Our Experience: Telehealth

The time has finally come: You can now get a medical marijuana card in Missouri — but where do you go? 

Larger cities across the state have offices set up specifically for receiving a medical marijuana recommendation, but many rural areas of Missouri don’t have this available to them. There are some traveling pop-up opportunities, but these usually operate on a first-come, first-served basis, meaning that you have no idea how long your wait will be before arriving.

Thankfully, Missouri is a state that allows telemedicine. 

What is telemedicine? 

Telemedicine uses technology to offer long-distance diagnosis and treatment for patients, often over a video-chat. In Missouri specifically, the law states that “prescribing drugs without sufficient examination is prohibited,” meaning that healthcare providers cannot prescribe based solely on a phone consultation or online questionnaire — they must have a video-chat examination in order to write a prescription, including for cannabis. 

Telemedicine allows patients to have a doctor’s visit from the comfort of their own home, which can be beneficial if it’s difficult to travel due to a handicap or illness. This is also a good option for busy patients, or for those who simply feel overwhelmed in a clinical setting (something quite common!). When it comes to cannabis, telemedicine offers complete discretion; no one except for you, your doctor, and the state ever need to know about your medical marijuana card application. 

What’s it like to get your medical marijuana card via telemedicine? 

Rachael Dunn and I both got our medical marijuana cards with telemedicine services; Rachael used Health and Life Missouri, a company based in Southeast Missouri that is owned by a female veteran, Debra Ahsbah, and works with a physician based out of Festus. I used PrestoDoctor, a company that offers telemedicine services in California, Nevada, New York, Oklahoma, and of course, Missouri. I met one of their co-founders, Rob Tankson, years ago at an educational cannabis event in California and have been following PrestoDoctor’s national expansion ever since. 

Both Health and Life Missouri and PrestoDoctor asked us to set up an account to get started. 

With PrestoDoctor, I then completed a profile where I added my phone number and address then uploaded my photo. Next, the prompts guided me to choose a 10-minute appointment time, allowing me to easily select a day and time that worked for me from a list of available options — and the options even extended late into the evening (9 p.m.), which I really appreciated! Finally, I was asked to input my credit card information with reassurance that I wouldn’t be charged until my appointment. 

After scheduling, I was directed to a list of things to do before my appointment: upload my driver’s license and any medical documents (not required, but helpful), fill out a medical questionnaire including things like my height and weight, symptoms for which I’m seeking relief, current medications, and any past medical marijuana experience I may have along with information about the last time I saw a doctor. 

Lastly, the site guided me through a technology test to make sure that everything was running smoothly, then displayed a collection of cheery green checkmarks next to every item on my pre-appointment to-do list. This was probably my favorite thing about the entire experience; nothing is worse than that moment where you’re trying to start a video chat and something isn’t working right, or when you realize you forgot to answer that one question — so this gave me confidence that everything was truly ready to go. From start to finish, this setup process took me about 40 minutes.  

Rachael had a similar experience; the system to schedule her appointment made it easy to choose her day and time, pay, and easily access all of her forms. Both companies sent reminders leading up to our appointments.

From there, I was able to enter the chat room and wait for my doctor. He joined me at 5:31 p.m., greeting me with a warm welcome. He let me know that this was just like any other doctor’s visit; he was in a room alone, and everything said between us would remain confidential in accordance with HIPAA law. 

I will admit, at first it felt a little weird to be video-chatting with a doctor. 

   

I think that there can be a stigma around “getting your medical marijuana card online,” and my brain defaulted to feeling like a kid being accused of trying to cheat the system. Despite my knowledge, to my very core, that cannabis is medicine for me, I launched into my classic nervous rambling, telling him all about my migraines, anxiety, and chronic back pain I’ve been struggling through since high school, almost as if I needed to defend my request for a medical marijuana card. I told him that I had found cannabis just 7 years ago and how much it had helped me live a more balanced and healthy lifestyle. 

Dr. Atienza was kind and professional. It was obvious that he was listening closely, and responded with thoughtful questions that calmed my nerves. While any three of my issues could have been used as “qualifying conditions” for recommending medical marijuana (and I had assumed that since I’d uploaded paperwork around my generalized anxiety disorder, that would be the condition listed on my application to the state), Dr. Atienza let me know that because he is not a psychiatrist, he could not prescribe for anxiety and would be focusing on my back pain — a chronic condition for which I’ve tried everything from physical therapy and massage to chiropractic care. He gave me a few personalized suggestions based on what I had shared with him, reminded me that I have access to unlimited, free follow-up calls any time I need… and we were off the video-chat by 5:38. 

Following my appointment, I was sent a draft of my recommendation sheet that I had to securely add my social security number to, then it was signed by Dr. Atienza and emailed to me for upload and submit to the Missouri DHSS website. After submitting my patient and at-home-cultivation applications to the state, I received my approval and patient license number in just 4 business days. 

While Rachael’s process looked similar at Health and Life Missouri, she actually did everything on the go — quite literally! 

“I did my telehealth appointment while riding in the car to Springfield… I genuinely wanted to know if it would work. Highway 44 has decent service for the stretch and the appointment took less than 30 minutes,” Rachael said. 

While the appointments are slotted for 15 minutes each, Rachael hadn’t filled out the medical questionnaires ahead of time, so her physician walked through them with her. “He asked questions about what has and hasn’t worked for treatment for my conditions, just like most people would expect of any doctor.” Rachael also brought along and showed medicine that she’s been prescribed for her conditions, although it wasn’t a requirement. 

“I was impressed by how thorough Dr. Mertins was and how he took the time to speak to me about what to look for in strains, when available at dispensaries, for my conditions. He also spoke about compliance and rights, a topic of education direly needed to ensure patients protect themselves.”

“I received my physician certification within hours and uploaded it [to DHSS] as soon as I reached my destination. The application was approved by the state before I left Springfield, within just 24 hours! I was absolutely amazed at how fast and easy this process was; the system was clearly set up to increase patient access.” 

Both of us were quite pleased with our experiences. “I was truly impressed at the efficiency, professionalism, and ease of the site, company as a whole, and the physician. I’m not great at going to the doctor as I should, but I was completely comfortable going through the certification process with Debra and Dr. Mertins by my side,” Rachael said. “To top it off, Health and Life Missouri will send a reminder 10 months after the appointment to remind patients to schedule their renewal. This reminder is on top of the appointment and paperwork reminders, which was so thoughtful for a clinic to do and super helpful to someone as busy as me.” 

Although telehealth is relatively new, that doesn’t mean it’s difficult to navigate. This service, now offered by many clinics, increases patient access regardless of schedule, condition, or location challenges. Whether you’re looking to get your medical marijuana card, have your questions answered, or work with a doctor on a treatment plan, Missouri’s cannabis telehealth community makes it easy to get support on your health journey.