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EXCLUSIVE: Doctor accused of running a medical marijuana mill

January 10, 2010

BY KAREN VELIE

Former co-workers are accusing Dr. Atsuko Rees, a physician at HealthWorks in San Luis Obispo until July 2009, of writing medical marijuana recommendations for almost anyone who asked, while not claiming the bulk of payments for the visits as income.

The allegations come as medical officials across the country are asking if a small number of doctors are responsible for authorizing the vast majority of medical marijuana cards — possibly abusing a law meant to help patients with chronic health problems. These few doctors, many known for spending five to ten minutes with patients before diagnosing them with a chronic illness, are said to be practicing sub-standard medical care as they rake in between $150 to $250 for each diagnosis.

HealthWorks employees allege that Dr. Rees, a former co-owner of HealthWorks who now practices at Rees Family Medical on Higuera Street in San Luis Obispo, would see as many as 60 to 70 patients on so-called “Marijuana Fridays” when she practiced at HealthWorks. Both Dr. Rees and Mary Eanes, a physician’s assistant Dr. Rees continues to work with, would approve patients’ medical marijuana status. However, to comply with California law, Dr. Rees would sign off on patients as if she had seen each patient personally, former co-workers said.

Neither Dr. Rees nor Eanes returned numerous phone calls asking for comment. However, a call to their office confirmed the group is continuing to issue medical marijuana cards.

Even though Dr. Rees saw patients of all ages at HealthWorks, the bulk of her marijuana card clients fell between the ages of 15 and 25, with a large number visiting the clinic on, or within days of, their 18th birthday.

Medical marijuana patients under age 18 must have a parent present when seeing a doctor or visiting a dispensary, according to California law. Nevertheless, Dr. Rees gave a medical marijuana recommendation to a 15-year-old Nipomo boy who walked into the clinic complaining of headaches. He provided a note from his mother that said he could seek medical care without an accompanying parent.

Dr. Rees started writing cannabis recommendations in 2007 and since then has written more than 30,000 medical marijuana approvals for everything from sleeping problems to anxiety.

Cynthia Scott, a former business partner of Dr. Rees at HealthWorks, said that shortly after Dr. Rees began advertising for patients seeking medical marijuana, they began seeing scores of cannabis-seeking patients. Scott said many patients would come to the counter requesting to see the “marijuana doctor.”

Scott also said that when the partners began battling over the clinic’s growing reputation as a marijuana prescription mill, Dr. Rees told Scott not to worry because she was “keeping it all off the books.” Nevertheless, the partners’ disagreements escalated until Dr. Rees agreed to leave HealthWorks.

“She would put the money in her lab coat,” Scott said. “She would have pockets full of cash.”

While at HealthWorks, Dr. Rees also saw patients for medical problems not related to marijuana. A former employee, who was responsible for billing insurance companies, said Dr. Rees allegedly would pad the bills by reporting she had seen patients for at least 25 minutes, when in reality she had spent less than 10 minutes examining the client.

The illegal act of false billing, referred to as up-coding, can cause the insurance reimbursement for a medical visit to jump from $56 to $83.

HealthWorks’ current physician, Dr. Donella Jenkins, said that although Dr. Rees left HealthWorks some six months ago, the business continues to turn away multiple patients who are asking to see the “marijuana doctor.”

Approximately a year ago, officials at the Grizzly Academy were considering hiring Dr. Rees to help provide medical care for their students.

“I learned from nurses at HealthWorks that Dr. Rees was using the office to sell marijuana prescriptions,” said Dr. George Ward, a local physician who worked with students at the Grizzly Academy. “I said ‘she is not the doctor we want around our youth.’”


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I do have to admit that 30,000 recommendations in 3 years sounds rather staggering. That would be 200 recommendations a week for 3 years (allowing for a 2 week vacation each year) to the tune of $4,500,000. Does HealthWorks really have 30,000 records on file for MMR’s?


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“While it is both legal and accepted medical practice to see underage patients with a note from a parent without a parent present, my policy is to require the presence of a parent or guardian.”


