In Mississippi, where Dr. David Allen worked as a heart surgeon, authorities seized his home and ranch this year after finding $800 worth of marijuana and $1,000 in hashish. A grand jury is to consider a cultivation charge that could net him 30 years in prison under Mississippi's drug laws.

In Sacramento, where he now lives, Allen is a legal, licensed member of a community of physicians that enables hundreds of thousands of Californians to lawfully consume or grow marijuana for personal use.

His recently opened cannabis evaluations clinic on Auburn Boulevard is a newcomer in an increasingly robust medical industry. Born with California's Proposition 215 in 1996, the profession is newly energized by the federal government's recent decision to relax enforcement policies for 14 states that have legalized medicinal use of marijuana.

Voters approved California's Compassionate Use Act amid stories of AIDS patients needing marijuana to boost appetites and cancer patients needing it to counter nausea and other side effects of chemotherapy.

These days pot physicians, touting marijuana as a healthier alternative to pharmaceuticals, are writing medical cannabis recommendations for a far wider range of ills, from restless leg syndrome to psoriasis, from sleep apnea to menopause.

The widely available doctor's "recommendations" – they're not formal prescriptions – stir intense debate in the medical community, even among cannabis doctors.

Doctors argue over whether the recommendations, costing anywhere from $50 to $250 each, go to patients who truly need medical marijuana or help facilitate recreational drug users and provide hefty profits for the doctors writing the notes.

Doctors are barred by state law from giving out marijuana or instructing patients where to get it. But cannabis recommendations are necessary for patients to make their purchases at the pot dispensaries now sprouting like Starbucks in some communities.

The dispensaries must operate as nonprofits. The doctors are under no such constraints.

170,000 patients seen

Already, a lucrative medical industry is taking shape with pot evaluation networks such as MediCann, a "health and wellness service" started with one San Francisco clinic. It now operates 20 offices in California – including sites in Sacramento, Elk Grove and North Highlands – and has overseen the care of 170,000 cannabis patients since 2004.

"The growth has been steady. We open up a new clinic every few months," said Matthew Desanto, MediCann's marketing director. "Honestly, it's just that patients need to use cannabis as medicine."

In the past year, another group, Marijuana Medicine Evaluation Centers, opened clinics in 10 California cities. It advertises on "WeedMaps," an Internet service for patients seeking doctors, dispensaries and other pot services.

The newfound visibility of the medical marijuana trade is pronounced on the eclectic boardwalk of Venice Beach in Los Angeles.

Along the boardwalk's short span, greeters work the crowd in front of three oceanfront clinics, pitching the benefits of medical pot. One large beachfront house holds the Medical Kush Doctor physician's office and the Kush Clubhouse dispensary. Another doctor's walk-in clinic is next door to a dispensary entrance, where a woman shouts out: "Free hash bar – patients welcome!"

In his Sacramento office, where medical diplomas are displayed with a news article on a rare beating heart bypass surgery he performed in Mississippi, Dr. Allen is bullish on his career change to full-time pot doc.

Allen was living in California last February when his Mississippi ranch was raided. He denies participation in any illegal marijuana activities.

Jackson County, Miss., Sheriff's Lt. Curtis Speirs said Allen is being investigated for felony cultivation and distribution.

"In the state of Mississippi," Speirs said, "whether you think it's for medicinal use or not, it's against the law."

In California, Allen charges $150 for medical evaluations and exults over his work with pot patients.

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