In November of 2018, Missouri voted to legalize medical use of cannabis, making them the 33rd state to do so. As the state builds momentum toward adult use, a number of interesting things are happening that prove how different just every path to legalization is.
Today’s guest is Internist Mimi Vo. Mimi graduated from medical school at the age of 23, and discovered that there was a massive educational gap when it came to the potential use of cannabis.
Now, in addition to practicing medicine in St. Louis as the CEO of Vo Medical Clinic, she’s also the Co-Owner of YEN-ology, an organization representing healthcare and patient rights for cannabis patients, and the Head of Healthcare Education and Training at the Missouri Medical Cannabis Trade Association. The St. Louis Business Journal also named her one of the most influential businesswomen of 2019.
Today, Mimi joins the podcast to tell the story of her own awakening to the medical potential of cannabis, the promising research she’s seen in medical cannabis, and how the coronavirus crisis is impacting cannabis business owners on both sides of the industry at this time.
- How Mimi discovered the potential of medical cannabis – and used data, not stories, to change her strict father’s perception of cannabis.
- Why cannabis is essentially apolitical in Missouri – and why rural communities actively want cannabis businesses to open there.
- How the COVID-19 crisis changed the developing cannabis industry in Missouri – and the frustrations Mimi has faced as a medical practitioner.
- Why attempts to keep the global economy moving could negatively impact cannabis prohibitions – and the unique challenges for businesses that can’t qualify for any federal aid money.
- How universities are finally formally integrating cannabis science, extraction, and dispensary procedures into their curriculum – and why it looks a lot like trade programs for wine and beer.
“I started doing my own research, looking at the science and the data and realized that I was missing this whole chapter of what cannabis was as a medicine. It was not something I ever learned in medical school or residency.” – Dr. Mimi Vo
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Rick Kiley: Hello, everyone, and welcome back to The Green Repeal. I’m Rick Kiley, one of your hosts along with my co-host, Jeffrey Boedges. Hello, Jeff.
Jeff Boedges: Hi, gang.
Rick Kiley: And we are joined here today by Dr. Mimi Vo. Dr. Vo is an internist in St. Louis, Missouri. She’s affiliated with multiple hospitals in the area, attended the University of Missouri Kansas City Medical Schools, has been practicing as an internal medicine physician in the St. Louis area for over 10 years. She’s the CEO of the Vo Medical Clinic, good name, and half of the team that runs YEN-ology, which is a business that represents two of the most important aspects of the medical cannabis business, healthcare, and the understanding of legal rights for patients. She also sits on the board of the Missouri Medical Cannabis Trade Association where she serves as the head of the healthcare education and training committee, and she was selected as one of the most influential businesswomen of 2019 by the St. Louis Business Journal and most importantly, she is a St. Louis homegirl. Jeffrey, I cannot say this.
Jeff Boedges: Go Cards! Go Blues! Yeah.
Rick Kiley: Go Cards.
Dr. Mimi Vo: Yay!
Jeff Boedges: Yes. And I hope the Rams lose.
Rick Kiley: This is quite the list of accreditations, Mimi. Is there anything else we missed here, something that you want to add?
Jeff Boedges: I mean, you were just doing something for the historical society today. Come on. There’s got to be something else.
Dr. Mimi Vo: No, you guys got it. You got it. I graduated from high school at the age of 17 and graduated from medical school at 23. So, this has been a lot of my life and working in my dad’s medical practice since I was a child.
Rick Kiley: Wow.
Jeff Boedges: Were you practicing medicine as a child?
Dr. Mimi Vo: So, no, but my dad would teach my sister and I how to suture. One year he actually accidentally cut himself with a chainsaw and he sewed himself at home without any anesthesia and we had to help him. So, we’ve just been integrated in medicine and he would take us on hospital rounds when we were little.
Rick Kiley: Wow.
Jeff Boedges: I can appreciate that. During the COVID lockdown, I did a number on one of my hands in superglue, little superglue, little medical tape, some Neosporin. I’m at 30% now.
Dr. Mimi Vo: Superglue is amazing. Superglue will do it.
Jeff Boedges: Yeah.
Rick Kiley: Yeah. He should show you a picture of that finger soon because I don’t know if it’s healing properly.
Jeff Boedges: Yeah. I was just telling Rick my guitar career is probably severely damaged, which is okay. I don’t play guitar.
Rick Kiley: We’re going to give it up.
Jeff Boedges: Yeah. Yeah, it’s the bottom. Yeah. All right. So, I guess we’ll get into the questions. So, how did you come to be where you are today? It seems like it’s in the family gene pool that you would be a doctor. Were you always slated to be a doctor?
Dr. Mimi Vo: Yes, apparently. I told my parents like when I was two or something that I wanted to be a doctor and so they kept that going. They kept that narrative going and I always was told that I told them I wanted to be a doctor. So, that’s all I remember.
Jeff Boedges: And why? Why did you want to be a doctor? Did you just like the idea of what dad did? Or you thought, “You know what, I want to make a lot of money.”