I suggest that Dr Rees familiarize herself with California law before she gets herself into big trouble. It is absolutely against the law to give a marijuana recommendation to a minor without consulting with the parent in person. That’s a fact, check with the AG or any knowledgeable lawmaker.


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Two points:

1. Medical marijuana in California is governed by Health and Safety Code section 11362.5. It says nothing about a requirement to meet with a parent in person. Neither does CA Family Code sections 6500-6911 that discuss who can authorize medical treatments for minors. The CA Medical Board website, http://www.medbd.ca.gov/medical_marijuana.html , says: “If a physician recommends or approves the use of medical marijuana for a minor, the parents or legal guardians must be fully informed of the risks and benefits of such use and must consent to that use. ” Again, nothing about a requirement for consulting with a parent in person. So, if you know that it is ‘absolutely against the law to give a marijuana recommendation to a minor without consulting with the parent in person’, please tell me, what law are you referring to?

2. Even if you were correct, I fail to follow your logic. Dr. Rees states that despite there being no legal requirement, her policy is to require the presence of a parent or guardian. So she is consulting with the parent in person. So how would she get herself into big trouble?


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[…] last week, Cal Coast News ran an article describing how one medical doctor has been accused by co-workers of writing medical marijuana […]


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“She would put the money in her lab coat,” Scott said. “She would have pockets full of cash.” claims her co-worker, the goverment created this supply and demand enabling her to do this,

(if it really happened), and she wouldn’t be the first in this capitalistic country to capitalize on a demand created by laws or the lack of them, remember slavery was a legal highly profitable trade. My point decriminalization of this weed, is way, way over due, and this doctor has only done what this country is based on, taking money from the other guys, using a doctor’s degree as a tool to do it, all completely legal.

Now; if we were smart all this could be stopped by voting for the legalization of the drug THC.

As far as I know no one has smoked some and gone out and committed violent crimes, suicide, as they do on prescription pain killers, meth, booze, heroin, well you get the picture.

I feel this doctor has been wrongfully accused by a jealous co-worker who didn’t have,pockets full of cash, stranger things have happened.

And if you really need proof, go and see Dr. Krakovesky at the old pain center on foothill, talk about a racket, you fill out a first grade comic and they see you for five minutes, fill yours scripts for powerful pain killers and dangerous tranquilizers, but watch out, a few misguided words out of your month and this nice doctor becomes Hitler, stating ,”How about I dismiss you as a patient,” in a heavy German accent!

I went cold turkey off highly addictive medicines, causing me to never trust anyone in specialized medicine, and to put it bluntly, suffer at the hands of the Dictator at the Pain Center, Dr. Krakovesky. Don’t ever go there and if you are unfortunate enough to have too, beware they can take it all away, at least you can buy more pot, if you run out.


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EDITOR’S NOTE: This is a rebuttal submitted by Dr. Atsuko Rees in response to the allegations raised in the article by Karen Velie.


This is Dr. Atsuko Rees. My rebuttal has taken awhile because I did not receive any phone calls or requests for comments from CCN, and did not know anything about this article until after it appeared.


Medical marijuana is recognized by the American College of Physicians (the largest organization of internal medicine doctors in the US) as a valid and valued treatment for many health problems. It is not a panacea, but many chronic pain patients are able to reduce their intake of narcotic medications, cancer patients are able to eat and function better, migraine sufferers experience relief, and so forth. Some data indicate that medical marijuana is associated with an improvement in indices of aging.


Whether due to misinformation provided by sources, or due to sloppy or biased reporting, the article is very inaccurate and misleading. Some of the objectionable points follow:


Ms Velie states (she doesn’t allege or quote someone who might know, she states) that I have written 30,000 recommendations for medical marijuana in the last three years. This is wildly false; I have seen perhaps a tenth of that number. I “rake in” (I find that term somewhat unprofessional and prejudicial) $150 per such evaluation (this is the sole fee, unless other testing is required); if I’d have done 30,000 of them I could retire.


I would anticipate that it is true that a small number of providers authorize the vast majority of medical marijuana cards in this county, as there are very few doctors who include medical marijuana in their practices at all. I cannot speak for ‘these few doctors’ and I have no idea how long they spend with their patients.


