I would like to tell you about the most embarrassing thing that has ever happened to me in my years of working as a palliative care physician. This happened a couple of years ago. I was asked as a consultant to see a woman in her 70s -- retired English professor who had pancreatic cancer. I was asked to see her because she had pain, nausea, vomiting ... When I went to see her, we talked about those symptoms and in the course of that consultation, she asked me whether I thought that medical marijuana might help her. I thought back to everything that I had learned in medical school about medical marijuana, which didn't take very long because I had learned absolutely nothing. And so I told her that as far as I knew, medical marijuana had no benefits whatsoever. And she smiled and nodded and reached into the handbag next to the bed, and pulled out a stack of about a dozen randomized controlled trials showing that medical marijuana has benefits for symptoms like nausea and pain and anxiety. She handed me those articles and said, "Maybe you should read these before offering an opinion ... doctor."
Ispričao bih vam najneugodniju situaciju koja mi se ikada dogodila u dugogodišnjoj praksi kao liječniku palijativne njege. Dogodilo se to prije nekoliko godina. Tražili su me da kao konzultant posjetim ženu od 70-ak godina, umirovljenu profesoricu engleskog koja je imala tumor gušterače. Tražili su me da je vidim jer je patila od boli, mučnine, povraćanja... Kada sam je posjetio, pričali smo o tim simptomima i tijekom te konzultacije, pitala me mislim li može li joj pomoći medicinska konoplja. Prisjetio sam se svega što sam naučio na fakultetu o medicinskoj konoplji, što nije dugo trajalo, jer nisam naučio apsolutno ništa. I tako sam joj rekao da, koliko znam, od medicinske konoplje nema baš nikakve koristi. Nasmijala se, kimnula i posegnula za svojom torbicom pored kreveta i izvukla snop od desetak nasumično kontroliranih pokusa, koji pokazuju da medicinska konoplja ima povoljne učinke za simptome poput mučnine, bolova i tjeskobe. Dala mi je te članke i rekla: "Možda biste trebali ovo pročitati prije negoli dajete svoje mišljenje, doktore."
(Laughter)
(Smijeh)
So I did. That night I read all of those articles and found a bunch more. When I came to see her the next morning, I had to admit that it looks like there is some evidence that marijuana can offer medical benefits and I suggested that if she really was interested, she should try it. You know what she said? This 73-year-old, retired English professor? She said, "I did try it about six months ago. It was amazing. I've been using it every day since. It's the best drug I've discovered. I don't know why it took me 73 years to discover this stuff. It's amazing."
I pročitao sam. Te noći pročitao sam sve te članke i našao još hrpu novih. Kada sam je posjetio sljedeće jutro, morao sam priznati da izgleda kako postoji neki dokaz da konoplja može biti medicinski korisna i predložio sam joj, ako je zaista zainteresirana, neka je proba. Znate li što je rekla? Ta 73-godišnja umirovljena profesorica engleskog? Rekla je: "Probala sam je prije otprilike šest mjeseci. Bilo je nevjerojatno. Od tada je uzimam svaki dan. To je najbolji lijek koji sam otkrila. Ne znam zašto mi je trebalo 73 godine da je otkrijem." (Smijeh)
(Laughter)
'Nevjerojatna je.'
That was the moment at which I realized I needed to learn something about medical marijuana because what I was prepared for in medical school bore no relationship to reality.
To je bio trenutak u kojem sam shvatio da trebam nešto naučiti o medicinskoj konoplji jer ono za što sam se pripremao na fakultetu, nije imalo veze sa stvarnošću.
So I started reading more articles, I started talking to researchers, I started talking to doctors, and most importantly, I started listening to patients. I ended up writing a book based on those conversations, and that book really revolved around three surprises -- surprises to me, anyway. One I already alluded to -- that there really are some benefits to medical marijuana. Those benefits may not be as huge or as stunning as some of the most avid proponents of medical marijuana would have us believe, but they are real. Surprise number two: medical marijuana does have some risks. Those risks may not be as huge and as scary as some of the opponents of medical marijuana would have us believe, but they are real risks, nonetheless. But it was the third surprise that was most ... surprising. And that is that a lot of the patients I talked with who've turned to medical marijuana for help, weren't turning to medical marijuana because of its benefits or the balance of risks and benefits, or because they thought it was a wonder drug, but because it gave them control over their illness. It let them manage their health in a way that was productive and efficient and effective and comfortable for them.