Dr. Mimi Vo: No. So, my grandfather was a physician too. So, he used herbs to treat people. He was very well known in his village. And when my dad turned 13, my dad was sent to the big city to Saigon to Ho Chi Minh City and was told to stay there and go to high school and become a doctor because that’s where the medical school was and during the French occupation, there was a French-run medical school. So, then my dad became a doctor and served in the war as a trauma surgeon for the South Vietnamese Army alongside US surgeons. When he came to America, he redid his training and did his residency in St. Louis. So, we moved from Springfield, Illinois where I was born to St. Louis, Missouri, and that’s where I grew up. And he had a medical practice and that my mom ran a Chinese restaurant. And so, I grew up halfway between making crab rangoons in the back and taking orders as a five-year-old and then on the side working at my dad’s office, helping the receptionist put away charts and things like that.
Jeff Boedges: Crab Rangoon is a uniquely St. Louis cuisine though. When I moved up to the northeast, they’re like, “What is that?” They didn’t have it up here. They have it now but they called it crab wontons for a while and not as good. Yeah. That’s crazy. All right. So, how did your dad get out of Vietnam? Was he out before the fall of Saigon or did he get out at that time?
Dr. Mimi Vo: On the 30th of April 1975 when North Vietnam took over Saigon and they invaded Saigon, that was like the very last day of the war, that was the same day that a lot of people left and my dad, actually, his brother gave him some money and said, “You’ve got to leave. You’re a South Vietnamese Army. You serve with the Americans. You cannot stay here.” So, there was a big ship in the middle of the river, the Saigon River, and he boarded that ship of it was like 3,000 people on a ship meant for 1,000. And my mom and her seven younger siblings, she was the oldest of eight. She and her seven younger siblings also were on the same boat and left that same day. My mom’s father was in the Air Force and he’s been missing in action since that day, and her older brother was in the army and he ended up being found and joined our family in the United States years later.
Jeff Boedges: Wow. That’s incredible. That’s a crazy story. I will say that that’s a first on The Green Repeal.
Rick Kiley: Yeah. No one can top that yet.
Jeff Boedges: No, I don’t think anyone will top that. All right. So, yeah, and you just mentioned that your great grandfather was also a medical person and that he used herbs and had definitely more of an Eastern approach, a more holistic approach to medicine. Is that something also that runs in the family?
Dr. Mimi Vo: I grew up if I had a scratch or like a cut, my mom would go to the freezer and grab a piece of turmeric and break it off and put it on my scratch. And growing up using Eastern herbs was a part of my upbringing, but cannabis was not considered an herb. We’re Asian…
Jeff Boedges: That’s what we called it in college.
Rick Kiley: But that’s weird because it’s a small herb.
Dr. Mimi Vo: Well, it’s considered not in the Asian community. In Asian community, Asians are a bunch of rule followers. So, it was like you follow the rules. If something’s illegal, you do not touch that. And my dad just scared the bejeesus out of me and my sister growing up so we never really touched anything or looked at anything. Even though we had friends or cousins who would have dabbled in that in high school, in college, but we never did. And like I said, I graduated from medical school at the age of 23 so I was very young and went to residency. Again, hearing about cannabis about what it is and what it can be, I never really looked into any of that anymore until probably about 10 years ago, when the movement happened as far as repealing prohibition and patients starting to speak up and I started to open my mind to the possibilities. And at that time, I started looking to herbal medicine and taking an herbal medicine course through Wake University and learning about different herbs.
And so, I started becoming a little bit more open-minded about what the possibilities were for herbal medicine. And then when I worked as an internist and started seeing patients who said, “Hey, I was in Colorado and I used this for migraine headaches and it was amazing,” or an elderly patient come home and say, “I was in California and I use this cannabis salve and it helps my arthritis.” It really did change my perception of things and I became curious. So, I started doing my own research looking at the science and the data and realize that I was missing this whole chapter of what cannabis was as a medicine and it was not something I ever learned in medical school or residency.
Jeff Boedges: Yeah. We’ve heard some similar stories to that to a slow awakening that happens with a lot of people, frankly, and even anecdotally, I’ve mentioned to my father about this show, and my dad was a very straight line guy, St. Louis guy, a high school teacher. If he would have found out that I had dabbled in cannabis in my high school years, it would have been, yeah, I wouldn’t be here talking to you today. Let’s put it that way. But that’s also a little bit, I grew up in Missouri and I feel that the state, I feel like now like when I look back as a kid that it was a little bit more progressive. I feel like there’s actually been a little bit more of a move towards the right, a little bit more towards this conservative sort of approach in the political machinery there. So, I was actually pretty pleasantly surprised when they decided to legalize medical cannabis. I didn’t even really realize it was on the radar. And I’ve been living up here for a long time. I’ve been up in the northeast now for 25 years so my perception is definitely skewed. My politics have definitely become skewed up here. But how have the people so far of Missouri and again, we know there’s St. Louis and there’s Kansas City and there’s everything else, how have they embraced medical cannabis?
Dr. Mimi Vo: I was so surprised as well. And same thing with my father when I started becoming more open about my pro-cannabis stance, he initially was not too excited. He was not very happy with that because he was like, “I put my daughter through medical school and then she took over my practice and now she’s out there talking about cannabis publicly and she’s one of only like three doctors in the whole State of Missouri who’s willing to speak publicly about it.” So, he wasn’t too excited and he didn’t really believe all the data and science that I was telling him was available. So, while we were trying to get the amendment to pass, I would do speaking engagements to engage and educate the public and I made sure he came to every single one. So, after about ten of those, his perception’s change so he definitely now and the patients who’ve come into the office.
