of people with toolboxes to deal with relapse flareups and stress, and we’re experts at it now, and so that’s, you know, that’s sort of what it morphed into. It’s why it’s more than just, you know, a marijuana clinic, you know, or a marijuana whatever you wanna call it.

George:  Yeah. So the data and the research that we’re doing captures each of those tiers, right? So, how are patients in terms of their improvement in sleep, anxiety, depression? How are they able to participate in activities of daily, you know, higher activities of daily living, whether that is PT, OT, or, you know, mental health therapy, and then how, you know, tier three, how are they overall? Is there, is there quality of life improvement, and, you know, was it all worth it? And so I think … I mean, I know we’re very excited to, to be able to in the very near future share that data, but I think that our experience is probably not unique in that a lot more practices should be taking the same approach so that, as a community, we’re sharing this and, and that we make progress together.

Michael:  Something I hear from-

Steven:  Retrospectively, Michael, the data’s compelling retrospectively. Well you know, when people come in in the shape that they’re in, it’s chilling how many of them are on opiates, how many of them are on benzos, how many of them are on dangerous combinations at high doses. I mean, the things we uncover and the layers you gotta cut through, it is so complex. Like, we’re not doing it justice here.

Michael:  I hear a lot about more holistic treatment in the medical setting from most physicians that are actually treating with cannabis and everything that you’ve just been saying about how the sometimes secondary symptoms or issues that people are dealing with, like sleep, like depression, that even just treating those can improve somebody’s quality of life even if you’re not able to eliminate the pain, or the issue that they’re dealing with. Do you think that … and this is more of a philosophical approach question — Do you think that openness to cannabis lends itself more to that kind of treatment or that that kind of treatment is an inherent part of treating with cannabis?

Steven:  Which came first, the chicken or the egg? Because that’s really the question. You know, the healthy makes a [inaudible] know, George?

George:  That’s a, it’s a really good question, and it, let me give you a sort of the beginnings of the practice for us. So Steven and George open up a pot practice, and everybody in the medical community is going, “Ha ha ha,” except that fast forward a year later, and the same providers whose patients have seen Steven and George are now asking for less narcotics, reporting a better quality of life, are seizure-free, are pain-free, or are able to use the toolbox Steven talked about to deal with their anxiety, their depression, and their insomnia, and all of a sudden, providers who were so apprehensive before became our largest referrals or referral networks. And they didn’t have to pick up a prescription pad anymore. They didn’t have to write for 90 of Norco every month for their patient because they found or they discovered that cannabis works.

So, I think we’re making forward motion, forward movement, as a practice to the general medical community at large in that the first step is openness to the treatment, right? I tell patients all the time, “Plant-based medicine is not a novel concept. It has been around for a millennia, and some of the same medications that prescribers prescribe are, you know, the same medications that they prescribe for pain, uh, for, uh, cardiac conditions, for, uh, cancer care. I mean, they are plant-based medicine, and so cannabis is a safer alternative [laughs] to those plant-based medicines as a plant-based medicine and then it just clicks, and once it clicks, and patients start reporting back to other providers about their experience with our clinic, we’ve opened up now the greater community to an openness about it.

You’re right, Michael. If you look at qualifying conditions state-to-state in the United States, right, they’re so varied and they’re such an array, and I truly believe that is because cannabis may have a positive impact on hundreds of conditions, and so whether, you know, you’re a patient of ours in Oklahoma or Massachusetts or California or Illinois, they all report the same overall benefits despite having different qualifying conditions in their respective state program. So I think in the next half-decade the sort of dynamic of this conversation’s going change, and it’s going to be, “Where can we use cannabis instead of using all of these other things, and how can we make people better using cannabis?”

Steven:  And Michael, let me say something here. You want to hear a secret? One of our by far, biggest referral sources: pain physicians.

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George:  Yeah.

Michael:  So, this is actually the next question that I wanted to ask you, and you touched a lot on it, George. Are you seeing more and more referrals from other doctors, from, you know, from GPs, from specialists and how, when you, when you track the trajectory of the changing attitudes among the general public and, and legislation and legality, where has the biggest change been in that regard within the medical community?

Steven:  Yeah, I was chuckling because we have a huge referral base, like, literally 60, 70% of the patients are referred in, you know, from providers from a host of orthopedics, psychiatry, pain physicians, GP, and so, you know, we’re getting them from everywhere, and I think the biggest change is sort of its acceptance into modern day culture, you know? If you, it’s not this taboo thing that you’re smoking a joint behind a building, call the police and an arrest, and, you know, I, I think it’s, it’s much more understood. Many of the states are mandating physicians take at least a, a few CME credits and courses to introduce them to it, and I think it … People are becoming more and more comfortable with it.