Stoga sam počeo čitati više članaka, razgovarati s istraživačima, počeo sam razgovarati s liječnicima, i najvažnije, počeo sam slušati pacijente. I tako sam napisao knjigu koja se temelji na tim razgovorima, i ta knjiga je zaista obradila tri iznenađenja, iznenađenja za mene. Jedno, koje sam već dao naslutiti, da medicinska konoplja zaista daje neke povoljne učinke. Ti učinci ne moraju biti toliko veliki ili zapanjujući, kao što bi neki od najgorljivijih predlagatelja medicinske konoplje željeli da vjerujemo, no, ti učinci su stvarni. Drugo iznenađenje, medicinska konoplja ima neke rizike. Ti rizici ne moraju biti toliko veliki ili zastrašujući, kao što bi neki od protivnika medicinske konoplje željeli da vjerujemo, ali to jesu stvarni rizici, bez obzira na sve. No, treće iznenađenje bilo je najiznenađujuće. A to je da mnogi pacijenti s kojima sam razgovarao, a koji su se okrenuli medicinskoj konoplji radi pomoći, nisu joj se okrenuli samo zbog njezinih povoljnih učinaka, ili zbog ravnoteže između rizika i koristi, ili zato što su mislili da je ona čudotvoran lijek, nego zato što im je pružila kontrolu nad njihovom bolešću. Pomoću nje upravljali su svojim zdravljem na produktivan i učinkovit način, te učinkovit i ležeran za njih same.
To show you what I mean, let me tell you about another patient. Robin was in her early 40s when I met her. She looked though like she was in her late 60s. She had suffered from rheumatoid arthritis for the last 20 years, her hands were gnarled by arthritis, her spine was crooked, she had to rely on a wheelchair to get around. She looked weak and frail, and I guess physically she probably was, but emotionally, cognitively, psychologically, she was among the toughest people I've ever met. And when I sat down next to her in a medical marijuana dispensary in Northern California to ask her about why she turned to medical marijuana, what it did for her and how it helped her, she started out by telling me things that I had heard from many patients before. It helped with her anxiety; it helped with her pain; when her pain was better, she slept better. And I'd heard all that before. But then she said something that I'd never heard before, and that is that it gave her control over her life and over her health. She could use it when she wanted, in the way that she wanted, at the dose and frequency that worked for her. And if it didn't work for her, then she could make changes. Everything was up to her. The most important thing she said was she didn't need anybody else's permission -- not a clinic appointment, not a doctor's prescription, not a pharmacist's order. It was all up to her. She was in control.
Da bolje predočim, pričat ću i o drugom pacijentu. Robin je bila u svojim ranim 40-im godinama kada sam je upoznao. No, izgledala je kao da je u svojim kasnim 60-ima. Patila je reumatoidnog artritisa preko 20 godina, ruke su joj zbog artritisa bile kvrgave, kralježnica iskrivljena, morala je koristiti invalidska kolica kako bi se kretala. Izgledala je nemoćno i slabo, mislim da je fizički vjerojatno i bila takva, no emocionalno, kognitivno, psihološki, bila je među najčvršćim ljudima koje sam ikada upoznao. I kada sam sjeo pored nje u jednoj ambulanti za medicinsku konoplju, u Sjevernoj Karolini, kako bih je pitao zašto se okrenula uzimanju medicinske konoplje, kako je utjecala na nju i kako joj je pomogla, počela mi je govoriti o stvarima koje sam već čuo od mnogih pacijenata prije. Pomogla joj je kod tjeskobe, pomogla joj je kod boli, kada se bol smanjila počela je bolje spavati. A sve bih to čuo i prije. No, tada je rekla nešto što još nikada nisam čuo, a to je da joj je dala kontrolu nad životom i nad njezinim zdravljem. Mogla ju je koristiti kada je htjela, kako je htjela, u onoj dozi i onoliko često koliko joj je odgovaralo. A ako joj nije odgovaralo, mogla je to mijenjati. Sve je ovisilo o njoj. Najvažnija stvar koju ju rekla, bila je ta da nije trebala ničije dopuštenje, ni zakazani termin u bolnici, ni liječnički recept, ni uputu od strane ljekarnika. Sve je ovisilo o njoj. Imala je kontrolu.
