SIOUX FALLS, S.D. (KELO) — More than a year past the legalization of medical marijuana in South Dakota, there are currently 150 practitioners approved by the state to recommend medical cannabis to patients. There are just over 2,600 total state card holders, as of Sept. 6, 2022, when the state last updated its numbers.

With just 150 approved practitioners in a state of around 900,000 people that makes for quite a physician-to-patient ratio.

With a total of 2,621 patients (again, as of Sept. 6) to 150 practitioners, this averages out to around 17 patients per practitioner. However, we also know that there are some pretty significant outliers.

Mayson Bedient is one such outlier. Back in June, 2022, Bedient, a doctor of osteopathy spoke with KELOLAND News about his work with MyMarijuanaCards (MMC), a company which connects patients with doctors who can recommend marijuana and assist the patient with their application to the state program.

At the time we spoke with Bedient, there were around 1,150 card holders in the state. Bedient estimated he had recommended around 400 of them. Assuming all those he recommended were approved, Bedient would have accounted for around 34.78% of all card holders.

Bedient is a South Dakota doctor, but he does not do his marijuana consultations through a South Dakota health system. Rather, the consultations are done through the aforementioned MyMarijuanaCards, where he works a few weekends a month seeing patients.

You may have seen advertisements for MyMarijuanaCards, or a company like it, in recent weeks as more of them are coming to South Dakota.

KELOLAND News spoke with MyMarijuanaCards’ CEO and Founder Molefi Branson about the industry.

“We just simply help to connect patients with practitioners that are interested in doing medical marijuana certification,” Branson said. “The process is fairly simple.”

First, he says, you make an appointment, either online or over the phone, before being sent intake forms. Branson says that these digital forms will need to be completed prior to coming into the clinic for an in-person meeting with a physician.

“The doctor is going to review those intake forms with medical records and either approve or deny them. If they approve them, then they’re going to be charged for the appointment, and then put it into the state system where they’re going to get their card,” Branson explained. “If they don’t get approved, then there’s no fee.”

This is about the exact same process patients undergo when working through a similar business, MMJ Card Clinic, South Dakota (MMJ). We spoke with Alyssa Anderson with MMJ, who explained a very similar process.

While walk-ins are allowed, Anderson advises making an appointment ahead of time. Both she and Branson describe their processes as quick; somewhere in the range of 5-10 minutes generally. Both also stress the importance of bringing your medical records with you.

“They’re the linchpin of the process,” Branson said. “If you don’t supply some medical records, then you’re guaranteeing yourself that by the time of the doctors appointment, we’re actually just going to turn you back around.”

Don’t know how to access your records? Anderson says that’s something they often help patients with, whether it’s helping them sort out which records they need or helping them figure out how to request the records as a whole.

Any concerns you may have about the legitimacy of the process might be allayed by the fact that the practitioners conducting the appointment must be certified by the state, not only to practice medicine, but must also be certified to recommend medical marijuana through the DOH.

Anderson also pointed out that, just as with any other type of health care, any info you provide to MMJ (and to MMC) is confidential under HIPAA, just as it would be with any other sort of medical treatment.

Where do these doctors come from? Both Branson and Anderson said they had to go looking for them to start with. Branson noted that he sent around 3,000 emails to practitioners in South Dakota when coming to the state to set up the clinic. He says about 15 replied.

Fees for services such as those provided by companies assisting in the medical card process seem to hover around the $200 range for patients, though companies do offer different sorts of discounts and promos at times.

Why would someone pay $200 on top of the additional $75 fee to the state though, instead of simply talking to their doctor?

This is again where we highlight the fact that in the entire state, there are still only 150 practitioners certified by the DOH. Perhaps that low number is on account of a lack of awareness or an unwillingness to participate, but with over 2,600 card holders, it seems clear that a lack of demand is not the issue.

KELOLAND News reached out to Sanford and Avera to ask their positions on their providers recommending medical marijuana.

“Sanford does not endorse or oppose the use of medical marijuana. It is up to each individual Sanford provider to determine the use of medical marijuana in regards to each patient’s individual care plan and what they feel is medically best for their patients,” said Dr. Joshua Crabtree, clinic vice president at Sanford.

Avera’s statement was similar, saying in an email: “Avera believes in the practitioner-patient relationship, and supports each physician or advanced practice provider in using their clinical judgment to decide what is best for each individual patient. Avera stands behind each practitioner’s decision to certify or not certify.”

Despite both these systems statements however, there remains only 150 practitioners.

This is where medical marijuana card companies step in. In a state with a little over 2,600 card holders, Branson says MMC has handled a little over 1,800 applications.

“We asked, ‘What’s the need for a company like ours?,” said Branson, “We fill that need and fill that gap.”

Essentially, Branson and Anderson argue companies like theirs help patients access medicine that they otherwise would have no way of getting, considering practitioners willing and able to recommend medical marijuana are few and far between at the moment.

Anderson also points to another need these companies fill: education. She said there is a lack of information on the process provided by the state, and that companies like MMJ connecting patients with practitioners also provide information on how the process will play out.

Branson notes that MMC also provides educational materials, both in-person and via regular updates on the MMC website