Maryland’s Medical Marijuana Laws a Mine Field for Physicians

 

             Maryland’s Medical Marijuana Laws a Mine Field for Physicians

 

 

 

 

 

One question physicians should ask themselves is: What civil and criminal penalties may I incur in the event I prescribe Marijuana? Neither Maryland’s inept and corrupt Medical Board nor its self-serving Medical Society have issued any statements concerning potential penalties. House Bill 881 signed by Governor Martin O’Malley in April of 2014 required the Department of Health and Mental Hygiene and its Marijuana Commission to derive regulations governing the dispensing of medical Marijuana. Recently directives have been released concerning physician involvement in procuring Marijuana for potential patients. Physician liability was not addressed by these rules or prior statue. Worse, Marijuana is listed as a Schedule 1 substance along with Heroin, LSD and other potential abusive drugs. Under federal rules prescribing Marijuana is a felony unless given prior dispensation by authorities. In recent times federal prosecutors have turned away from charging physicians with Marijuana law incursions if their respective states legalized it. This could change at a moment’s notice. Maryland physicians who become involved in accommodating patients seeking “medical Marijuana” run many risks for few rewards.

 

 

 

Physicians will have to move through multi levels of paperwork to be allowed the privilege to certify individuals to obtain “medical Marijuana.” An unrestricted active medical license and a spotless record of compliance with state regulatory structure is a must. Being politically well connected, similar to those chosen to be dispensers of this drug, would not hurt either. Physicians contemplating being listed for medical Marijuana certification should review all available literature issued by state authorities with particular emphasis on any statements by the Attorney General’s Office and the Medical Board.

 

 

 

Maryland Board of Physicians has a habit of inventing rules and standards care after the fact. Never proactive this Board cherry picks which sections of its legal Title it will follow depending upon who is before it. With a lawyer as the Executive head of this administrative entity expectations were the Board would have created guidelines for implementing House Bill 881, since it had 3 years. Without protections from civil and criminal penalties lawyers will have a literal field day prosecuting cases. Worse incorrectly certifying a patient or a patient who crashes a vehicle, with this Schedule One drug in his or her system, the physician’s liability may be substantial. Point is prescribing Marijuana could be entrapment for physicians.

 

 

 

Lastly does malpractice insurance cover prescribing of Schedule One drugs and the resulting detriment this drug could cause to a patient? Approximately 23 states have legalized Marijuana in some form or manner. Each state manages the legalities and judicial responses to this psycho active drug differently. Maryland’s Board of Physicians is not managed as it should. Control has been given over to lawyers with minimal input from physicians. The unpredictability of this Board’s actions, lacking specific written guidelines and standards for physician involvement with this highly potent drug, may not be worth the risk for health care providers.

 

 

 

The author of this article cautions physicians to be wary of signing on to prescribing Marijuana until such time as the civil and criminal liabilities have been “totally clarified.” Maryland’s Board of Physicians and its attack dog the Attorney General’s Office will quickly blame doctors, not themselves, for prescribing mishaps related to Marijuana, even though they have promulgated no rules as of this writing. In the event you want to learn how corrupt your medical board is read a few of the articles at: medicalboardusa.com.

 

 

 

Mark Davis MD

 

platomd@gmail.com

 

medicalboardusa.com

 

onandoffthehill.com

 

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SPEX: SPECIAL PURPOSE EXAMINATION OUTLINE MARK DAVIS MD SPEX TUTOR

SPEX COVER EBOOK NO JPEG-page0001

                SPEX: SPECIALPURPOSE EXAMINATION OUTLINE

 

                                  Mark Davis MD SPEX TUTOR AND MENTOR

 

                                                  platomd@gmail.com 

 

                             

 

                                      

 

Special Purpose Examination, commonly called SPEX, is a test unlike any you have taken before. Created by the minds at the Federation of State Medical Boards it attempts to test a physician on a wide range of subjects. Federation officials claim in their literature that every physician, regardless of specialty, should have knowledge of the subject matters contained within the structure of the SPEX. Their claim further notes that participants in this exam who stayed current with general medical literature should not find the questions on this test “totally unfamiliar.” Reading the Federation’s literature many candidates for the SPEX,  who took this exam, would contest the Federation’s description that common medical knowledge is sufficient to obtain a passing grade. The high rate of failure speaks for itself.