And if that seems like a little thing for somebody with chronic illness, it's not -- not at all. When we face a chronic serious illness, whether it's rheumatoid arthritis or lupus or cancer or diabetes, or cirrhosis, we lose control. And note what I said: "when," not "if." All of us at some point in our lives will face a chronic serious illness that causes us to lose control. We'll see our function decline, some of us will see our cognition decline, we'll be no longer able to care for ourselves, to do the things that we want to do. Our bodies will betray us, and in that process, we'll lose control. And that's scary. Not just scary -- that's frightening, it's terrifying. When I talk to my patients, my palliative care patients, many of whom are facing illnesses that will end their lives, they have a lot of be frightened of -- pain, nausea, vomiting, constipation, fatigue, their impending mortality. But what scares them more than anything else is this possibility that at some point, tomorrow or a month from now, they're going to lose control of their health, of their lives, of their healthcare, and they're going to become dependent on others, and that's terrifying.
I ako se to čini kao mala stvar za nekoga tko ima kroničnu bolest, nije, nije uopće. Kada se suočimo s ozbiljnom kroničnom bolešću, bio to reumatoidni artritis, lupus, tumor ili dijabetes, ili ciroza, mi gubimo kontrolu. I uočavate što sam rekao - 'kada', a ne 'ako'. Svi ćemo se u nekom trenutku u životu suočiti s ozbiljnom kroničnom bolešću, zbog koje ćemo izgubiti kontrolu. Gledat ćemo kako nam otkazuju vitalne funkcije, kod nekih i kognitivne funkcije, više se nećemo moći sami brinuti za sebe, raditi ono što želimo. Tijelo će nas izdati, i u tom procesu, izgubit ćemo kontrolu. A to je strašno. Ne samo strašno, to je zastrašujuće, užasavajuće. Kada pričam sa svojim pacijentima s palijativne njege, od koji se mnogi suočavaju s bolešću od koje će umrijeti, oni zaista imaju od čega biti uplašeni. Bol, mučnine, povraćanje, zatvor, umor, nadolazeći kraj. No, ono što ih plaši više od svega, je mogućnost da će u nekom trenutku, sutra ili za mjesec dana, izgubiti kontrolu nad svojim zdravljem, nad svojim životima, zdravstvenom njegom, i da će postati ovisni o drugima, a to je zastrašujuće.
So it's no wonder really that patients like Robin, who I just told you about, who I met in that clinic, turn to medical marijuana to try to claw back some semblance of control. How do they do it though? How do these medical marijuana dispensaries -- like the one where I met Robin -- how do they give patients like Robin back the sort of control that they need? And how do they do it in a way that mainstream medical hospitals and clinics, at least for Robin, weren't able to? What's their secret? So I decided to find out.
Stoga nije uopće čudo da se pacijenti poput Robin, o kojoj sam vam upravo pričao, koju sam sreo u toj klinici, okreću medicinskoj konoplji pokušavajući vratiti neki privid kontrole. Kako to čine? Kako te ambulante u kojima se izdaje medicinska konoplja poput one u kojoj sam sreo Robin, kako oni pacijentima poput Robin vraćaju kontrolu koja im je potrebna? I kako to uspjevaju kada redovne bolnice i klinike, barem kod Robin, nisu uspjele? Koja je njihova tajna? Stoga sam odlučio saznati.
I went to a seedy clinic in Venice Beach in California and got a recommendation that would allow me to be a medical marijuana patient. I got a letter of recommendation that would let me buy medical marijuana. I got that recommendation illegally, because I'm not a resident of California -- I should note that. I should also note, for the record, that I never used that letter of recommendation to make a purchase, and to all of you DEA agents out there --
Otišao sam u kliniku na Venice Beach-u u Kaliforniji i dobio preporuku koja mi dozvoljava kao pacijentu korištenje medicinske konoplje. Dobio sam pismo preporuke koje mi dozvoljava kupnju medicinske konoplje. Dobio sam tu preporuku ilegalno, budući nisam stanovnik Kalifornije, trebam to istaknuti. Trebam istaknuti također, neka se zna, da nikada nisam iskoristio to pismo preporuke kako bih je kupio, i za sve vas agente DEA-e tamo vani...
(Laughter)
(Smijeh)
love the work that you're doing, keep it up.
cijenim to što radite, samo nastavite.
(Laughter)
(Smijeh)
Even though it didn't let me make a purchase though, that letter was priceless because it let me be a patient. It let me experience what patients like Robin experience when they go to a medical marijuana dispensary. And what I experienced -- what they experience every day, hundreds of thousands of people like Robin -- was really amazing. I walked into the clinic, and from the moment that I entered many of these clinics and dispensaries, I felt like that dispensary, that clinic, was there for me. There were questions at the outset about who I am, what kind of work I do, what my goals are in looking for a medical marijuana prescription, or product, what my goals are, what my preferences are, what my hopes are, how do I think, how do I hope this might help me, what am I afraid of. These are the sorts of questions that patients like Robin get asked all the time. These are the sorts of questions that make me confident that the person I'm talking with really has my best interests at heart and wants to get to know me.