Rick Kiley: How many did it take? How many like was it the…
Dr. Mimi Vo: Fourth maybe.
Rick Kiley: The fourth time?
Dr. Mimi Vo: Yeah. Maybe like halfway through he was like, “Okay. Yeah.”
Rick Kiley: And what ultimately convinced them though? Was it the fact that he loves you, he trusts you, you’re smart and you’re bringing him along or did he sort of get connected to the data? Was it sort of like the social sort of?
Jeff Boedges: Yeah, it wasn’t. It wasn’t my personality. It was the data.
Dr. Mimi Vo: More of the data and the science and I think that he have that once and I was putting up here’s the citation for this. It’s in the JAMA article. It’s in the New England Journal of Medicine article. And then actually, on a few occasions, he talked to some people in the audience and he would come home and say, “I met this gentleman who said that he has had lung cancer, stopped all his chemo, and whatnot and he has been cured for years just from using cannabis alone.” And he was so awed by some of these people that he talked to and their experiences with cannabis have helped them. And that doctor part of him I think really kicked in.
Rick Kiley: I haven’t heard the cannabis cures cancer one yet and that is – it’s a good slogan, by the way.
Dr. Mimi Vo: The Israeli Cancer Institute in Israel is working on that, particularly with Dr. Meiri, and the past president of the Society Cannabis Clinicians. Dr. Jeffrey Hergenrather. I’m a board member of the SCC. He was in Israel for a few months actually working on that data with Dr. Meiri. It’s pretty amazing.
Rick Kiley: Wow. This is specific to lung cancer or other types as well they’re looking at?
Dr. Mimi Vo: Different types of cancer. And what we find is that different strains affect different cancer cells differently. So, there might be one strain that helps prostate cancer but does nothing for lung cancer and then a different strain that helps liver cancer but nothing for another type. So, we just don’t know yet what it is, which cannabinoid it is and which profile it is that’s helping.
Jeff Boedges: That’s groundbreaking.
Rick Kiley: It’s unbelievable.
Jeff Boedges: Yeah. We had Ken Wolski on last time about a couple weeks ago and we just posted this today but we were asking him because he’s also in the medical field and also a cannabis…
Rick Kiley: Activist.
Jeff Boedges: Activist. Thank you. And so, but he was mentioning that we were wondering if people with lung conditions, especially now in the time of COVID, if it was advisable for some of these folks to perhaps lay off the flower and look at other types of intakes is a possible workaround. The funny thing is he’s like, “I’ve met a guy that had asthma, really bad asthma, and found out from him that the only thing that actually helped his asthma was cannabis, was smoking cannabis, and getting the cannabis into the lungs.” And he’s like, so that guy would typically or technically be more susceptible to the effects of COVID because of the asthma, but through his use of cannabis, he was actually able to defray some of that risk. So, it is counterintuitive.
Dr. Mimi Vo: Yeah. And there’s some data looking at alpha-pinene, it’s the terpene. It’s what’s in pine needles and what they believe that if you walk through a forest and you smell the pine needles, that that’s actually a bronco dilator and dilating your bronchial tubes, like an inhaler would for asthma. And that’s why cannabis is actually used for people with sleep apnea, chronic obstructive sleep apnea, and it reduces the number of apneic episodes and they’re breathing. So, it’s interesting.
Rick Kiley: Does it cure snoring?
Dr. Mimi Vo: I haven’t seen that. My husband’s a horrible snorer.
Rick Kiley: Yeah, we should look into that.
Jeff Boedges: It does, but not in the way you think because people who drink a lot snore a lot. And so, but people who smoke a lot, don’t always drink a lot.
Rick Kiley: Here’s my other idea, Jeff. So, they have those like…
Jeff Boedges: The Breathe Right strips?
Rick Kiley: The Breathe Right strips but it’s where it’s like a sublingual like THC thing that goes through the skin right here so you put it on and then you wear it.
Dr. Mimi Vo: Some anti-inflammatory action maybe?
Rick Kiley: What do you think?
Jeff Boedges: You’re just given that idea away on the air? Alright.
Rick Kiley: I don’t know. I got someone who maybe is in the industry could help us with this product. I’m just pointing it out there.
Jeff Boedges: I love that idea.
Rick Kiley: Yeah. All right. Write that one down.
Jeff Boedges: I did. I did. I’m just trying to think of a clever name for it. It’s got to be better than Breathe Right. It’s got to be…
Rick Kiley: Yeah. Breathe Righter.
Jeff Boedges: Or More Righter.
Rick Kiley: Breathe Awesome, dude.
Jeff Boedges: Yeah, that’s it. That’s exactly it. Breathe Bitchin. Alright. So anyway.
Dr. Mimi Vo: You did ask me about as far as Missouri and being conservative. Like you said, there’s St. Louis and Kansas City which is more liberal and more open to cannabis but it is really interesting. Most of the people I meet are probably more along the conservative lines and get their cannabis. So, what you’re seeing in Missouri is it doesn’t matter what political side you’re on. It’s cannabis or not cannabis. A lot of people that I’ve met, wonderful people who are conservative or republican are very pro-cannabis.
Jeff Boedges: Actually, I do know some pro-cannabis Republicans in Missouri as well. So, it must be a thing.
Rick Kiley: Are they like taking the more like libertarian stance where it’s just they feel like commerce is commerce and this product should be allowed to sort of run? Or is it a social justice issue? Like what do they…
Jeff Boedges: They believe in the data? Yeah.
