When it comes to making health decisions, there are a lot of people bucking for seats at the table.

The federal government wants its say. The state government definitely jumps up and down and waves its hands. There are the insurance companies. There are the pharmaceutical companies. Sometimes churches want to be involved. Politics gets a piece of the pie in almost everything. Even corporations and organizations that wouldn’t seem related tend to rally for their part.

Sometimes it seems like the two parties that should be most important — the patient and doctor — become nothing more than incidental, interchangeable parts in a process being decided by everyone else.

It’s the kind of thing that people seeking alternative therapies might be looking to avoid. Maybe that pushes some people to seek medical marijuana in an effort to cut out insurance companies and other middlemen. But with the federal and state governments arguing about whether cannabis is legally acceptable therapy, good luck with that.

A Spotlight PA story shows that there is another hurdle for those patients: marketing.

Doctors who choose to approve patients for Pennsylvania’s legalized medical cannabis cannot advertise that practice. But marijuana card companies can.

Marijuana card companies are a kind of matchmaking service, but instead of getting someone a date, they connect a patient with a symptom treated by medical cannabis with a doctor open to prescribing that treatment.

The state Legislature didn’t let doctors advertise for fear of having doctors who were only in the business for the money. Lawmakers didn’t want a doctor’s office to become a marijuana card factory.

But by allowing marijuana card companies to do exactly what they feared doctors would do, they have the same result. Even worse, the process is a step removed from the code of ethics and myriad other regulated responsibilities of a licensed doctor.

The lawmakers’ fears were not misplaced. They were not wrong to attempt to keep the marijuana program as medical as possible rather than becoming an opportunity for the slickness of an ad campaign.

The problem is they did not prevent the advertising or the shiny, Big Pharma-style marketing machine. They simply put a detour between the patients and the doctors who wove through a maze of other business and marketing without guardrails.

If the legislators still believe in the limits they set on doctors, they should apply them to the other businesses. If they don’t still have those fears, they should take the handcuffs off the physicians.

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