Iako mi to nije omogućilo kupnju, to pismo je bilo neprocjenjivo, jer mi je omogućilo da postanem pacijent. Omogućilo mi je steći iskustvo koje prolaze pacijenti poput Robin kada idu u ambulantu gdje se izdaje medicinska konoplja. I kroz što sam sve prošao, kroz što oni prolaze svakodnevno, stotine tisuća ljudi poput Robin, bilo je zaista nevjerojatno. Ušao sam u kliniku, i od trenutka kada sam ušao u mnoge od tih klinika i ambulanti, imao sam osjećaj kako je ta ambulanta, ta klinika, tu zbog mene. Bilo je pitanja na početku o tome tko sam, što točno radim, što točno želim tražeći recept za medicinsku marihuanu, ili proizvod, koji su moji ciljevi, koji su moji prioriteti, moje nade, što mislim, čemu se nadam, kako bi mi to moglo pomoći, čega se bojim. To su vrste pitanja koja se pacijentima poput Robin neprestano postavljaju. To su vrste pitanja s kojima sam siguran da osoba s kojom razgovaram iskreno radi u mojem najboljem interesu i želi me dobro upoznati.
The second thing I learned in those clinics is the availability of education. Education from the folks behind the counter, but also education from folks in the waiting room. People I met were more than happy, as I was sitting next to them -- people like Robin -- to tell me about who they are, why they use medical marijuana, what helps them, how it helps them, and to give me advice and suggestions. Those waiting rooms really are a hive of interaction, advice and support.
Druga stvar koju sam naučio u tim klinikama je dostupnost informacija. Informiranost od strane osoblja za pultom, ali i od ljudi u čekaonici. Ljudi koje sam sretao bili su više nego srdačni, dok sam sjedio uz njih, ljudi poput Robin, kako bi mi ispričali tko su, zašto uzimaju medicinsku konoplju, što im pomaže, kako im pomaže, te kako bi mi dali savjet i preporuke. Te čekaonice su zaista poput košnica za interakciju, savjete i podršku.
And third, the folks behind the counter. I was amazed at how willing those people were to spend sometimes an hour or more talking me through the nuances of this strain versus that strain, smoking versus vaporizing, edibles versus tinctures -- all, remember, without me making any purchase whatsoever. Think about the last time you went to any hospital or clinic and the last time anybody spent an hour explaining those sorts of things to you. The fact that patients like Robin are going to these clinics, are going to these dispensaries and getting that sort of personalized attention and education and service, really should be a wake-up call to the healthcare system. People like Robin are turning away from mainstream medicine, turning to medical marijuana dispensaries because those dispensaries are giving them what they need.
I treće, osoblje za pultom. Bio sam zadivljen koliko su ti ljudi bili željni provesti ponekad sat vremena i više, pričajući mi o nijansama ove vrste biljke naspram one druge, pušenja naspram udisanja pare, uzimanja kroz hranu naspram tinktura, sve to, zapamtite, bez da sam išta kupio. Sjetite se kada ste zadnji puta otišli u neku bolnicu illi kliniku i kada je zadnji puta itko s vama proveo jedan sat, objašnjavajući vam ovako nešto. Činjenica da pacijenti poput Robin idu u te klinike, idu u te ambulante, i dobivaju ovakvu vrstu osobne, prilagođene pažnje potrebne informacije i uslugu, zaista treba postati poziv na buđenje sustavu zdravstvene skrbi. Ljudi poput Robin okreću leđa službenoj medicini, okreću se ambulantama za medicinsku konoplju, jer im one daju ono što im treba.
If that's a wake-up call to the medical establishment, it's a wake-up call that many of my colleagues are either not hearing or not wanting to hear. When I talk to my colleagues, physicians in particular, about medical marijuana, they say, "Oh, we need more evidence. We need more research into benefits, we need more evidence about risks." And you know what? They're right. They're absolutely right. We do need much more evidence about the benefits of medical marijuana. We also need to ask the federal government to reschedule marijuana to Schedule II, or to deschedule it entirely to make that research possible. We also need more research into medical marijuana's risks. Medical marijuana's risks -- we know a lot about the risks of recreational use, we know next to nothing about the risks of medical marijuana. So we absolutely do need research, but to say that we need research and not that we need to make any changes now is to miss the point entirely. People like Robin aren't seeking out medical marijuana because they think it's a wonder drug, or because they think it's entirely risk-free. They seek it out because the context in which it's delivered and administered and used, gives them the sort of control they need over their lives. And that's a wake-up call we really need to pay attention to.