Dr. Mimi Vo: Yeah. The people that I’ve met are just very passionate about cannabis as a plant and that it should be available to everyone and they’re all medical patients. So, they have had personal experience with it.
Rick Kiley: Right. Okay. Got it.
Jeff Boedges: Okay. So, and how is it going in Missouri right now? I know that it’s legal, but are the dispensaries actually open yet?
Dr. Mimi Vo: Not yet. And there was Greenway Media which is a cannabis magazine here in Missouri, put out a survey, and most of the readers and people in the industry who are also license holders, I think that the highest percentage of people believe that dispensary will be open in September is the thought. The cultivators that I know are still building out and they’re not letting COVID affect them at all, that work is still being done, but there has not been a commencement inspection yet of any of the cultivators. So, none of them have started growing and that’s for three or four months.
Rick Kiley: When was it legalized for medical use like how long has it been?
Dr. Mimi Vo: November 2018 during the election but licenses were awarded just in December just a few months ago.
Rick Kiley: Okay. We go faster than Maine.
Jeff Boedges: And we do know that that’s a lengthy process, the licensing process. We’ve talked to a number of different retailers in different states across the country and the hoops of fire that they have to jump through are fairly substantial. And some of the financial requirements, like at least in some of the other states we’ve talked to, we know that they have to actually have the lease on the location before they’ll get the license. You need to have a lease on a location a year before you begin to make money. That’s a tough business model for a lot of people. So, yeah, it’s an interesting thing. Like in some of the states in the northeast, there are some while the states have legalized that some of the local communities, the counties nor the towns have said, “Not in my town. You’re not putting a dispensary here,” any issue with that at all in Missouri?
Dr. Mimi Vo: No. Actually, in Missouri, we’re seeing the opposite. These rural communities were really vying for companies to come to build warehouses and to buy land and they want these businesses in their communities. And you’ve been in Missouri. In some of these rural towns are just getting smaller and they really do want the jobs. I practiced in Franklin County where my dad opened his practice in 1986. It’s an hour west of St. Louis and that’s where his main practice was. I practiced there for a few years and I know people in that community were all super excited about getting a dispensary or getting more of the cultivation centers there. There was only one small town in western closer to Kansas City independence that really tried to fight back when it tried to put up barriers. But the amendment that was passed said that all communities had to accept these businesses.
Jeff Boedges: Okay.
Dr. Mimi Vo: But not a lot.
Rick Kiley: Have any of like the agricultural businesses that are in Missouri, like change their business to sort of get into it now that you know of? They would stop growing corn and stop growing some other crop?
Dr. Mimi Vo: No, I haven’t seen that. I know there was one old nursery in near Joplin, Missouri. There’s a physician, a cardiologist who bought that old nursery that was not in production, that was not working. There’s nothing growing at the time that he bought it in order to make that a cultivation center to grow flowers.
Jeff Boedges: Yeah. And most of the grow things that we’ve seen or heard about, they have to be inside. They can’t grow outside. So, no one’s really growing outside for the most part.
Dr. Mimi Vo: In Missouri, you can and some business models of cultivators here, how they have it is they would have because you could have 30,000 square feet of canopy. They have some of their canopy set up indoors for the high-quality flower and then they have the outdoor greenhouse or outdoor grows that they had planned on using for oils for extractions. So, I know some of the business models for companies here had that but correct, most of them are doing indoor or some hybrid model.
Jeff Boedges: Right. Is it an integrated model there? Because again, the way up here is most of the time it’s grow on-site, extract on-site, sell on site.
Dr. Mimi Vo: It can be vertically integrated, but Missouri didn’t require it. So, there were many people applied just for dispensary or apply just for a manufacturing processing license. So, the one exciting thing about Missouri is patients can grow on their own at home.
Jeff Boedges: That was my next question.
Dr. Mimi Vo: I have a lot of patients who grow and they love that part of it because it’s so meditative, and it’s such a healing process as far as grow your own medicine.
Jeff Boedges: Right. And what’s the limit on plants in Missourian production?
Dr. Mimi Vo: So, it’s eight clones or like eight small plants, eight non-flowering, larger plants. I think it’s like over 16 inches non-flowering and then eight flowering plants.
Jeff Boedges: And so, right now is that the number one sort of source for people who need medical marijuana in Missouri since the dispensaries aren’t open?
Dr. Mimi Vo: I would say it’s not the number one because the number of people who obtained, there’s over 50,000 medical patients in Missouri and not that many cultivation licenses that were awarded to patients, that were given to patients because you can apply as long as you…
Jeff Boedges: So, you have to get an extra license to cultivate so you can have one that says you do it but you’re going to have another that says you can grow it. Alright.
Dr. Mimi Vo: Actually $100 to apply for the cultivation license.
Jeff Boedges: Right. Good investment. Save you the dollars off your first visit to the dispensary. All right. And then, well, also we know right across the river there in Illinois, adult use has been legalized. So, how much money is driving across the bridge into East St. Louis to buy?
Dr. Mimi Vo: I would say a lot. Many of my patients that’s where they’re getting supply, and they do honor the Missouri medical cards so that patients do get like a 10% discount or some of the dispensaries have medical Mondays where they will only serve medical patients on those days but the wait is very, very long. I have a patient of mine who this was about maybe two months ago, a month or two months ago said that when the COVID outbreak started, they were having people line up in cars, and she says that cars were in four long lines. She was there for about an hour-and-a-half waiting in her car and the line really didn’t move much at all. So, she just left and went home. So, yeah, very, very long lines for sure.