I think if you add on to that now an opiate epidemic and a benzodiazepine epidemic and a drug epidemic and a pharmaceutical epidemic or whatever, and you look at it versus cannabis and the safety and efficacy of it against all of these meds, it makes more sense to physicians even if they were against it initially because, you know, you’re not having to worry that your patient’s going to die or overdose or withdraw. That’s a real concern for say, like, a guy like me. When somebody’s shot or stabbed and I’ve done a seven-hour operation on them or they’ve lost a leg, they’re going to require pain management, and many of these people are hit with narcotics and something.

So, because of, you know, unfortunately, Michael, it’s very sad to say this, but change doesn’t come easy, and usually it comes on the back of tragedy and, you know, like many other things that happen in this world. So I think now that lots of people died of opiates and with the acceptance of cannabis and the familiarity with it and the usage of it, I think all of this has sort of conspired nicely together to make people more aware and more accepting.

George:  Yeah, and I would also just piggyback on that, and say that you know, I think provider culture is catching up with patient culture, and what we have found in the last, you know, year or so is more patients are asking their providers for cannabis, and even those providers who are like, “Sure, here you go. Here’s your certification. You qualify. I have known you for forever, and I know that this may be an option,” then comes the “Now what?” question. Right? It’s … So, the patient goes back and says, “Okay. Now what? Like, thank you for certifying me, but can you give me guidance?” And for an orthopedic surgeon or for a pediatric epileptologist or for, um, an endocrinol-, they, they want to be able to provide their patient with information and oftentimes find themselves, you know, uneducated about the topic. So, in the meantime, our practice also has a lot of referrals from certified patients, from their …

You know, so I think what’s going to happen, just to sort of circle back to what we said before is, eventually, cannabis has to become its own, its own sort of specialty or you have to … You, you have to practice enough in the space to be able to provide good care, and so if, you know, what we’re finding is if you’re not in that space as a provider, you either send your patients … You, we’ve, we’ve seen an influx of patients who come to us for the entire process, or the minority experience is that patients come to us having been certified for the “Now what?” answers to their question. So, I, it, it’s all going to change.

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Michael:  How has the pandemic changed your practice, both in the way that things work in sort of a more logistical way, but also the types of treatment or recommendations that you give people?

George:  Sure. So for all of the dispensary workers listening, we just wanted to say thank you as a practice. In most of the states with a medical cannabis program in the United States, those services, those workers are deemed necessary and for good reason. Cannabis has impacted so positively the lives of patients who use it for their medical conditions that one of the things that I’m proud of and, you know, uh, or I’m happy to see is that those services have been kept open.

From a practice perspective, we know that cannabis is integral in the treatment of the patients and their qualifying conditions, but that not all patients, whether they’re geographically bound from a provider office or have an immuno-compromising condition that would give them pause to go out and seek certification or go to a dispensary. Things are changing in the industry, right? There’s a lot more curbside pickup of product where there wasn’t before. The delivery services are becoming readily available, and for us, as a practice, in states where we had, where we have brick and mortar locations, we’re starting to see a lot more adaptation of telemedicine services for post-certification follow-up care, and telemedicine not just in the cannabis space, but in the United States, is now, I believe, the new norm, right? It is a safe, efficient way that provides patients access to providers from the comfort of their own home and doesn’t predispose them to all of the external conditions that would give someone worry.

So, for us, we’ve seen patients more comfortable with using telemedicine as a service. We’ve seen patients relax because now they’re in their own home, and they can ask the questions that they may not have asked in the office, which… This experience has lent us to getting a real deep dive into patients’ lives. I mean, um, you get to see what their home life’s like. They’re relaxed. They don’t have that wall, and they, they provide so much more information. It’s made for consultations to be, I think, even stronger than they, than they were before.

From a medication perspective, as it relates to COVID, cannabis medicine and COVID, one thing that we get asked a lot is, “So, what about smoking? What about baking, uh, uh, vaping? What about combustible product?” And as a practice, we certainly find that there’s merit and the utility in those product formulations, right? Quick onset, short duration of action can be used for acute symptom management and so sans pandemic, I mean, we certainly have recommend those products on a day-to-day basis. However, in this environment, I think what we stress is that if you have a [inaudible] state and the dispensary product availability and the menu list, if you have access to other products that provide quick onset, short duration of action, and can be used for acute symptom management, we recommend those over vaporized or inhaled products given that there’s a link between COVID and lung implications.

