Meet Jordan Tishler

Harvard-trained physician Jordan Tishler, MD, left conventional medicine to pursue a career as a cannabis specialist/business executive, advocate, and educator. In this interview, Tishler talks about how he has carved out a career in the cannabis industry and shares his advice for other medical professionals who would like to do the same.

Q: How were you introduced to medical cannabis?

A: Actually, it was because of my job as an emergency department (ED) physician that I became interested in cannabis medicine. I spent countless hours taking care of veterans whose lives were substantially harmed or even destroyed by substances. My realization that I had never seen anyone in the ED because of cannabis toxicity led me to think that I should look into the value of cannabis as a medicine.

Q: It seems that few clinicians have had instruction in this area, and some experts indicate that we need a lot more research to move forward with medical cannabis.

A: Many of us were not taught about the endocannabinoid system or cannabis. However, there are many medications we use that we did not get taught about in school and that we learned about later as they were invented. Medicine is a lifelong learning pursuit.           

While it’s been fashionable amongst certain political circles to say that there is not enough research on cannabis, nothing could be further from the truth. There’s an extensive 70+ year history of research into cannabis and THC. It is a difficult literature to comprehend because it is, in fact, so voluminous. I spent several years combing through this literature before I became convinced that cannabis could be used as a medicine if it were appropriately applied to the right patients and the right illnesses.

Q: In your role as a professor, do you have the freedom at Harvard Medical School to teach about medical cannabis?

A: I am able to, and do, teach about cannabis as medicine regularly to my colleagues at Harvard and around the globe.

Q: What are some of the best resources you recommend to others who want to learn more?

A: As a result of the difficulty in disseminating this information to my colleagues, I formed the Association of Cannabinoid Specialists (ACS). I strongly recommend its educational offerings as a good starting point. It offers multiple levels of resources that help new learners get their feet wet as well as dive deeply into the subject as their knowledge and interest grow.

Q: What important tips would you want to pass along to clinicians who are unfamiliar with medical cannabis?

A: I think the first thing that’s important is just to be absolutely well educated on the science of cannabinoid medicine. It's important that we are not simply repeating what we have been told, particularly of the stoner-lore variety. Be careful of the educational resources that you use, as many of them are simply not accurate. A good, evidence-driven source is the resources available through the ACS.

Further, I think we must practice this sort of medicine in an impeachable manner. This means spending significant time with our patients, explaining what they need to understand, being specific about our medical recommendations, and following them up closely. This is true in all fields of medicine, but we are clearly under the microscope.

I have not really experienced any negative responses or criticisms from my colleagues over the years, and I believe this is because I always lead with patient care and with scientific evidence. The value to my patients, and by extension to me, of using cannabis medicine, is extraordinary. It has provided relief for many that simply has not been achievable using conventional medications.

Q: Congratulations on being named Americans for Safe Access 2021 Medical Professional of the Year. Please share several of the best ways to ensure safe access for patients.

A: Safe access has often become equated with access to cannabis plant material that has been properly safety tested. However, this is only part of the equation. No medication is safe. Medications are only safe if we use them properly. It is crucial that we, as clinicians, step up and provide the guidance that patients need to use this medication well and safely, just as we would do for any other medication that we might prescribe.

All of my patients leave my office with a full explanation of their medical regimen and a written prescription of what to get and how to use it, even if that prescription does not hold the force of law that a conventional prescription does. I think this is crucial in communicating to my patients how to use the medication safely and effectively.
What’s been commonplace until now has been for clinicians to abdicate this responsibility to the dispensary budtender. This is not in the patient's best interest, as the dispensary agent has a significant conflict between the patients’ needs and their need to sell lots of cannabis products. Further, there are no budtenders with medical degrees, and they are simply not equipped to guide choices for our patients.

Q: Since you are president of the ACS, please highlight a few of the association’s goals.

A: The goals of the ACS have always been twofold: to provide education to clinicians and to lawmakers so that we can achieve better systems for our patients. We have, as I've mentioned, several great evidence-driven educational resources already available. We have new, deeper lessons in the works. Many of these resources are available to members without any additional fee.

Benefits to members include a newsletter, access to these educational resources, access to several scientific journals, and networking opportunities, including monthly mentoring with more experienced clinicians. There’s a lot of work to be done, and we have several standing committees, including education and advocacy. If people want to become involved to help move the ball down the field, there’s no better way than to participate on one or more of these committees for the ACS.

Q: What has been your experience using telemedicine through your company, inhaleMD? Any experiences to share?

A: Prior to COVID, I used telemedicine but only rarely. I was not a great fan. Since COVID, however, I’ve found that I’ve made the transition to entirely remote care with great ease. In fact, on balance, I think telemedicine is better for this sort of practice and intend to remain virtual for the foreseeable future.

Q: And you offer a fellowship opportunity, is that right?

A: In addition to the work that I've done with the ACS, I have trained many clinicians, physicians, nurse practitioners, and physician assistants in cannabis medicine. Most recently, I did an intensive training program with my current practice partner, Jill Becker, MD, and that has become the model for our training fellowship. We are now offering this sort of training to other clinicians as a more formal fellowship process (inhalemd.com/fellowship).

Q: You have such a varied career associated with medical cannabis. Any suggestions for clinicians who want to advocate for medical cannabis in creative ways?

A: It's true that I do a whole lot of different things in this medical cannabis space. This has grown very organically, and really each role has come about due to a need. I certainly never meant to be in private practice, but that was how I was able to bring cannabis medicine to my patients and to be able to go back to the academic medical centers and educate my colleagues.

Consulting in the cannabis business sector is complicated. If you want to advocate for the best interest of your patients using evidence, it can be very hard to interface with cannabis companies that often are less interested in evidence and the patient's well-being than they ought to be. This is not to say that there are not great companies out there but that it is a process to find and interface with them.

Conflict of interest is a large problem in the medical world in general, but in the medical cannabis world, it is rampant. I strongly suggest to your readers that they maintain a healthy distance from business endeavors that might unduly influence their patient care. Not only is our credibility on the line but so is that of the entire medical cannabis industry.

Q: Any parting thoughts?

A: At risk of sounding like a Boy Scout, I have to say that for me, everything starts and ends with the patient. I think this is a good way to be. When it comes to cannabis medicine, my mantra has always been “it's about the care, not the card.” I hope that others will join me in this pursuit and join me in the ACS.

— Michele Deppe is a freelance writer based in South Carolina.