SALT LAKE CITY — Doctors in Utah's largest health care system will be now able to recommend cannabis for patients who have conditions that qualify under the state's new medical marijuana law.

Intermountain Healthcare announced Thursday that it has created a process in which a letter can be given to patients affirming their relationship with their provider, that they have a qualifying condition and could benefit from medical cannabis treatment.

"We're ready for patients to meet with their physicians, their nurse practitioners, physicians assistants, and begin the conversation around, 'Is medical cannabis something that I should consider? Is this something given my health conditions, do you think this might help?''' said Mark Briesacher, Intermountain's chief physician executive.

Utah voters approved a ballot initiative, Proposition 2, last fall legalizing medical marijuana. State lawmakers later replaced it in December with a more restrictive law in what they described as a compromise with Proposition 2 backers.

Patients who receive the letter would still have to buy their drugs illegally on the street or the black market in Utah or travel to a state that offers recreational marijuana. Medical cannabis dispensaries are not scheduled to open in Utah until 2020.

"While we're applauding that this effort has happened, right now the state's turning a blind eye as to where you're actually procuring your medications," said Christine Stenquist, founder of Together for Responsible Use and Cannabis Education, which launched the citizens' initiative. "Patients are still suffering a little bit, but we're moving the ball down the field."

Intermountain talked to patients, families, advocates, doctors, nurses and pharmacists to understand what they need, what the law means to them and what the law requires, Briesacher said.

"We've worked diligently to verify protections to providers who choose to give letters to their patients and ensure our process fully complies with state law," he said.

Briesacher said Intermountain is not mandating that health care providers discuss medical marijuana options with their patients. And the letter is not a prescription, but rather a recommendation. He likened it to a doctor suggesting ibuprofen or vitamin supplements.

Patients would determine what form and dose of cannabis to use like a diabetic determining how much insulin to use.

"We're not getting into dosing at this point," Briesacher said, adding that comes later as the law is implemented.

"This is the first of many steps to come," he said. "There are still many things for us to understand."

Marijuana use in any form still remains against federal law. Briesacher said the risk of Intermountain running afoul of federal is low but not zero.

"This is a new risk for us," he said.

Former Republican state Sen. Steve Urquhart said he hope's Intermountain's program would shift the discussion from politicians, lobbyists and special interests "who know very little about this topic" to a dialog between patients and doctors.

"I think that will change everything. There's needs to be changes in the law, and I'm hopeful that Intermountain will take the lead on this," he said.

Though medical cannabis advocates lauded Intermountain's move, at least one of them said he thought it would have taken much longer for the hospital to get to this point.

Connor Boyack, Libertas Institute president, said he had low expectations and expected a fight with health care providers to get the medical marijuana program going. He said it would fall "flat on its face" if doctors wouldn't recommend marijuana treatment.

"I'm honestly and very pleasantly surprised," he said.