So, most of the time, patients are responsive to that. They, too, are looking for alternatives, whether that’s tincture, sublingual spray, sublingual films, transdermal patches, topicals, etc., and so it also has added the science, right? It’s like, “Oh, they’re all alternatives. This is like a pharmacy. You’re giving me recommendations that I would not have otherwise thought about,” and, and so it strengthened, I think, our practice, um, and, and that’s sort of been our experience, right, Steve?

Seven-Fingered Cannabis Sativa Leaf
Leaf from a cannabis sativa plant.

Steven:  Yeah, no, I mean, that’s, yeah, beautifully put. I think we can do equally as effective, if not more, like George was saying. We’re able to practice in a safer environment. We have a patient population that is sick, that has the highest comorbid conditions, like hypertension, like diabetes, and they’re immunocompromised, and I think to, to be able to not miss a beat and the seamless transition of them through their phases of care, it’s, if anything, it’s enhanced the practice, if I’m being honest, although this is an absolute tragedy, but it’s shown us that telehealth is here to stay. In our practice, it’s essentially equally as effective, perhaps even more, like George said, which, uh, just gave me idea for another study where… Every day, Michael, there’s a new study we’re doing, but, anyway, with the effect of telehealth. I think we can thank God that we’re able to practice in a safer environment and still be able to help our patients.

Michael:  How many states are you in? How can people find you? Um …

George:  Yeah. So we are in every medical state that allows for telemedicine as a platform for certification and follow-up care. To date, I think 15+. Our website is Leafwell.co where you can also find our brick and mortar locations under the banner LeafwellMD. On there, there is a number of different resources. We believe in patient education and in both provider and patient being informed, so you can get the latest and greatest from the cannabis community there. In the About Us section, if you are a patient and interested in participating in patient studies, whatever they may be in the future, you can sign up so that we keep you front of mind and communicate with you, and, um, that, that’s also where you can access our, our telemedicine platform and see a provider in your respective state, uh, generally, uh, in less than five minutes from the time of log-in, um, uh, to, to the time you see a provider.

Michael:  I’m wondering, you talked about how you hope that cannabis medicine becomes a specialty in the future. So you guys have, you know, multiple brick and mortar locations. I’m assuming you’re not speeding between each one.

George:  Steven’s in one right now.

Michael:  How hard is it to find other physicians and medical professionals who are, who have that, that specialized knowledge, who can give us the kind of care that, that you guys are setting out to give people? How much education do you need to give and how much is that education of the medical community a part of what you guys are trying to do?

George:  Yeah, so we take the vetting process of onboarding new providers very seriously. It is a, you know, they undergo a number of interviews. We ask for philosophies of care, and their reason for their interest in joining. We only onboard providers who are passionate about self-development, learning about the cannabis, the cannabis practice, learning the latest and greatest in cannabis care, and who have empathy and a passion for patient care. Right? We are a people first company, and we’re not, you know, we’re, we’re not anything where we have standards that are, that are that or, or nothing else. So, you, uh, you will meet as a patient on the other side of your screen, whether desktop, laptop, or phone, somebody, somebody who is as passionate as Steven and I are about cannabis care.

Um, our organization, education is key. I will send out … You know, there’s internal messaging almost daily, studies to read, podcasts to listen to, webinars to be a part of, because we also believe that education, both sharing our experience and, and learning about others is paramount in progressing this further and we’re very committed to research, which I think is an important part of a practice, so that other practices or those who want to get involved in cannabis medicine can learn from our experiences, too.

So I would say that sort of sums us up as a company is that, is that we are a people first company whose providers are also people first.

Steven:  And I think all the providers, Michael, are also good communicators, and the majority of them are very academic-minded, as well.

George:  Yeah, and, and actually I don’t know that this was mentioned, but just as an example, if you are a, a patient with questions or if you just want to learn more information, our platform is accessible to anyone, and you’re only charged if you qualified, so even if you wanted to log on to speak to a doc about questions you have about whether or not you qualify about what to expect, I mean, you’ll get in front of somebody very quickly and won’t be charged unless you want to proceed with the qualification process. So, we’re accessible to everyone live or in print or digital, and we really believe in that as a model.

Michael:  Well, this has been fascinating for me. I hope it’s useful for our listeners and readers, and I hope to have you guys back on to speak to you again soon.

George:  This was a delight, and we are, we’re happy to come on any time you, any time you’ll have us.

Steven:  Thank you, Michael. It was very fun.

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