Jeff Boedges: Yeah. So, actually, well, one last question about Missouri. I think you had mentioned to me or I read it someplace that there was some momentum gaining for adult use in Missouri. Is that also true?
Dr. Mimi Vo: Yeah. So, there was and we already had started signature collections. I was part of the advisory board for that initiative, with Dan Viets and a handful of people. They had already started signature collections and were really on par to get that happen but then with the COVID-19 outbreak that had to stop because they weren’t able to go out and collect signatures anymore. So, now, there’s another group, kind of in tandem, that’s looking at possibly this for 2022. Possibly even for next year. I know that there’s some talks about seeing how that can happen for next year.
Jeff Boedges: Okay, cool. Well, let’s keep our fingers crossed. Maybe on April 20, it’ll make the crossover. Alright. So, really, one of the things we wanted to have you in for today is to talk really about the 600-pound gorilla and that’s COVID and really how it’s affected nearly every aspect of life in the United States right now. But obviously, the cannabis industry is no exception. So, we want to really kind of ask you about your experiences with both COVID and with cannabis as it relates to both treatment and the impact on the business like what we just spoke about now about having to table the adult-use until next year. So, one of the articles, when I was doing a little bit of research on it, was that there recently was some frustration you were expressing about how hard it was to get equipment, how hard it was to get testing supplies and those types of things in the early days. How’s that going there?
Dr. Mimi Vo: Yeah. So, initially, it was absolutely horrible. This was about the beginning of March. There was a conference here at MoCannBizCon, Missouri Cannabis Business Conference. So, there were about like 500 all the cannabis business people and we were all together. A couple of people had viral illnesses and had said, “Oh, yeah, I’m better now and some people who got ill directly after that.” And I was starting to see lots of my patients with COVID symptoms. I couldn’t get them tested, called myself, try to figure it out myself. There’s one day that I saw three patients. I could not get them tested despite they had traveled back from Japan and Vietnam. And I that evening had an asthma flare-up so I was having trouble breathing and the very next morning at 9 AM or 8:30, I called my staff I said, “Meet me at the office. We’re getting our supplies. We’re shutting down. We’re switching to telemedicine now, like in 30 minutes.”
So, we got all of our things and we moved over to a warehouse building that I own because I morally I didn’t feel right sitting in my office and have people knocking on the door. It would have crushed me and I knew that. So, we changed directly over to telemedicine at that point. I then for the next few hours was calling the state between seeing patients trying to figure out how can I get myself tested? And I was told that, well, you can’t until you have a fever was one of the criteria and then the next day I developed a fever and I was like, “Well, I need to get tested,” and I still couldn’t try to get supplies from the lab and that had all been ordered previously, but still hadn’t received it and still couldn’t get it and I was just really frustrated. So, through other physicians and the network that I have reached out to media and there was an article in St. Louis Post-Dispatch, I think was like March 11 or 12th or so.
And I think that I was frustrated, but it was frustrations for many, many doctors about 1,000 doctors I’m on a Facebook group with that felt the same way in St. Louis alone. And nobody could really speak up because they all work for one of the three big hospital systems here and so everyone’s like, “Speak up. Nobody owns you. You have your own medical practice. You’re in private practice. Speak up. And here are some numbers. Why don’t you reach out to these people so you can get like some media attention?” And so, when that came out, it was very great to see that that that helped. Many people realize that this is here in St. Louis, that it’s not just an East Coast thing that there are cases here in St. Louis and that people need to take it seriously. So, I think that it really did help a lot of the people here take it seriously.
Jeff Boedges: Did the governor call you personally? Did the gov say…
Dr. Mimi Vo: No.
Jeff Boedges: No?
Dr. Mimi Vo: No. And I reached out to a lot of people in the Department of Health and people here emailed and got no response back. This was prior to going to the media but got no response back and people I’ve met before and actually talked to you in the Department of Health here in Missouri, that just heard nothing, was all crickets until I spoke to the media and it was like Mercy Hospital was like, “Come. We’ll test you,” and then LabCorp Vice President called me and say, “What supplies do you need? Let us get you the supplies,” and I’m like I’m one doctor. What about all the other 1,000 doctors telling me they’re experiencing the same exact issue? So, now the testing’s a little bit better. The LabCorp will give me five tests at a time. So, once I use those up, they’ll give me five more and then the hospitals actually their testing ability is much, much better and I’m doing antibody testing in my office.
Jeff Boedges: So, the big question is, did you test positive?
Dr. Mimi Vo: No, I was negative. And so, I was testing negative, but the false-negative rate is so high at 30% to 40% that I didn’t really just completely rely on that. I still self-quarantined for two weeks and did all that. And then when antibody testing was available, I drew myself and 12 other employees and family members that I had contact with during that period of time and I myself drove it to Quest Labs and said, “These are to run,” and I remember the guy looked at me and he goes, “We’re not even starting this until tomorrow.” And I’m like, “Great. Then we’ll be the very first people that do antibody testing on here in St. Louis.” All 12 of us came back negative so our antibodies were negative and my sister goes, “I feel like we just got rejected from corona college or something.”
