OPENING IN FAYETTEVILLE: An artist’s rendering of the Arkansas Medical Card clinic that will help certify patients for medical marijuana. Arkansas Medical Card

Arkansas residents seeking a physician to certify them for a state medical marijuana card now have specialty clinics to turn to.

In Fayetteville, the Arkansas Marijuana Card clinic, which opened at 1617 N. College Ave. Oct. 7, provides patients with a “medical marijuana primary care physician,” said Connor Shore, president of Ohio Medical Alliance, the parent company of Arkansas Marijuana Card.

“We want to help people get approved,” Shore said. “That’s our mission, to increase patient access and affordability for patients … while operating within the scope and laws that govern the program.”

Another multi-doctor clinic opened in Arkansas within the past year: AR Cannabis Clinic. AR Cannabis Clinic’s website lists clinic locations accepting appointments in Little Rock (at 1121 S. Bowman Road), North Little Rock, Texarkana and Bentonville, as well as clinics “coming soon” in Fort Smith, Hot Springs, Fayetteville, Jonesboro, Pine Bluff, West Memphis, Clinton and El Dorado. AR Cannabis Clinic did not return calls for more information by press time.

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To obtain a state medical marijuana card, a person must have a doctor’s certification that he or she has at least one of 18 qualifying medical conditions approved by the Arkansas Department of Health. Shore said some patients may be reluctant to get a card because of what they may encounter when seeking the physician’s certification. The clinic “allows patients that are seeking treatment for medical marijuana to do so from a doctor that is compassionate and understanding and knowledgeable about how marijuana works. They don’t need to go through the process of asking, or being nervous about asking, their primary care provider. … Many primary care providers are not familiar with marijuana or not open to recommending it.”

Parent company Ohio Medical Alliance opened its first clinic in May 2018 after the Ohio legislature legalized medical marijuana in 2016. Since then, the company has opened nine more clinics in Ohio and seen “over 20,000 patients.” Shore said that in Ohio, “over 90 percent” of patients who brought in their medical records were approved by a physician for a card.

Shore said patients “usually” bring their medical records to the clinic to provide evidence of their qualifying condition. “It’s hard for the doctor to confirm they have a diagnosis without any medical records,” he said. To help patients who come to Arkansas Marijuana Card without a referral from their primary care doctor, or for those without access to records from past treatment, Shore said the clinic has a medical records team that helps patients track down the information.

“We don’t want to waste the doctor’s time, we don’t want to waste the patient’s time taking a trip out to our office, so we speak to them [before their visit] and make sure they have a qualifying condition,” Shore said. “If they’re 20 years old, they’ve never been to a doctor, and they have back pain, they’re probably not going to get approved.”

Shore said it is “each physician’s discretion” to approve or deny a patient for a medical marijuana card, but added that “if a patient, for example, doesn’t get approved by one of our physicians that we know tends to be more strict, we would let them have a free evaluation with a different physician to see if that might do it, because we don’t put pressure on the physicians.”

Any medical doctor or doctor of osteopathy licensed to practice in Arkansas with a current DEA number — meaning they’re allowed by the U.S. Drug Enforcement Administration to write prescriptions for controlled substances — is authorized to sign the physician certification form for a patient seeking a state medical marijuana card. Shore said Arkansas Marijuana Card is working with two physicians who do “other part-time work” in the state, but he expects the number of doctors employed by the clinic to increase as Arkansas’s medical marijuana program expands. In Ohio, Shore said, a “wide range” of doctors work for the state’s 10 clinics.

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“We’ve got people who had a career in hematology in Ohio, or are anesthesiologists. Some are retired, some still work part time, and we have a few physicians who work with us full time,” Shore said. “So I imagine it will be the same in Arkansas, with a mix of people doing part time, some people starting their career doing this full time, or retired physicians working part time after they’ve already sold their private practice. It’s a nice, diverse group.”

Arkansas Marijuana Card does not accept insurance. Shore said no physician or clinic offering evaluations on a patient’s eligibility for a medical marijuana card can accept insurance “because there’s no billing code for an evaluation for the purposes of obtaining medical marijuana.” Shore said some clinics take insurance and bill the evaluation as a “normal consult,” but Arkansas Marijuana Card — and all of Ohio Medical Alliance’s clinics — wants to “stay on the safe side of not misleading by omission when dealing with the insurance companies.”

Shore said Arkansas Marijuana Card charges patients a fee of $260, which covers patients for a year. Follow-ups with a doctor after an initial appointment are free. Shore added that the company “understands that’s a lot out of pocket for some people,” so patients have the option to split the $260 fee into two or three payments.

AR Cannabis Clinic’s website lists a $250 fee for “new patient certification” and a $100 follow-up appointment fee. Pure Care Clinic’s website lists its 30-minute “medical marijuana patient recommendation” service for $150, which includes the physician evaluation as well as assistance submitting the ADH application for a state medical marijuana card. The state also charges a $50 application fee.

Before its opening in October, a press release from Arkansas Marijuana Card said the clinic had already scheduled appointments with “hundreds” of patients. Shore said the clinic was able to “get in front of the right audience” largely through “organic search and social media,” which he said was also key to the company’s launch of its first clinic in Ohio. He added that “advertising is very restrictive” in the industry: Companies that sell cannabis products can’t run ads on Google, Facebook or Instagram because of the platforms’ terms of service, so Ohio Medical Alliance has to rely on “great content and great information” being shared by patients who use their services.

While advertising within the cannabis industry can be tricky, Shore said Ohio Medical Alliance was able to open its Fayetteville clinic without having to navigate the layers of red tape faced by marijuana cultivators and dispensaries, who must work closely with the Arkansas Medical Marijuana Commission.

“Everything else is so heavily regulated — the dispensaries, the cultivators, the processors, the testing facilities — but … the program sets out rules for doctors to recommend [and] how they should recommend, and then we employ doctors that are certified to do so,” Shore said. “We just employ physicians that happen to provide a specific service.”

Shore said the company has “reached out” to the state Medical Marijuana Commission, and it expects to have more interaction with the commission once patients at the Fayetteville clinic submit their applications to the state. The president added that Ohio Medical Alliance has a “very good working relationship” with the Ohio Board of Pharmacy.

In addition to the company’s 10 clinics in Ohio, the Ohio Medical Alliance has opened three clinics in Missouri. Shore said the company decided it was going to enter Arkansas “maybe three or four months ago.” It began the process by researching existing clinics in Arkansas and examining the medical marijuana amendment to ensure the company would be able to “effectively help patients in the state.” Shore said some states require that patients have an existing three- or six-month relationship with the doctor who signs their physician certification form, which “makes it impossible for our specialized clinics to come into those states.” The company signed its lease for the Fayetteville office “about a month ago,” Shore said.

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Shore said Ohio Medical Alliance hopes to open Arkansas Marijuana Card locations in Fort Smith, Little Rock, Hot Springs and Jonesboro by the end of 2019. The president acknowledges this is a “big push,” but he feels “pretty confident” they’ll be able to do so: Shore said the company opened six clinics in Ohio within three months. As of Oct. 18, the ADH has approved 25,905 medical marijuana ID cards, and as of Oct. 22 the state’s 10 dispensaries have sold over 2,159 pounds of cannabis, totaling $15.36 million in sales.