 

Medical Boards send their SPEX candidates into this exam literally blind. They provide no guidelines, literature or other information to enable a potential examinee to know what they will be confronting.  Most candidates I have come in contact with were given a phone number of a faceless bureaucrat at the Federation of State Medical Boards to call. The voice on the other end is more interested in collecting the enormous exam fee than guiding the examinee on how to study for this very broad based test. It is to the benefit of this Federation for you to fail because they can collect additional test fees. Obtaining an edge up on the questions and subject matters of this exam is extremely important. Why? Because it can make the difference between passing or failing. It will only take a few questions marked the wrong way to fail this extensive exam. Hence SPEX tutoring came into being.  As a tutor I come into contact with many who have moved through this exam. Their feedback is enormously helpful for future test takers. Reviewing books on the market, many of them antiquated for this test, have not been very helpful to the multitude of examinees who could not make it through this exam the first time. Physicians taking this exam two, three and even four times are not uncommon. Since there are no legitimate live courses available the tutor, Mark Davis MD, can provide help to overcome the hurdles of a test designed to fail. The content of this e-book provides a glimpse how a tutor can be of great assistance to a potential examinee.

 

 

 

Given by computer over a one day period this test is a challenge to fully complete in the allotted time. There is a total of 336 questions divided into 7 segments each containing 48 clinical presentations. Each segment is given 64 minutes to complete. This provides 1.3 minutes per question. Many of these presentations are a full page long with paragraphs that contain 8-10 sentences or more not including the multiple answers to evaluate. Being well versed in the content of this exam and its layout is extremely important. The Federation of State Boards’ description of this exam is illusive at best. Listed subject matters on their website concerning this exam are incomplete. Therefore tutors, such as this author, are indispensable to help a potential examinee through the maze of literature necessary to succeed.

 

 

 

Versatility in many subject areas is a must to conquer this expansive exam. There is an array of radiographs one must be able to assess quickly. These x-rays do not always have the clarity one would expect on an exam yet you are expected to know the answer to the problem presented. When x-rays are displayed the written clinical presentation may not always be clear exactly what the author of the question is looking for. There have been a number of x-rays which have been repeated over the years and a tutor can clue you in to those he or she has come across. Certain types of fractures, dislocations and injuries show up more often than others. In the pulmonary category there is a focus on certain disease states. Both pediatric and adult equivalents must be known by the test taker as well.

 

 

 

Reported that EKGs are not of the best quality is also a fact. The clinical presentation may request a treatment based on your diagnostic capability therefore analyzing the cardiogram appropriately is a must. SPEX designers may have purposely introduced artifact into their EKGs to confuse the test taker into thinking they are viewing a rhythm other than it really is. Certain patterns have shown up more frequently in recent years which your tutor would be able to reveal to you.

 

 

 

Though clinical genetics is a class we took in our medical school days it is ever present on current SPEX tests. The Federation’s foray into genetics encompasses inheritance, chromosomal anomalies and phenotypic expression. The test participant should be aware of both pediatric and adult presentations of genetic anomalies. Emphasized most recently is the percent of genetic expression for specific diseases. Your tutor can enlighten you on which diseases were most frequently represented on the test.

 

 

 

Orthopedics is showing up more frequently on current exams. Many of the presentations are purposely misleading which diminishes the amount of time you have for evaluation.  Fractures, dislocations and tumors in both the pediatric and adult age ranges have been displayed. Knowing which have shown up more frequently could save you much time. Many of these presentations are not common bone diseases therefore a tutor who has communicated with prior examinees is someone you should seek out. 

 

 

 

Vaccines have been included in recent exams. An odd presentation of a very common disease showed up more than once in the most recent circuit of exams. The wording was straight forward yet those who studied for this exam overlooked this disease. It is not enough to know vaccine schedules. One must understand when to apply them in emergency settings and or not use them as a specific case is referenced. A tutor could be instrumental here.

 

 

 

There are thousands of variations of cardiac disease. Yet the Federation of State Boards appears to want their physicians to know certain disease states. Knowing Cardiology is not sufficient. Odd presentations of symptomatology are examined on SPEX.  Also tested is the examinees ability to elicit certain symptoms to arrive at a diagnosis. Physical diagnosis is tested in a number of ways. When to test and when to withhold testing of a patient is paramount. Which cardiac drug to select when a patient presentation is given is of utmost importance to know. As a tutor for SPEX those who have taken this exam several times reported back the recurring themes the Federation of State Boards has utilized in cardiology.