Jeff Boedges: That’s really more like you got front row to the corona concerts.
Rick Kiley: Someone wrote somewhere that sometimes it feels like he or she had coronavirus like for an hour a day every day like it’s one of these things that it’s on your mind. You like get the symptoms. You think you have it. There’s still all this other stuff out there.
Dr. Mimi Vo: Oh, there are so many viruses.
Rick Kiley: I’m just having like it’s allergy season here and like tree pollens up I’m like, “Oh, I probably got coronavirus,” but it’s just allergies. It’s weird.
Jeff Boedges: I’m sure that’s why my hand hurts. It’s coronavirus.
Rick Kiley: So, other than the telemedicine, how else has COVID been affecting your business? Are you able to serve your patients the way that you want to?
Dr. Mimi Vo: The first few weeks it was really we were on a mode to try to triage. It was let’s keep the numbers in the hospital down. The hospitals are inundated. My friends who are in the hospital emergency rooms were just the waits were really long, patients were in the intensive care unit. I was just trying to triage and to save my colleagues who are in the hospital. My sister is actually a nephrologist at St. Louis University Hospital and my brother-in-law is a GI doctor at St. Mary’s Hospital. And so, we’re just triaging and trying to do the best I could for patients. It was working well for the first few weeks. Of course, there were times when it’s difficult because I don’t know if I’m doing the right thing. Really should that person go to the emergency room? It was a lot of calling them every day. How are you today? Did you check your oxygen levels? How are things going? Can we drop off an O2 set monitor for you so you can monitor yourself? And things like that.
So, the last about four weeks, I’ve actually started opening up. We’ve set up a curbside blood draw and curbside vaccines so you can drive up, stick your arm out, we can draw your blood and we get back on your way. So, that’s kind of been really interesting. Never thought that would happen.
Jeff Boedges: Vaccine, what are you vaccinating for? Because we can’t vaccinate unless you are. If you are vaccinating for COVID you can be really, really well off after this.
Dr. Mimi Vo: No. There are my patients who like it was time to get their third Hepatitis B of their series or they needed their Hep A or a slew of other things. Some still needing their tuberculosis screening tests with their PPD, things like that.
Rick Kiley: Got it.
Jeff Boedges: Cool. All right. So, as far as like the chronic conditions that you’re treating with cannabis, has this changed the drug’s efficacy at all, the COVID? Are you prescribing it less, recommending it less? Or how has it impacted your treatment using cannabis?
Dr. Mimi Vo: So, as far as patients who are using cannabis right now, what I have recommended as well as people in the Society Cannabis Commissions is to have patients continue to use cannabis if you’re using it chronically for pain or for insomnia or whatnot. Because right now with this added stress and with mental illness, we don’t want people to not use the medicine that they’re probably using that’s helping them. We do urge people to try not to use smokable products if they do develop and they do get sick, maybe not using their smokable products and using their oils or tinctures or edibles instead, but I think that it really hasn’t changed at all, the management of patients who use it chronically. I think it’s similar to what we’re doing with patients who have blood pressure or diabetes that doesn’t really change that other than being a little bit more cautious and people have underlying illnesses to be watching for fevers and for symptoms more closely.
Jeff Boedges: Are you using other herbs in your arsenal from your lessons to treat some of these issues as well?
Dr. Mimi Vo: So, not so much herbs but vitamins, a lot of different vitamins. So, we know that vitamin D deficiency that people who are vitamin D deficient have more serious illnesses and more critically ill when they develop COVID-19. From the very get-go, myself, my family, and my patients, I recommended everyone to take vitamin D supplements and it’s an anti-inflammatory and there’s a benefit of it in other viral illnesses too. There is a recently Medscape article and I haven’t looked at the actual journal article yet, but that patients who have vitamin D deficiency are eight times more likely to have critical illness. So, I’m having patients take their vitamins. Melatonin, I’m using also as an anti-inflammatory and helpful for patients. Vitamin C or zinc, I’m sure you guys are hearing all this with vitamin C and zinc for patients.
Jeff Boedges: I haven’t heard the C or zinc. The D in melatonin, I should have like preferred customer billing.
Rick Kiley: It’s part of my regimen as well.
Dr. Mimi Vo: Yeah. Oh, good, good. So, vitamin C, we’re using vitamin C infusions in the hospital in critical care, critical illnesses, critical patients as an antioxidative medication, and zinc is being used along with hydroxychloroquine in the hospital setting to prevent entry of virus into the cell. So, those are things that are being used. Although, I’m not personally using vitamin C or zinc. Just trying to make sure that I’m taking a multivitamin and eating healthy and exercise. It’s really important because we need to make sure we’re sleeping enough and be at the best health we can be in case we do get sick.
Jeff Boedges: And what about some of the more highly publicized effects of COVID like for instance, loss of taste This is one where I think like cannabis has got to be perfect for that because nothing tastes better than Oreos after cannabis. So, are you using it to fight any of the symptoms of COVID right now?
Dr. Mimi Vo: No. So, I’ve had six patients who tested antibody positive that I was pretty sure that they had COVID but I couldn’t get them tested initially. And three of those people actually their only symptom was anosmia. They couldn’t smell and they couldn’t taste. But those patients that had those symptoms on, they weren’t cannabis users. So, I did not recommend it.
Jeff Boedges: Are those people having an issue maintaining weight or they feel, I mean, I just got to imagine if you can’t taste or smell.
