"Cannabis is a miracle drug that works so well for so many reasons, for so many people, that millions are willing to risk jail and property seizures to use the medicine," he said.

He said he is dedicated to serving the people who tell him that cannabis "is better for my migraines, for my asthma, for my menstrual cramps" than traditional treatments. "How can you deny these patients?"

Construction worker Brent Bomia, 36, who said he had back surgery after a work-related fall, showed up with his medical records and got a recommendation from Allen.

"I'm happy he is here," said Bomia. "I believe as a community this is a steppingstone to more people realizing medical marijuana really helps."

Prop. 215 applied broadly

Under Proposition 215, physicians can recommend cannabis for cancer, anorexia, AIDS, chronic pain, spasticity, glaucoma, arthritis, migraines or "any other illness for which marijuana provides relief."

Clinical support for pot's potential health benefits comes from the likes of Dr. Donald Abrams, chief of oncology at San Francisco General Hospital and professor of medicine at the University of California, San Francisco. Abrams conducted state and federally funded research that showed marijuana to be beneficial for patients with HIV and for pain from nerve damage.

"I see cancer patients every day who suffer from loss of appetite, weight loss, pain, anxiety, depression, insomnia and nausea," he said. "With cannabis, I can recommend one medicine instead of writing prescriptions for six or seven."

But Dr. Lee Snook, a Sacramento pain physician who serves on the public policy committee for the California Society of Addiction Medicine, is alarmed over the burgeoning use of medical cannabis.

Snook, who heads Metropolitan Pain Management Consultants Inc., said he encounters many patients with marijuana recommendations who don't need them or are better served by other treatments.

"People go into an outpatient clinic, say, 'I have chronic pain,' pay $100 for a card," Snook said. "That's it. I see it as a business. I don't see it as practicing medicine at all."

The National Organization for the Reform of Marijuana Laws – which advocates easing marijuana restrictions – lists more than 160 California doctors and clinics as "medical cannabis specialists." Their work, as with all doctors, falls under the scrutiny of the California Medical Board.

Since 1996, the board has investigated 81 complaints against doctors who recommended pot to patients.

Regulators revoked licenses for 10 physicians for violating guidelines published to ensure they conduct in-person "good faith" examinations and review patients' health and medical histories when recommending cannabis. Some were sanctioned for failing to detect overt, drug-seeking behaviors.

Medical Board records indicate some pot doctors attracted attention after other physicians or psychiatrists complained. Other complaints came from undercover police who said they got cannabis recommendations with little or no medical exam.

All 10 license revocations were stayed and the doctors allowed to continue practicing under supervised probation.

In July, the Medical Board sanctioned Dr. Robert Cohen of Santa Monica for recommending cannabis without a physical exam or patient records for a board investigator who said she was a mother of five and needed pot to relax.

In August, the board found that El Dorado County doctor Marion Fry improperly recommended marijuana to a patient with chronic paranoid schizophrenia despite warnings from Merced County health officials that pot exacerbated his condition.

The board put Fry's medical license on probationary status for three years. That action came two years after she and her husband were sentenced to federal prison for conspiring to grow and distribute marijuana. A trial revealed that her medical pot recommendations netted between $750,000 and $1 million over a 26-month period.

Even some pot doctors question whether the expanding industry has sufficiently established standards and oversight.

Dr. Frank Lucido, a Berkeley family physician and leader in the medical marijuana movement, worries about a proliferation of "quick-in, quick-out mills that pretty much give out cannabis recommendations to anyone 18 or over that has money."

"It gives the industry a bad name," he said.

Lucido said he pre-screens patients in a telephone interview, conducts 45-minute examinations and requires medical records documenting serious health issues.

Then, there is Venice Beach.

On an oceanfront featuring four new pot clinics, one employee drew in passers-by by handing out fliers adorned with a cannabis leaf and a list of medical conditions.

"Do you have any of these?" he asked. "We can get you a recommendation. It will only take a few minutes."

Gilbert, a 42-year-old Los Angeles man who didn't want his last name used, was in and out of the doctor's office next to the hash bar. He got a cannabis recommendation minutes after a brief exam and blood pressure check.

"He asked me what medications I was on and what do I think marijuana would do," said Gilbert, who said he smokes pot to alleviate pain and high blood pressure.

"Pot smokers are going to be pot smokers. If this is going to make them feel better, then so be it."

Call The Bee's Peter Hecht, (916) 326-5539.