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Dr. Roger J. Foster's examination room is in a seedy office next to a boarded-up Sacramento city incinerator in a scruffy Alkali Flat lot of warehouses and used car dealers.
Foster's office has no stethoscope or blood pressure cuffs – or, for that matter, Foster, at least not in the flesh. It does, however, have a computer with a camera mounted on the monitor.
Bedraggled customers filled every seat the other morning, waiting for the receptionist to usher them into the exam room, where they would speak to the doctor via Skype.
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After a few minutes – two or three, not much more – each would emerge, pay $40 cash, plus another $10 cash to have their photo taken and glued onto a laminated "takecare420.com" card authorizing them to possess and grow marijuana for personal use.
On his website, confidential420.com, Foster enumerates 249 conditions that could qualify for a card, among them cancer, AIDS, diabetes, schizophrenia, nightmares, stuttering, genital herpes, cocaine and amphetamine dependency, and (editor, take note) writer's cramp.
I couldn't care less what consenting adults inhale or ingest. But as Dr. Skype's operation shows, medical marijuana in California is much less about relief for people who have AIDS or suffer from the harsh effects of chemotherapy than it is about making an easy buck, cash only, please.
Foster graduated from Wayne State medical school in 1948 and has been licensed to practice medicine in California since 1953. He is 90, but stays busy, maintaining Skype-office hours of 11 a.m. to 6 p.m. five days a week, and noon to 4 on Saturdays.
During a lull, I asked to talk with him. The receptionist typed an email and a man with multiple earrings stepped out from a side room and introduced himself as Terry Colorado, the business manager. No, he said, the doctor wouldn't chat.
Colorado said the doctor speaks to his customers from Los Angeles, though records reflect a physician by Foster's name has an address in Las Vegas.
"There's nothing illegal and nothing fraudulent," Colorado said. "Nothing anywhere says you can't use Skype. Not Skype; let's say 'telemedicine.' "
Foster might have gone on operating as he has for the past 18 months, except a Christian group, International Faith Based Coalition, is protesting on behalf of Now Faith Church of Deliverance, which is one door away. Bishop Winston Harris said his flock includes children, who must walk past Foster's customers to enter the house of worship.
"They smell like marijuana," Harris huffed.
Minister Marvell Wilson, who is helping Harris, made a point of telling me that as a man of God, he cannot lie. But he also wanted to check out Foster's operation. So he filled out the requisite form a few weeks ago and was ushered into the exam room.
Wilson said he told Foster by Skype that his back hurts. He timed the "exam" at 42 seconds. He returned to the receptionist and counted out $40 for the exam and $10 for his takecare420 card, though he's dead set against drug use.
"We're going after the concept that allows someone to bring this element to a sanctuary," Wilson said. "The idea that someone could use legality to bring about immorality is what we're going after."
Ever since 1996, when voters approved Proposition 215 authorizing medical marijuana, lawmakers have tried and failed miserably to regulate the wacky industry.
Under pressure from federal authorities who have shut down largely unregulated marijuana operations, legislators again are proposing bills they say would offer some order.
Legislators call the bills works in progress. More accurately, they would be sops to emerald entrepreneurs who, if they become legit, could show their gratitude by providing tax revenue and campaign money. Supporters include the United Food and Commercial Workers, which represents pot shop workers and is part of Democrats' labor support.
Assemblyman Tom Ammiano, a San Francisco Democrat who has pushed several marijuana bills during his tenure, is proposing Assembly Bill 473, which would place marijuana stores under the regulatory control of the Alcoholic Beverage Control Board, a department that has done a stellar job of limiting liquor stores in poor urban areas.
Senate President Pro Tem Darrell Steinberg, leading the Senate effort, said his Senate Bill 439 is intended to regulate the industry so the feds will stand down and let shops dispense weed to people in need.
Steinberg said his bill ensures that cities and counties would retain the power to ban marijuana stores, a right that the California Supreme Court affirmed earlier this month.
Indeed, the legislation does say cities could use zoning ordinances to ban dispensaries. But the bill also would strip local prosecutors of the power to charge operators with criminal wrongdoing.
"This bill is opposite of local control," said Sen. Ted Lieu of Torrance, the only Democrat who bucked the Democratic leader and joined Republicans in voting against the bill. "It pre-empts local law enforcement."
Neither Steinberg's nor Ammiano's bills would regulate doctors who issue scripts. The oversight is so significant that it must be intentional. If doctors can issue scripts to customers for the asking, whether they are ailing or not, the dispensaries that the legislation would legalize would boom.
California's failure to regulate pot doctors raises many issues. Here's one: Steinberg has carried legislation to help people with severe mental illness. The list on Foster's website of 249 conditions that could be treated with marijuana includes schizophrenia and bipolar disorder. Studies have shown marijuana use can exacerbate severe mental illnesses.
Taken aback that a doctor might approve marijuana for people who are severely mentally ill, Steinberg said: "The last thing people with schizophrenia need is marijuana."
Then there's the issue of using Skype to examine "patients." Medical Board spokeswoman Cassandra Hockenson said the board expects doctors to conduct actual, not virtual, exams before authorizing marijuana use.
"You can't do a physical examination over Skype," Hockenson said.
Dr. Skype's business manager disputed that in an email, saying: "Telemedicine is in fact in-person, face to face. If the Medical Board of California intended the evaluation to include a physical examination, in the physical presence of the doctor, it would have stated so."
The Medical Board is not known for moving quickly. Dr. Skype's license to practice doesn't come up for renewal for another two years. He can conduct plenty of exams between now and then, collect lots of cash and issue many more laminated takecare420.com cards, via Skype from Los Angeles, Las Vegas or who knows where.