 

 

 

 

 

 

 

A wide range of pulmonary presentations have confronted recent examinees. The examiners have introduced an international flavor to the test. Diseases normally not seen frequently in the United States have challenged test takers. Remember you have approximately 1.3 minutes to evaluate an x-ray, graph or chart. In addition you must read and evaluate the clinical presentation before moving onto the 4-5 answers to select. Preparation is key. With few exceptions the flash cards offered for study of SPEX and other books sold were not very helpful in this section as reported to me. Variants of common pulmonary disease states both in the pediatric and adult categories were also amongst the offerings.  Several deceptive presentations of lung cancer and uncommon bacterial/viral diseases made their mark on examinees. Knowing where to emphasize your studies in this medical subject is paramount.

 

 

 

Psychiatry had a wide presence on recent exams. A series of symptoms describing a patient’s personality was frequently seen. The examinee was required either to make the correct diagnosis or chose the medication for that diagnosis. Some of these presentations were a full page in length.  One clever presentation gave a description of an infection which required a psychiatric diagnosis. There are several methods to cut down the time for evaluation of these types of questions.

 

Check with your tutor for the best approach. Parsing your time is one of the keys to passing SPEX.

 

 

 

Numerous questions in gastroenterology, both in the pediatric age group and adults have been given on recent exams. These questions frequently but not always have x-rays along with their extensive description of diseases. Knowing which age groups these diseases appear more frequently would substantially cut down the time in finding the answer. Remember many of these clinical presentations appear the same except for a few distinguishing characteristics.  Questions related to the liver and the various toxic encounters it incurs should not be overlooked.  A large number of errors are made in this area of the anatomy. Your tutor can cue you in on what has been seen most recently.

 

 

 

A wide ranging knowledge of infectious disease is a must to move into the passing grade zone. This subject overlaps with every other category of disease on the exam. Odd presentations of common diseases have been seen. Both domestic and foreign vermin are presented to challenge the examinee. In some questions a specific symptom or set of symptoms may be given and you have to know the disease presented in order to answer which treatment modality is needed. This is called a second level question. This type of question is seen frequently. A patient presents to a physician with several symptoms of severe neurological disease. On first glance at the question the examinee may not consider this is an infectious disease problem, yet it is. The Federation test writers do an excellent job with  infectious disease questions literally misleading the test candidate by adding vacuous information to the introductory paragraph of a given question.  Your challenge is to get beyond the confusing verbiage to quickly delineate the answer.  Tutors are helpful here because they can clarify the fine differences in questions to get to an answer sooner.

 

 

 

There are numerous questions on Oncology and Hematology. Many of the books on the market have physicians studying various slide presentations of cells or other extraneous lab data. If that makes the examinee comfortable then by all means study this material. Recent tests did not have microscopic slides for these specific subjects. Questions are definitely recycled.  Additionally a clinical setting may be given requesting the examinee to answer several questions based on its contents. This type of presentation was given throughout the test. On the Oncology side pulmonary, bone and skin cancers have been frequently seen.  These questions either ask the diagnosis and or the most common treatment mode.  Few may request the cause of the cancer which may not be as obvious as one would think. A vast array of hematology questions have been seen from bio-chemical deficiencies to blood born cancers. Your tutor can be very helpful here directing the examinee to emphasize certain areas of study.

 

 

 

Neurology and Neurosurgery questions are part of the repertoire of presentations. Symptomatology is similar for many of these diseases. Therefore questions can be quite confusing. With limited time available the examinee must get into the “meat” of the question quickly. Knowing the physical findings specific for compressing lesions and or vascular anomalies would be very helpful to the test candidate. Within these fields your ophthalmological knowledge will also be tested. Knowing the layout of specific nerve roots could help answer some of these complex questions. Your tutor can enlighten you on some of the more broad based approaches examinees should take to get beyond these types of questions.

 

 

 

Nephrology is represented by many key questions from urinary crystals to cancers. Vascular anomalies have been presented in creative ways to throw the examinees’ thinking for the proverbial loop. A multi-prong study approach should help the test candidate through these difficult questions. Let your tutor guide you to the best approach in this subject.

 

 

 

Special Purpose Examination (SPEX) has shown itself to be incredibly difficult. Failing this exam two, three and even four times has occurred frequently by test candidates. The cost in time and money can be cut down substantially for examinees by proper preparation and study for this exam. A tutor who has a wide ranging knowledge of this exam and who has come in contact with a multitude test candidates is well suited to help the potential examinee.  Please contact Mark Davis MD at platomd@gmail.com to inquire concerning fees and study times available.

