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PRESCRlPTI0N FOR CHANGE / With 43 medical marijuana dispensaries in San Franci... Page 4 of 8 Sacramento and Stockton, and three are in Southern California. Talleyrand's Medicann runs weekly advertisements in local newspapers with "Only $100 examination fee. Lowest in California," prominently displayed. The ad lists medical problems considered worthy of a recommendation for a card, including migraines, nausea, chronic pain, backache, menstrual cramps, depression, glaucoma, and other conditions. "Marijuana has little side effects. If you get to know the patient and they tell you it's helpful, it probably helps them," Talleyrand said. Marijuana is an alternative to over-the-counter painkillers or harsh opiates and other narcotic pain medication, he said. "Those things really wreck you if you take them long term," he said. "Marijuana is finding a niche where it's the intermediary between the two." Prop. 215 allowed marijuana recommendations for people with cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraine, or "any other illness for which marijuana provides relief." The 1996 proposition's purpose is to ensure "seriously ill Californians have the right to obtain and use marijuana for medical purposes," according to its text. In San Francisco, doctors sign a physician's statement -- a city document printed on green paper -- listing the patient's name, his or her medical condition, and the doctor's license number and office information. Doctors also decide how long the recommendation is valid, with a limit oftwo years. The city verifies the information by calling doctors whose names they don't recognize or -- with the doctors they frequently see -- by making sure the form is complete, Okubo said. The form is returned to the patient, who pays a $25 fee for the card, and the only recorded information is the card number, when it was issued and when it expires. The city maintains no list of patient names. "It's a fairly straightforward process from our point of view," Okubo said. Talleyrand's clinics have a paid staff of 30 people statewide. About 500 people receive recommendations from his clinics each week -- 10 to 20 are turned away -- and the most common ailment is pain, which accounts for about half of all medical conditions, he said. Doctors ask patients to bring in documentation of their ailments from their primary physician and then spend about 15 minutes looking at the patient's medical history and deciding whether to give a recommendation, he said. Talleyrand or other doctors will also make diagnoses, but he said that is less common. "I take every illness seriously," Talleyrand said. "I want to see if the illness is affecting someone's daily life. If they're willing to pay the price and go through the long line of a medical office, it's affecting their life. It's a judgment call. (The law) asks me to decide what is serious in someone's life, and it's a difficult question." http://sfgate.com/cgi-binlarticle.cgi ?file=/c/a/2005/04/24/MNGDTCEA9Hl.DTL&type=pr ... 4/29/2005