Dr. Mimi Vo: No. Still eating fine and their weight still had been fine. So, I think despite the fact that their food doesn’t taste right to them, one of the patients after it’s now six weeks, he’s 80% back as far as his taste and smell, and the other patient she’s about six weeks out and she’s about 50% better.
Jeff Boedges: Whoa.
Dr. Mimi Vo: Yeah, I’ve told them that it’s going to be about 8 to 12 weeks. And this does happen with other viral illnesses where the virus can attack those nerves and cause anosmia. So, we’ve seen this before. It’s just that the percentage is much higher with COVID-19.
Jeff Boedges: Yeah. That was a new one for me. I had never heard of anosmia before. Frankly, you’re the first person I’ve actually heard use the term anosmia. I’ve heard you can’t taste and smell which is funny because I run with a bunch of nerds so I would think I would have heard that but it’s a new one. I’ll be using it in dinner conversations tonight.
Rick Kiley: Nice.
Jeff Boedges: Yeah. All right. So, well, let’s switch just gears one more time here again. Because you work with MoCann and I know that you’re a partner at YEN-ology is really more on the legal side and you’re on the medical side. I would be just kind of curious because you seem like a student to the game, what do you think the chances are, the country and the states, in general, are going to go into a great deal of debt trying to keep everybody afloat during this time. So, I’m just kind of curious, what kind of effect do you think that might have on the prohibition and the illegalization of cannabis, especially for adult use?
Dr. Mimi Vo: What I’m hearing from people as far as the physicians from the side of cannabis clinicians and cannabis business owners throughout the country is they don’t think that it’s going to be a huge effect on the cannabis industry because that those who use cannabis as a medicine are going to continue to need their medicine and continue to be a user of cannabis. So, I think from that standpoint, I don’t believe that it will be or they don’t believe that will be a huge effect. I am personally not sure. I have heard from some businesses here who are starting up that they’re having some difficulty with investors because this is the new industry here in Missouri. So, as some of the companies won licenses, they weren’t completely capitalized yet. They’re still looking for investors and those investor dollars. One of the people that I spoke to, she said that the investors that she had been talking to are owners of casinos and people who are in the gaming industry. So, the casinos here are closed and I have no idea when those will actually open. So, that’s going to be difficult. For those companies who are starting up, I think it’s going to be very difficult for investment dollars.
Jeff Boedges: Right. Yeah. Well, clearly, they weren’t able to take advantage of PPP. They can’t avail themselves to any of the federally-created relief programs for obvious reasons. Have you talked to anyone who you feel like is not going to survive, any kind of people in the business who are going to suffer completely?
Dr. Mimi Vo: So, I think that I’ve seen a couple of ancillary services that are going to have some difficulty. Some of the consultants who are consultants for the industry, I’ve seen that they are struggling because they’re not able to travel to do the consulting work and these businesses are going to really focus on their core business and not do a lot of marketing and things like that. Ancillary businesses are going to be affected more. My business partner, Sarah and I, actually, we’re on our way to start off opening our cannabis learning center where I was going to educate people who want to be in the industry and educate them about cannabis science and how to be a dispensary agent and how to be a consultant for patients as well as teaching classes on CBD and pets or like using cannabis for people who are elderly and have chronic medical conditions. So, we have had rented a space, put down hardwood floors. We’ve gotten our things, ordered our tables and chairs, and me and Sarah we’re going to be educating. She doing the legal part, I doing the medical part, and also doing education for doctors and nurses and those people as well in an advanced science course.
So, that all has completely stopped because I can’t open when I can’t be doing courses in person. And our model was to do in-person training. There’s a lot of online training, that’s great and I’ve done like 10 of them. There’s great ways to learn online but we wanted, our platform was to learn in-person in order for that socialization part of it, but also to network and meet people and have a little store, a boutique part of that experience as well. And so, that’s completely stopped. So, we’ve been affected in that way.
Jeff Boedges: Yeah. I can’t imagine, like I said, that there’s very many people who haven’t been affected, very few but some very positively. So, we work in a lot of wine and spirit clients and some of these guys are having a real heyday. The spirit sales are way up.
Dr. Mimi Vo: And Amazon.
Jeff Boedges: And Amazon, yeah, Amazon, but I got to imagine too it’s too bad that the cannabis dispensaries weren’t open because I got to imagine this probably would be a heyday for them in Missouri.
Dr. Mimi Vo: Yeah. Well, I believe that they passed legislation recently to allow drive-thru that these dispensaries as they’re building out now that they’re going to have a drive-thru portion. So, that’s a positive and there were some legislators here who were trying to ban telemedicine, telehealth because patients were getting their medical marijuana certification cards via telemedicine. They wanted to ban that and just yesterday I just heard that actually that was for sure not going to be banned. I mean, everyone’s going to telemedicine so how are you going to ban telemedicine? That’s huge.
Rick Kiley: Yeah. And is anxiety one of the conditions that you can prescribe cannabis for in Missouri?
Dr. Mimi Vo: So, anxiety disorder, yes. Actually, Missouri’s list of qualifying conditions is actually long.
Rick Kiley: Okay. Got it.
Jeff Boedges: And you mentioned that what kind of certification does a doctor need in order to be able to prescribe? So, if I’m just an MD, I can’t start prescribing marijuana or I can?