 

 

 

Mark Davis MD

 

platomd@gmail.com

 

SPEX Tutor and Mentor

 

Medicalboardusa.com Protecting Physicians from Medical Board Abuses

Medicalboardusa.com Protecting Physicians from Medical Board Abuses

Medicalboardusa.com is a website designed to provide support to physicians who are under the duress of a medical board intervention and or a malicious malpractice case. When targeted physicians become isolated, their stance in the community is diminished and the economic drain is potentially enormous. With the latter in mind this site seeks to connect physicians with others who have been down this road and appropriate people who can protect them. Medicalboardusa.com seeks lawyers who are extremely cognizant of administrative law that governs medical practice. Medical Boards have counsel well versed in this segment of the law and their targets should have equal representation.

Medical Boards have moved on from oversight of their flock to confrontational assaults with physicians. When targeted a physician should expect the worst from their medical colleagues who sit on these tribunals. With the misuse of standards of care and complex regulatory structure medical boards now entrap physicians with bogus compliance cases. These actions are performed to improve their sanction numbers amongst the states. Studies of the Arizona, Texas and Maryland Medical Boards display they have been politicized to a point that they lost the purpose of their original intent. Case after case reviewed displayed only strong legal representation by a lawyer who knew his/her way around the regulatory mind field had successful outcomes. This site should be a first step for accused physicians to discuss their cases before answering any letter from a medical board inquiring about their practice.

Mark Davis MD
Platomd@gmail.com
Medicalboardusa.com

Maryland Medical Society: A Self-Serving Entity

Maryland Medical Society: A Self-Serving Entity

In the course of time the original intent of the Maryland Medical Society has been lost. Predating the Maryland Board of Physicians and its multiple prior incarnations the Society, commonly called MedChi, has become a commercial entity with little regard for those who pay its bills. Claiming to represent all licensed physicians in Maryland its membership rolls are a fraction of the total practitioners statewide. Presently the Society’s website is designed for commercial ventures with sidebars stating how this quasi entity is protecting physicians. The Society is no longer a hedge against an adversarial medical board. Decades ago reviews of physicians’ practices were governed by The Peer Review Handbook generated by a cooperation between MedChi and the Board of Physicians. This is no longer the case as the Society stepped back to take a tertiary role selling insurance and deceptive enticement to bring unsuspecting physicians into the fold. Their targets have been younger physicians inexperienced in practice and the practices of the corrupt Board that licensed them. These doctors will learn quickly when they need this Society their cries for help will fall on deaf ears.

In recent decades the Maryland Medical Society has enabled the Board of Physicians to become the unscrupulous and corrupt Administrative government agency that is in force today. Hundreds of physicians are picked off every year by an effort between the Board and Maryland Attorney General’s Office. With absolute immunity the Board is able to escape retribution by their victims especially when the evidence goes against them. The Society looks the other way claiming it is the proverbial watch dog against this errant Board and legislative efforts against the medical profession. This could not be further from the truth. Both the Medical Board and Medical Society are managed by lawyers. This is not science fiction but a reality that physicians end up confronting when the Board turns its eyes towards them. The cooperative effort between these two entities is elaborated on in the next section.

In the early 1990s the Medical Society published a journal which displayed a cooperative effort with the Maryland Board of Physicians. In this journal the Society would publish raw data concerning physicians who were condemned by the Medical Board. The Journal editors refused to take any response to the data from the physician being victimized by the Board. In the author’s case over a dozen pages of raw data, later found to be false, were published in the Society’s rag. After being told, in the most literal sense to go screw myself by the Society when I complained, the author filed a lawsuit in Baltimore City Circuit Court. Known for its left leaning decisions the author won the case after the Society’s lawyers lied about their connections to the Board. Case number 24C93201023 the Court found the Society had no direct connection to the Medical Board. Therefore it had no right or responsibility to published unedited and or raw data about a physician in their Journal. This author presented this case pro se and remarkably the judge agreed with me. In the aftermath of this decision the Board began publishing quarterly publications of sanctions against physicians written in an abbreviated style.

Maryland Medical Society’s website is far from accurate. Yes, it owns an insurance company which has expanded from malpractice coverage to anything and everything that needs to be insured. Yes, it puts on social events for physicians. Yes, it tries to attract a crowd of newly minted doctors who are unaware how little the Society will give them in return. With that stated the Society has not restrained a medical board whose primary goal is to improve its sanction numbers amongst the states. The foolish notion this entity will help doctors by overseeing legislative efforts concerning medical practice is absurd. The onerous rules on physicians’ backs have increased exponentially under this so-called watch dog. Having an attorney as CEO guarantees there will be little effort to help physicians when the Board turns its eyes on them. In discussions with a multitude of physicians over several years my point of view is widespread. Maryland has a medical society that is self-serving, unwilling and or unable to help physicians through the sanctioning process and does not have physicians’ welfare at the center of its existence. For these reasons and more the Maryland Medical Society only has a sub-segment of Maryland physicians as members displaying how smart my colleagues really are.

