While patients and producers involved in the New Mexico medical cannabis program brace themselves for the possibility governor-elect Susana Martinez will try to dismantle the program, the question of who she will appoint for Health Secretary figures as an important factor in the equation.

Gov. Bill Richardson himself has been a staunch supporter of the program, but his Secretary of Health, Dr. Alfredo Vigil, has been the focus of some frustration among providers, prospective providers and one former colleague. Former Medical Cannabis Program Coordinator Melissa Milam says Vigil told people in the program that he thought patients use medical marijuana because they don't have health insurance to get prescription drugs.

"Even after all these years, I don't think Secretary Vigil truly understands that medical marijuana works," Milam tells SFR. "This program is necessary and a lot of people in the state would be dead if it weren't for medical cannabis. I wish that he had a better understanding of the urgency of the fact that there's not enough supply to meet the demand."

Vigil sounded like a believer when he spoke with SFR, however.

"During the committee hearings when the original legislation was considered, there were people who were dying from cancer and HIV and other problems who came and testified, and I think we have very good information that those people have been benefitted," he says.

But Milam says Vigil has been one cause of the backlog of applications pending approval, "by not doing anything."

"It's been like pulling teeth," she says.

Patient Larry Love, who is starting his own medical marijuana call-in Podcast, notes that historically, Vigil has erred on the side of law enforcement by ensuring that only a conservative number of producers was approved at each go-round.

"Back in June (the DOH) did 11 visits to applications that were up to par - site visits," Love says. "The DOH sends people over to the location where the applicants are going to grow the medicine. In the beginning of July he approved five of the 11. In September they did 11 more site visits and only approved six. So looking at what Dr. Vigil has done in the past is that he has approved about 50 percent of what was needed at the time."

Albuquerque attorney Jeremy Theoret, who represents two current producers and six applicants, tells SFR he has seen instances where one producer is able to get approved while another one with a similar application isn't.

"It does seem like they're going to pick and choose wherever they need someone, and I think that's why (Milam) was I believe advocating if you meet the criteria you should just be accepted, because otherwise it does kind of seem arbitrary," Theoret says. "If you have done all the right things and you're not approved and somebody else is, I think that's the danger of having that kind of discretion and picking and choosing, because it does open that possibility."

Department of Health spokesperson Deborah Busemeyer tells SFR that because the purpose of the program is to serve the patients, the DOH considers the geographic area an applicant would be able to serve to be an important part of the criteria. One reason a producer might not be approved could be an inability to serve areas outside the producer's immediate area, or inability to serve the parts of the state where producers are most needed at the time, she said.

"I believe the Secretary of Health has been a cautious steward of the program, and I am not going to complian about his stewardship," State Senator Cisco McSorley, D-NM, a strong supporter of the Medical Cannabis program, tells SFR. "I agree with the Department's emphasis on trying to keep a close eye, and that's why I believe that the Department needs some resources."

Busemeyer says because New Mexico's Medical Cannabis program was the first one nationwide to establish a cannabis distribution and production system, the DOH is constantly evaluating the program to ensure that it functions as intended.

"We're trying to learn lessons as the program matures and figure out how to make sure the patients are getting what they need without creating any excess supply in New Mexico," Busemeyer says.

Although Martinez's transition team wouldn't release much information about the selection process for the new Secretary, Dr. Steve Komadina, former state Senator, obstetrician and chairman of the search committee for new DOH appointees, says the committee submitted a short list to Martinez about three weeks ago.

Santa Fe radiologist and former gubernatorial candidate JR Damron tells SFR that he went in for an interview with the transition team last week. Although Damron wasn't questioned about his position on policy issues, Martinez already has a sense of his views because he served as a health care advisor on her campaign.

"She understands pretty much what I believe, and we align pretty well," Damron says.

Damron says that as a diagnostic radiologist, he was not involved in directly treating patients in his practice, so medical marijuana isn't an issue that ever came up in his clinical work.

"Whoever takes over that position as Secretary of the Department of Health is going to have to understand that we have a governor who has come out against (medical cannabis), and feels that there are other medications that can do the same thing," Damron says. "I have not had that conversation with her, so I would if I were in that position."

Damron tells SFR that he agrees with Martinez that other medications can help patients with HIV/ AIDS, cancer and other chronic conditiions just as well. He mentions the synthetic form of THC, Marinol, among the alternative medications.

Vigil tells SFR that Damron "has shown a lot of concern and devotion to health policy issues."

Komadina himself has also been a name that has been floated as a prospective Health Secretary appointee, despite his role on the search committee. Komadina was a major sponsor of the Lynn and Erin Compassionate Use Act.

"The bill got taken away from me and given to (McSorley) because they didn't want a Republican to carry it," Komadina tells SFR. "I think there's a lot of good medical evidence that it's one more tool that can be used by physicans to help their patients in a variety of situations...I think it was good to give physicians one more thing that they could use to try to help people."

Komadina, who is also known as the pilot of the stork-shaped hot air balloon dubbed "Great Eggspectations" that makes appearances at various festivals, says Martinez's choice of Health Secretary shouldn't have a dramatic impact on the program, because "it's the law in the state of New Mexico, and it's the job of the Secretary to carry out the program."

Las Cruces pediatrician Catherine Torres has also been mentioned as a potential appointee.

Torres was appointed to the United States-Mexico Border Health Coaltion in 1999. According to a press release, she was part of a medical team that provided health care to rural areas near Las Cruces, along the US-Mexico border.

Torres didn't return calls for comment.

Another rumor is circulating that Vigil might stay in the administration, Theoret says.

"I have put my hat in the ring, because I care very much about the Department," Vigil tells SFR. "The three years I've spent I've just gotten started making long-term improvements in various areas."