Dr. Mimi Vo: As long as you’re an MD or DO with an active license in good standing with the board of healing arts here in Missouri. So, actively licensed.
Jeff Boedges: Okay. And so, when you’re going to do these classes for medical professionals, it was more just to sort of educate them on the symptoms and things like that that could be accurately treated?
Dr. Mimi Vo: So, as the board member of the Missouri Cannabis Trade Association and the Healthcare and Education Chair for the last two years, what I have been doing is actually going to these different medical groups and going to different hospitals and giving one-hour lectures. I put together along with other people on my committee a practical primer on medical cannabis where I put in research data, what it’s about, some pharmacodynamics and adverse effects and things like that in a one-hour eye-opening lecture and have been around the states speaking in hospitals and also actually gave at my alma mater, University of Missouri Kansas City School of Medicine. And that’s the very first time that a medical school has had actually cannabis education in the State of Missouri that’s not a part of a negative adverse effects kind of thing. So, it was something that I wanted to continue but also have a recurring course that was available for also nurses and vet techs and other people as well.
Jeff Boedges: What about nurse practitioners? Can they prescribe that kind of thing?
Dr. Mimi Vo: They can’t. As a nurse or a practitioner, they could be a consultant and educate patients and talk to them that they can’t sign off on a medical marijuana certification.
Jeff Boedges: And so, you mentioned that like going back to UMKC to lecture about the benefits and how to do it. Are any colleges or any of the big medical schools, are they starting to offer dedicated coursework and/or degrees in medical cannabis that you know of?
Dr. Mimi Vo: So, St. Louis University here actually SLU is starting a cannabis program. So, it’s going to be I think it’s a one-and-a-half-year program in cannabis science, where they’re going to go through the cannabis science, extractions, dispensary. They actually offer something similar for beer making and winemaking. And so, they’ve actually started this program and it’s going to start, it’s supposed to start this fall. And so, I’ve had a call out with the dean of the program and the assistant dean to be a part of that program.
Jeff Boedges: Okay. But that sounds more like the business side and less on the medical side to start at least.
Dr. Mimi Vo: Medical schools here we’ve actually reached out to all the medical schools and UMKC was the only one that would allow us to come speak.
Jeff Boedges: Well, that’s because you are the prodigal daughter. Is that what you call it?
Dr. Mimi Vo: No. It was really because like the other person who spoke with me, she also is a UMKC grad. So, we both are from UMKC. We know that the dean, he’s been there since when we were students a long time ago and so we were able to get in.
Jeff Boedges: That’s cool. All right. So, those are pretty much my questions. Rick, you got anything else you want to answer before we get into the crystal ball time?
Rick Kiley: No. We got to wrap it up with the same crystal ball here. So, we call this a podcast The Green Repeal for a reason. It’s because Jeff and I firmly believe that cannabis will be federally legal in the United States at some point in the not too distant future. We’re curious as if you, in fact, share that same feeling. And if so, when do you think it’s going to happen?
Jeff Boedges: We really got to get the pool.
Rick Kiley: Yeah. We have a pool going.
Jeff Boedges: Yeah. So, if you win, you’re going to win like $25 maybe. It’s a lot.
Rick Kiley: Yeah. Get a point in my new nasal strip company.
Jeff Boedges: Oh, man, that’s generous.
Dr. Mimi Vo: Wow. Okay. A crystal ball. I do share that sentiment that I think that it should be federally legal and that that it will be. As far as timing, I’ve listened to you guys. I know that some people are very optimistic. I’m probably more thinking like within the next 10 years.
Rick Kiley: Yeah. And you think medically, adult-use?
Dr. Mimi Vo: So, medically probably sooner. Yeah. I think adult-use maybe 10 years. Medically, four years.
Rick Kiley: All right, four years.
Dr. Mimi Vo: Missouri’s the 33rd state.
Rick Kiley: Yeah. I thought it was 35 but you probably know better than I do. So, yeah. All right. We’ll get there. We’ll get there. Well, this has been great. You have been a pleasure to talk to and you have a spectacular amount of information. I hope your business continues to do very, very well and you survived the telemedicine transition.
Dr. Mimi Vo: Thank you.
Jeff Boedges: I think it’s easier to survive that than the other way around.
Dr. Mimi Vo: I’d like to see us not be so divided as a country. I need to survive that.
Rick Kiley: Yeah.
Jeff Boedges: Yeah.
Dr. Mimi Vo: And just we need to bring more love and kindness to this world is what we need.
Rick Kiley: That’s a great way to close I think right there.
Jeff Boedges: Yeah. Thank you. I’ll take a lesson from that. Actually, I won’t even go into it but I had another conversation today. Someone else gave me that exact same wish today from St. Louis oddly, so I think everybody in St…
Dr. Mimi Vo: Midwesterners are loving and kind people.
Jeff Boedges: Yep. Yep.
Rick Kiley: I believe it.
Jeff Boedges: Well, you’ve been in business partners with one.
Rick Kiley: Yeah. Well, that’s been the problem, Jeff.
Jeff Boedges: Exactly.
Rick Kiley: The exception that proves the rule.
Jeff Boedges: Alright. So anyway, listen again, I think we’ll sign off here but thank you, Mimi. Dr. Vo, you’ve been fantastic.
Dr. Mimi Vo: Thank you for having me.
Rick Kiley: Cheers.