Direct Primary Care and Medical Cannabis with my Mentor Dr. Matthew Mintz

I first met Dr. Matthew Mintz when I was a medical student at The George Washington University. Encyclopedic, thorough, and jovial, Dr. Mintz was the preceptor you wanted because he was deeply committed to his patients and your success as his student. While planning to launch Healthy Home Pediatrics, I learned that Dr. Mintz had opened up his own direct primary care practice. I drove up and met him for poke near his office. The poke was delicious and the conversation was priceless! He continues to be one of my most committed mentors and a good friend.

Here Dr. Mintz shares his story about academic medicine, direct primary care, medical cannabis, and everything in between.

First, let’s start with what you do:

What is an Internal Medicine Physician and what does your average day look like?

Internal Medicine is essentially a physician for adults.  We are generalist physicians like Family Medicine and Pediatricians, but we only see adults, usually no younger than 16 years of age, but more commonly 21 and older.  Unlike Family Medicine physicians, we don’t have training in delivering babies or doing surgical procedures.  Most of the non-surgical medical subspecialties (pulmonology, allergy, gastroenterology, etc.) are Internal Medicine subspecialties (Dr. Fauci is an Internal Medicine physician).  However, there are many General Internal Medicine physicians, like myself, that don’t subspecialize and are either primary care physicians, like myself, or hospitalist physicians.  In addition to primary care, we take care of you when you are sick, can diagnose complex problems, and are quite good at treating common chronic diseases like asthma, diabetes, and high blood pressure. 

My day is not typical of most outpatient General Internal Medicine physicians, because I have a Direct Primary Care practice.

Why did you choose a Direct Primary Care practice, and how does your practice work?

There are many problems with our health care system, but a central one for primary care is while insurance reimbursements are pretty good for procedures and diagnostic testing, they are very low for primary care.  In order to have a successful practice, a typical primary care physician has about 2000-3000 patients at a given time and sees 25 patients a day. That’s why the typical patient experience is that they can’t get in touch with their doctor, aren’t able to see their doctor when they are sick, have delays getting an appointment with their doctor, spend a long time in the waiting room before their appointment, but very little time with the actual doctor.  A number of physicians, like you and myself have decided to have a direct relationship with patients, leaving the insurance middleman out.  For my practice, patients pay an annual fee, and in addition to all the primary care they need, I offer same day appointments, next day appointments, longer appointments, and 24/7 phone access.  So, my typical day is seeing a few patients a day (now mostly virtually) as well as calling or emailing them with results or answering questions. While I offer concierge level service, unlike most concierge practices, I do not submit to insurance so there are no extra charges or co-pays. 

How did you know becoming a Physician was the path for you?

I had fairly bad asthma as a child, so I became very familiar with the medical profession early on.  I also really liked the idea of combining science with interacting with people.  While I had decided that I wanted to be a physician before applying to medical school, it probably wasn’t until my clinical rotations working directly with patients that I knew I had made the right decision. 

What was your path to becoming the founder/ owner of your business?

I had never planned to run my own business.  After medical school and residency at The George Washington University School of Medicine, I joined the full-time faculty and stayed there for 20 years.  In addition to seeing patients, I had a number of educational roles, taught a number of courses, and my last few years was actually in the Dean’s office working on a new medical school curriculum.  However, while I had planned on spending the rest of my career there, a number of factors, including salary and commute, made it impossible to stay.  So, I decided to start my own practice. 

In addition to Primary Care, are there other services you offer? 

Yes.  I also do certifications for medical cannabis for Maryland and The District of Columbia.  This is not something that I ever imagined I would be doing, but a medical dispensary opened in my medical office building shortly after I opened my practice.  While I was initially somewhat hesitant about doing this, I quickly found that medical cannabis could be an excellent option for a variety of medical conditions, especially ones in which prescription medications aren’t working or cause a lot of side effects. 

What do you wish families knew about medical cannabis?

Medical cannabis does not have to be smoked and does not have to make you sleepy or high.  If used the right way, it can be highly effective for a variety of conditions, without being addictive or causing side effects.  While as I stated, I treat adults for primary care, the youngest patient I have certified was 3 years old, and the oldest was 99.  There are several conditions that children have that medical cannabis can be an excellent options, including Autism, ADHD, anxiety, and insomnia. 

This is very interesting, there are so many topics we did not learn about in medical school. From breastfeeding and midwifery to medical cannabis there just wasn’t enough time! Now as an Attending Physician, I learn so much every day. What does a medical marijuana certification entail?

Currently, there are 33 states and the District of Columbia where medical cannabis is legal. Though the process is slightly different in each state, in general they all use a similar 2-step parallel process: registration with the state and certification by a medical provider. In DC, you need to see the clinician first, in Maryland the order doesn't matter. There are other clinicians that can certify patients for medical cannabis. In Maryland, you can be a dentist, podiatrist, nurse practitioner, or physician. When certifying a patient, the certifying provider needs to ensure that the patient meets the state's criteria for medical cannabis. In most cases, certification is just filling out some paperwork, and most certifying providers are not physicians, and just spend a few minutes with you to fill out this paperwork, and of course charge you a fee. When I certify a patient, not only do I do the actual paper work part, but I do a thorough history, examination (pre-COVID), and give recommendations of exactly what to take, how to take it, and where to get it. I give these in writing to the patients so they can take it with them to the dispensary so they know exactly what to do. I am one of the only physicians in the area that does this. In addition, since I am a regular doctor, while I don't take insurance, I can give patients an invoice that they can submit to insurance for reimbursement.

What online resources do you frequently share with patients?  

For medical cannabis, there are unfortunately not too many good quality online resources that are geared for patients interested in using cannabis as a medicine.  There is plenty of information online, but there is virtually nothing online that tells patients how to use medical cannabis for a specific medical condition, including what type of medical cannabis to use and how to adjust the dose.  For this reason, I initially started creating handouts for patients when they came to see me for consultation.  Eventually, I turned those handouts into a book, which if finally published.  It is called “Medical Marijuana and CBD: A Physician’s Guide for Patients” (now available on Amazon). 

Finally, if folks want to get in touch with you, how should they do so?

Patients can call the office at 855-646-8963 or they can email me at drmintz@gmail.com.  There is also a lot of information about me and my practices on my websites: www.drmintz.com for my primary care practice and www.mdcannabisdoc.com for medical cannabis.