While the Canadian government prepares to legalize recreational cannabis nationwide by July 2018, the country already has a long history with medical marijuana. Their system has been in place for over 15 years now, but it has only recently been transformed into the lucrative industry that it is today.  

The number of patients signing up for medical cannabis tripled in just one year’s time, and some companies are even offering medical cannabis access on their health insurance plans. Serving as a go-between the doctors, patients, and marijuana producers are specialty clinics, and they’ve been reaping the benefits of this bustling market. 

These select clinics operate by taking referrals from doctors and setting up patient consultations with the physicians, who then write prescriptions for medical cannabis. The staff also provides education on marijuana and connects qualifying users with licensed companies. However, a number of specialty clinics receive payment from these producers, which has led to questions concerning the medical ethics of their practice. 

Through the Canadian Cannabis Clinics, a handful of licensed producers pay a counseling service called CanvasRX. According to the company’s CCO Ronan Levy, patients are free to choose the cannabis provider of their choice, but if one of the producers with a contractual obligation is picked, they pay a fee to the clinic. 

Another specialty clinic, CannaConnect, refers their clients to “a curated list of recommended producers.” They receive educational grants from these licensed producers, and in turn recommend that patients choose one of these providers. On the other hand, the Halifax-based Canabo Medical Corp. doesn’t receive kickbacks from marijuana producers at all. Instead, they sell anynymous patient data to licensed producers and insurance companies to use for market research purposes.   

On the outside, this might seem like business as usual, but some medical experts feel that these operations raise “some serious ethical concern.” Kerry Bowman, an assistant professor of bioethics at the University of Toronto, believes that some clinics might have their clients' best interest at heart, but it’s hard to tell apart those rightfully serving their patients from others that are primarily focused on accruing revenue. 

"The clinics that are running don't have any clear oversight.You've got a lack of transparency, you potentially have conflict of interest, and you potentially have kickbacks," Bowman said.

All in all, the issue isn’t so much that these clinics are making money for services provided, as this is pretty standard practice in many industries (including the medical sector) but some have taken issue with their unwillingness to allow proper oversight of their operations in general. Without it, some of these clinics could be charging excessive fees and providing lackluster follow-up care, and these issues could hinder the wellbeing of the most important part of this expansive system: the patient.