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High fashion in the medicinal high business

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The physician was wearing high heels, a tight-fitting white lab coat and lots of gold jewelry, which is not quite what you expect to see when you visit a pot doctor. Nor do you expect to see a chandelier the size of a Christmas tree in a waiting room decorated like an Indian palace.

Dr. Sona Patel told me that's just who she is. Her Melrose Avenue office, she said, is designed in much the same way as her home in Hollywood.

You may be wondering what I'm doing in the office of yet another cannabis specialist, given my fruitful encounter last month with a physician in Glendale. That doctor had told me he knew nothing about back problems because he was a gynecologist, but he wrote me a marijuana recommendation after a 10-minute "exam."

But in California, you're entitled to a second opinion, and I had some more questions. I was wondering how and why a doctor goes from conventional to herbal medicine, and I called Patel, intrigued by her glamorous ads in local publications. The whole California marijuana adventure seems like an herb-fired hallucination, but what must her story be?

Before I visited Patel, I called state regulatory officials to discuss my Glendale experience. Much has been written about the explosion of dispensaries, particularly since Los Angeles has made such a mess of things, allowing several hundreds of storefront pot outlets to open without permits. But far less has been written about the doctors.

Is there any oversight for those who appear to be running patients through mills at $100 or more a pop, faster than you can open your mouth and say, "Ahhhh?"

Not a great deal.

A spokeswoman for the Medical Board of California told me that only 81 complaints have been made against marijuana doctors since 1996, and investigations have led to disciplinary action against just 10 doctors. The medical board is expected to consider early next year whether to be a little more proactive, and re-establish guidelines for conducting exams and issuing "recommendations."

Frank Lucido, an Oakland physician, has been speaking out for doctors who fear they're all being tainted by unprofessional colleagues who are rubber-stamping marijuana recommendations.

"I schedule 45 minutes for a first-time patient and 30 for a repeat patient," said Lucido, who suggests that California has become the "Wild West," with thousands of dispensaries, hundreds of doctors and varying laws from one city to the next.

Lucido said he's trying to hold the middle ground between drug war partisans who oppose marijuana altogether, and those who are ready to party on the other side, faking medical need so they can light up recreationally.

Where does Dr. Patel stand?

Her office, which doesn't look like much from the outside, sits across the street from Melrose Organic Pharmacy, where I purchased some Skywalker buds as part of my research last month. Good for back pain, said the clerk.

At Patel's office, Shannon, the office manager, was also in high heels. All right, what is this, a modeling agency or a doctor's office?

The high fashion is just a style preference, said Dr. Patel, 34, who uses her own image in advertising materials, often in different hairstyles.

But is the glamour about creating a marketing niche -- she'll fix what ails you, and she looks like a beauty queen, to boot! -- in a crowded field?

No, Patel said. But as a matter of fact, she worked as a model to help pay medical school bills, and the glam shots she uses were actually meant to market a cosmetics line that never got off the ground.

So how did she get into herbal medicine?

Patel said she grew up in Chino Hills and went to medical school in the Caribbean, having wanted to be a doctor from the time she was 5.

She ran a family practice and clinic in Hollywood, but grew weary of prescribing pharmaceuticals with potentially serious side effects to patients suffering from diabetes, AIDS, migraines and other maladies. Some of those patients asked if she would recommend marijuana instead.

"I began to research it and incorporated it into my practice," Patel said.

To her surprise, patients often got greater relief from pot than from prescription drugs -- and they reported no side effects. In 2007, she shut down her family practice on Sunset and went herbal all the way on Melrose. Her answer to the obvious question? Yes, the money is better.

Patel told me she worked briefly in San Francisco and was the subject of an unflattering TV news story in which two TV producers said that getting a recommendation from her was laughably easy. The story, which I later checked, also noted that Patel was in hot pants and high heels on materials advertising her business, and that she used the name Doc 420, the 420 being street slang for marijuana. We've come a long way since Marcus Welby.

The story was a distortion, Patel insisted.

Well, whatever. I still find the high heels and lab coat a little strange, but it also seems weird that I can legally buy buds in virtually every corner of the city because a gynecologist said I could.

Patel said she now sees 15 to 20 patients daily and said she generally spends 30 minutes or so with each, and she reviews their medical records before recommending marijuana. On average, Patel said, she denies recommendations for between two and five patients daily who don't prove a medical need.

I should note here that before I met Dr. Patel, I got an e-mail from a patient who was upset about her denying him a recommendation, and that was one reason I wanted to meet her.

Patel said that if you haven't been previously diagnosed with a condition that has existed for at least six months, and you haven't tried conventional medicine, don't bother making an appointment with her.

But she's convinced that marijuana, used properly, is improving the quality of life for many patients who got no such relief from prescription drugs.

If marijuana becomes completely legal, regulated and taxed in California -- which is where we ought to go, if you ask me, ending the bogus drug war and the dispensary/recommendation charade -- it might mean the end of Dr. Patel's business.

If so, she said, she won't go back to conventional medicine. She might instead go back to school and study various Eastern and alternative medicines.

That would cost a ton.

But modeling got her through school once, and she's still got the high heels.

steve.lopez@latimes.com

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