Ako je ovo poziv na buđenje medicinskom sustavu, poziv je također kojeg mnogi moji kolege ili ne čuju, ili ne žele čuti. Kada razgovaram sa svojim kolegama, naročito s liječnicima, o medicinskoj konoplji, oni kažu: 'Trebamo više dokaza o tome.' Trebamo više istraživanja o povoljnim učincima te više dokaza o rizicima.' I znate što? U pravu su. Apsolutno su u pravu. Zaista trebamo mnogo više dokaza o povoljnim učincima medicinske konoplje. Trebamo također tražiti našu vladu da prebaci konoplju u skupinu II, ili posve izbaci iz klasifikacija, kako bi se omogućilo istraživanje. Također, trebamo više istraživanja o rizicima medicinske konoplje. Rizicima medicinske konoplje, mnogo znamo o rizicima rekreativne uporabe, a ne znamo skoro ništa o rizicima medicinske konoplje. Dakle, apsolutno trebamo istraživanja, ali reći da trebamo istraživanja, a ne reći da trebamo sada i nešto promijeniti, znači posve promašiti bit svega. Ljudi poput Robin ne traže medicinsku konoplju jer misle da je ona čudotvoran lijek, ili jer misle da nema nikakvih rizika. Traže je jer okruženje u kojem se ona isporučuje te njome upravlja i koristi, daje im jednu vrstu kontrole koja im je potrebna nad njihovim životom. I to je poziv na buđenje kojem zaista trebamo posvetiti pažnju.
The good news though is that there are lessons we can learn today from those medical marijuana dispensaries. And those are lessons we really should learn. These are often small, mom-and-pop operations run by people with no medical training. And while it's embarrassing to think that many of these clinics and dispensaries are providing services and support and meeting patients' needs in ways that billion-dollar healthcare systems aren't -- we should be embarrassed by that -- but we can also learn from that. And there are probably three lessons at least that we can learn from those small dispensaries.
Ipak, dobra vijest je što postoje lekcije koje danas možemo naučiti od tih mjesta koja izdaju medicinsku konoplju. I to su lekcije koje zaista trebamo usvojiti. To su često mala okruženja koja vode osobe bez medicinskog obrazovanja. I dok je neugodno i pomisliti da mnoge od tih klinika i ambulanti pružaju usluge i podršku, zadovoljavajući potrebe pacijenata, na načine na koje zdravstveni sustavi vrijedni milijarde dolara to ne čine, trebalo bi nas biti sram zbog toga, no, iz toga možemo i nešto naučiti. Postoje vjerojatno najmanje tri lekcije koje možemo naučiti od tih malih ambulanti.
One: we need to find ways to give patients more control in small but important ways. How to interact with healthcare providers, when to interact with healthcare providers, how to use medications in ways that work for them. In my own practice, I've gotten much more creative and flexible in supporting my patients in using drugs safely to manage their symptoms -- with the emphasis on safely. Many of the drugs I prescribe are drugs like opioids or benzodiazepines which can be dangerous if overused. But here's the point. They can be dangerous if they're overused, but they can also be ineffective if they're not used in a way that's consistent with what patients want and need. So that flexibility, if it's delivered safely, can be extraordinarily valuable for patients and their families. That's number one.
Prva, moramo naći načina da pacijentima damo više kontrole kroz male ali važne načine. Kako komunicirati s medicinskim djelatnicima, gdje komunicirati s medicinskim djelatnicima, kako uzimati lijekove a da im oni koriste. U svojoj vlastitoj praksi, postao sam mnogo kreativniji i fleksibilniji u podršci pacijentima, da koriste lijekove na siguran način, nadzirući simptome, s naglaskom na sigurnost. Mnogi lijekovi koje propisujem su oni poput opioida ili benzodiazepina, koji mogu biti opasni ako se premaši doza. Ali ovo je ključno. Oni mogu biti opasni ako se premaši doza, ali mogu biti i bez učinka ako se ne koriste na način, koji je dosljedan u onome što pacijenti žele i trebaju. Zato ta fleksibilnost, ako je pružena na siguran način, može biti izvanredno vrijedna za pacijente i njihove obitelji. To je prvo.