Regarding the fifteen year old I allegedly saw without a parent: that never happened. While it is both legal and accepted medical practice to see underage patients with a note from a parent without a parent present, my policy is to require the presence of a parent or guardian.


I can rarely see over 25 patients per day, 60 to 70 patients is a fantasy.


We do accept cash. I declare my income and pay my taxes. No one involved in this article has ever seen my tax returns.


At my partner’s request, the medical marijuana part of the practice was kept financially separate from the rest of HealthWorks.


Physicians’ assistants and nurse practitioners generally are employed by and supervised by a physician. I review and sign the notes and recommendations of my employed mid-level providers as required by law.


A couple of the posts were of concern to me. “Malovato” posted a concern about patients ‘running a scam’ and diverting the medical marijuana. Each patient receives an appropriate medical evaluation. If I learn that a patient is diverting medical marijuana, or narcotics or sedatives or any substance for which there may be a secondary market in our society, I discontinue the recommendation or prescription.


“Rukidding” states s/he went to HealthWorks for follow up with me after I had left, and was given ‘no explanation’ of where I had gone. I would like to apologize to for any inconvenience s/he experienced. The agreement between HealthWorks and myself was that HealthWorks would send a letter to all patients and disclose my new practice location to all callers and visitors asking for follow-up with me. I’m sorry that apparently did not happen. My posted flyer at HealthWorks indicating my new location was taken down.


It is true that my split with my partner at HealthWorks was less than amiable. I enjoyed creating HealthWorks, and until the uncomfortable end, I enjoyed working there and I valued the relationships with my employees there. I anticipate they’ll continue to do good work, and I wish them well.


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We allow Tylenol _an over the counter drug_ to be made in another county, skirt the Food and Drug Administration’s inspection of the product, sicken people with contaminants [all lots of Tylenol arthritis have been recalled recently please google], and we don’t allow the use of medical marijuana.


Un believable


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Well with all the people flocking for a marijuana recommendation, I think it’s time to just legalize it and stop all the confusion and game playing. The people want it and they have voted on it. This is no different than when there was prohibition. When the people want something they will get it by whatever means necessary, lets stop bogging down the legal system over a bunch of bogus propaganda. There is nothing wrong with marijuana. Alcohol is far more destructive and most people who use marijuana detest alcohol. “In with marijuana, out with alcohol”, say I.


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I will discuss this doctor’s care. I am a 47 year old male that lost my home in a fire that almost killed my wife and I. I started to have anxiety attacks to the point one sent me to the emergency room because I thought I was having a heart attack. My family doctor prescribed Xanex OVER THE PHONE without even seeing me. I just had to walk into the office and pick up the prescription. Xanex made me a zombie all day which does not fare well with the type of work that I am in. I went to see Dr. Rees, got a rec and haven’t looked back since. I medicate only in the evening before bed and no more severe attacks. Every time I have been there, the girl at the front desk has always taken my money, not the doc. Some people are such a joke. To think that regular doctor’s a some kind of GOD is completely off base. They get kickbacks from big Pharm all the time for prescribing a drug. Where do you think the free samples come from? Anywhoo, the state senate is looking at legalization as we speak.


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So, you are a guy with anxiety who smokes a little dope. Why not let Jack Daniels take care of your troubles like the rest of us?


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They have morphine, demoral (sp?),oxycontin and a host of other pain killers. Should we just limit it to one choice? Plus, I don’t like Jack Daniels. This is America. We get to choose.


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I am a doctor and there are no “kickbacks” for giving out samples, in fact it’s extra work and done as a courtesy to the patient. The kickbacks stopped more than 8 yrs ago they are not legal anymore. The samples are “free” to the patient and extra work, logging, storage space, regulation, etc to the doctor. the doctor makes no money off this whatsoever so you have no clue what you are talking about.


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I stand corrected. Didn’t know they changed that 8 years ago. I might not have had a clue about the kickbacks but the rest of my post is fact Nancy33.


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I agree with DeepBlueSLO that the step to take is an alert to the medical board. If the accusations are true, it should be discovered by that body and not first tried in the press.


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