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PRESCRIPTION FOR CHANGE 1 With 43 medical marijuana dispensaries in San Franci... Page 5 of 8 He said the point of advertising his price as the lowest was to contrast against doctors who charge as much as $300 for a recommendation. Like Talleyrand, several other doctors in the Bay Area have full-time practices that consist only of making pot recommendations. But not everybody who holds an authentic pot card has seen a doctor. Of the 8,200 current cardholders in San Francisco, 2,132 are designated as caregivers, who under Prop. 215 are responsible for housing, health or safety of the actual patient. These caregivers have the same ability to buy pot as the patient, and San Francisco allows each patient to designate as many as three caregivers. "They usually come in fours, en masse," said Eileen Shields, spokeswoman for the department of health. Only signatures from the patient and caregiver are required for the additional cards. Police Capt. Hettrich said he suspects the only real requirement for getting a patient card is paying an exam fee. "Because it's so easy to get a medical marijuana card, all the thugs out in Hunters Point, the Bayview and the Western Addition that are members of gangs picked up medical marijuana cards and can possess a half-pound of marijuana," he said, adding that there is now more marijuana for sale on city streets than at any time in his 34 years on the force. And, while most clubs allow customers to buy only I or 2 ounces, a higher half-pound limit was set by new California legislation in 2004. Much of that, according to Hettrich, ends up on the open market. "What they do with a half-pound is they break it up and go out on the street and sell it," Hettrich said. While most clubs will only admit card-carrying patients or caregivers, people try to enter with no card or other documentation, club owners say. Those people are given contact information for doctors like Talleyrand, or Dr. R. Stephen Ellis, who runs the www.potdoc.comWebsite. Ellis charges $250 -- cash only -- for a recommendation. He refused to be interviewed for this article. Both Kaiser Permanente and Blue Cross allow their doctors to give recommendations -- the organizations do not interfere in doctor-patient relationships, officials said -- but instead of signing the form, many Kaiser doctors provide a letter that is accepted by the city. Despite police assertions to the contrary, cardholding patients say getting a doctor's recommendation is not just a rubber-stamp procedure. Darci Sarchetti is 53 years old, disabled, and uses a wheelchair to stay mobile. "I went to my primary doctor and talked with her about (a recommendation). She didn't feel she knew enough personally about the issue to get involved," said Sarchetti, who was referred to another doctor and received a thorough examination. http://sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/04/24/MNGDTCEA9H I.DTL&type=pr... 4/29/2005