Mark Davis MD victimized by this Society once but never again.
Medicalboardusa.com presently under construction
platomd@gmail.com

This article will be posted on many sites so the maximum number of physicians will have the ability to read it.

Medical Boards’ War against Physicians

 

                                  Medical Boards’ War against Physicians

 

 

 

 

 

Erratic behavior by state medical boards has come to light across a nation starving for health care. Physicians have become pawns in a game medical boards play to enhance their sanction numbers. Sick, twisted and disturbing medical practices have no place in the spectrum of health care. Yet the majority of physicians being sanctioned are for frivolous reasons. A review of medical board sanctions from several states displays the capriciousness of their interventions. Paper compliance is one scheme these administrative entities use to deprive physicians of medical licenses. Another is the use of the term standard of care. Embedded in Tort law this phrase has been abused beyond reason. Most repugnant is irrational regulatory structure legislated into law against physicians for the purpose of micromanaging a physician’s practice. Stepping outside the boundaries of one regulation ensnares a doctor into a system bent on destroying his career. 

 

 

 

When the assault on a physician begins it is indelibly imprinted on the mind of the victim. Generally the inquisition is initiated with a subpoena or a notice of inquiry concerning a patient or patients. The cause of the action could be a complaint or randomly generated. In either case the physician is at the starting gate of a long process which will either be confrontative, intensely adversarial or a combination of both. Do not make the mistake of giving these errant boards anything more than requested. A smarter move would be to engage an attorney cognizant of Board procedure and regulation. This is very specialized area of the law not known to many attorneys. To go to war against an adversary with a big hammer one must have a hammer of his or her own. A board intent on sanctioning a physician, especially when the evidence goes in the opposite direction, will be successful unless the target is properly protected.

 

 

 

Medical Boards have exceeded their legislative mandates by perpetrating fraud on one entire segment of society, physicians. Prosecutorial misconduct is common against physicians who do not fall in line. In many cases the prosecution of individuals is so baseless it is openly apparently. The author will post a series of articles concerning his adventures in the nether world of deceit incurred against him by the Maryland Board of Physicians. The purpose of this writing and others to follow is to open a dialogue which will lead to physicians having proper guidance when confronting an outright assault on their careers.

 

Mark Davis MD

 

platomd@gmail.com

 

medicalboardusa.com

 

 

Lawyers and expert witnesses who would like to advertise their services on medicalboardusa.com please contact Dr. Davis at platomd@gmail.com

SPEX PREPARATION COURSE

 

 

 

SPEX PREPARATION COURSE

 

 

 

With an extremely high failure rate the Special Purpose Examination (SPEX) requires appropriate study to reach a passing grade. Designed by the faculty of the Federation of State Medical Boards this one day test is continuously in evolution. In its present incarnation there are 336 questions divided into 7 sections. Each section has 48 questions with a completion time of 64 minutes. Federation of State Board Literature is not precise concerning the contents of this exam. Many who have come to this test believed that minimal study was needed to pass. They were very surprised when their exam grades came in the mail. Required by state medical boards these entities provide minimal to no information in the exam’s contents or preparation. This mini course evolved out of the need for potential examinees to be provided with guidance on which subject matter to emphasize in their studies and which instructional material will give them the greatest chance of a successful passage of this exam.

 

 

 

Core Internal Medicine subjects are only part of this exam. A vast array of specialties which include multiple disciplines in surgery, pediatrics, genetics, psychiatry, medical statistics, obstetrics/gynecology and radiology have appeared on recent tests. This course will discuss question types which have appeared in current exams for the latter subject matter and allow the physician the maximum use of his or her study time. The course runs 2-3 hours and is performed by phone at a mutually agreed time. The cost is $300.  Please contact Mark Davis, MD at platomd@gmail.com with questions or to schedule a time to take the course.

 

 

Dr. Mark Davis, MD has counseled many physicians to help them in their ultimate goal to pass this exam.  Preparation from this course will be an invaluable aid in achieving a passing grade or better. Please contact Dr. Davis as soon as you know the SPEX is required for your medical licensure.  platomd@gmail.com