The Oregon Medical Marijuana Program requires participating physicians to be state licensed, and will only accept those that have a bona fide physician-patient relationship with patient applicants.  This includes an in person physical examination and a review of past medical history.  The review must cover current and past treatments for a debilitating medical condition, comorbidities, any history of substance misuse/abuse, current medications and consultation with the Prescription Drug Monitoring Program (PDMP) database for the patient’s receipt of controlled substances. Furthermore, the physician should document a treatment plan that includes alternative treatments to medical marijuana and an assessment of possible contraindications.  The physician should consider any patient’s past experiences with marijuana, and whether or not it was deemed beneficial.  If the physician determines that the patient may benefit from the use of medical marijuana to treat a debilitating condition, they must discuss the potential risks.  These include the variability of CBD/THC concentration and adverse effects among others.  The physician should conduct ongoing treatment that reviews any change in patient’s condition or functioning, as well as their response to therapy.  Detailed health records should be maintained.  Finally, any physician considering recommending medical marijuana to patients should complete at least three hours of Category I continuing education.   The CME program should explain the proper use of marijuana, including the endo-cannabinoid system, pharmacology and effects of marijuana (e.g., distinction between cannabidiol [CBD] and tetrahydrocannabinol [THC]; methods of administration; and potential side effects or risks). Physicians who recommend marijuana should closely follow the emerging evidence on the use of marijuana for therapeutic purposes and adopt consistent best practices.