Number two: education. Huge opportunities to learn from some of the tricks of those medical marijuana dispensaries to provide more education that doesn't require a lot of physician time necessarily, or any physician time, but opportunities to learn about what medications we're using and why, prognoses, trajectories of illness, and most importantly, opportunities for patients to learn from each other. How can we replicate what goes on in those clinic and medical dispensary waiting rooms? How patients learn from each other, how people share with each other.
Drugo - edukacija. Ogromne su mogućnosti za naučiti neke od trikova tih ustanova koje izdaju medicinsku konoplju, da bi se pružilo više edukacije a koja ne traži nužno mnogo vremena od strane liječnika, ili ikakvo njegovo vrijeme, već mogućnosti da naučimo koje lijekove koristimo i zašto, prognoze, tijek bolesti, i ono najvažnije, mogućnosti za pacijente da uče jedni od drugih. Kako možemo preslikati ono što se događa u čekaonicama tih klinika i medicinskih ambulanti? Kako pacijenti uče jedni od drugih, kako ljudi međusobno dijele iskustva.
And last but not least, putting patients first the way those medical marijuana dispensaries do, making patients feel legitimately like what they want, what they need, is why, as healthcare providers, we're here. Asking patients about their hopes, their fears, their goals and preferences. As a palliative care provider, I ask all my patients what they're hoping for and what they're afraid of. But here's the thing. Patients shouldn't have to wait until they're chronically seriously ill, often near the end of life, they shouldn't have to wait until they're seeing a physician like me before somebody asks them, "What are you hoping for?" "What are you afraid of?" That should be baked into the way that healthcare is delivered.
I zadnje, ali ne manje važno, stavljajući pacijente na prvo mjesto, kao što to rade te male ambulante, čime bi se pacijenti osjećali da imaju pravo na ono što žele i ono što trebaju, razlog je što smo mi, pružatelji medicinskih usluga, ovdje. Pitati pacijente za njihove nade, strahove, ciljeve i prioritete. Kao pružatelj palijativne njege, pitam sve svoje pacijente čemu se nadaju i čega se boje. Ali stvar je u sljedećem. Pacijenti ne bi trebali čekati da postanu teško, kronično bolesni, često blizu kraja svog života, ne bi smjeli čekati da posjete liječnika poput mene, prije nego ih netko upita, 'Čemu se nadate?' 'Čega se bojite?' To bi trebalo biti sastavni dio onoga što zdravstvena skrb pruža.
We can do this -- we really can. Medical marijuana dispensaries and clinics all across the country are figuring this out. They're figuring this out in ways that larger, more mainstream health systems are years behind. But we can learn from them, and we have to learn from them. All we have to do is swallow our pride -- put aside the thought for a minute that because we have lots of letters after our name, because we're experts, because we're chief medical officers of a large healthcare system, we know all there is to know about how to meet patients' needs.
Mi to možemo, zaista možemo. Ambulante i klinike diljem zemlje, koje izdaju medicinsku konoplju to shvaćaju. One to shvaćaju na načine za kojima veliki, standardni zdravstveni sustavi zaostaju godinama. No, mi možemo učiti od njih, i moramo učiti od njih. Samo moramo progutati svoj ponos, na minutu staviti misao po strani, da to što imamo mnogo slova i titula iza svog imena, jer mi smo ipak stručnjaci, jer smo važne medicinske osobe u velikom sustavu zdravstvene skrbi, da zato znamo sve što treba o tome kako zadovoljiti potrebe pacijenata.
We need to swallow our pride. We need to go visit a few medical marijuana dispensaries. We need to figure out what they're doing. We need to figure out why so many patients like Robin are leaving our mainstream medical clinics and going to these medical marijuana dispensaries instead. We need to figure out what their tricks are, what their tools are, and we need to learn from them. If we do, and I think we can, and I absolutely think we have to, we can guarantee all of our patients will have a much better experience.
Trebamo progutati svoj ponos. Trebamo posjetiti nekoliko ustanova koje izdaju medicinsku konoplju. Moramo shvatiti što oni rade. Moramo shvatiti zašto toliko pacijenata poput Robin napušta naše standardne medicinske klinike i umjesto njih odlaze u te ustanove gdje se izdaje medicinska konoplja. Moramo shvatiti koji su njihovi trikovi, koji su njihovi alati i moramo učiti od njih. I ako to učinimo, a mislim da možemo i apsolutno mislim da moramo, možemo jamčiti da će svi naši pacijenti imati mnogo bolje iskustvo.
Thank you.
Hvala vam.
(Applause)
(Pljesak)