TRENTON Four years after New Jersey became the 14th state to adopt a medical-marijuana program, legislators took testimony from dispensary operators and patient advocates who are proposing changes to give the struggling program a jump-start.

After the hour-long Assembly Regulatory Oversight Committee hearing ended Thursday, Chairman Reed Gusciora (D., Mercer) said the legislators would discuss the issues and "hopefully make improvements to the program" by introducing legislation and working with the state Department of Health.

Among the recommendations aired:

The department should revoke the three-year-old licenses of three dispensaries that have not yet opened and allow other operators to apply.

Doctors should be able to write prescriptions without being required to register for the program.

Chronic pain and post-traumatic stress disorder should be added to the dozen qualifying conditions.

The patient registration fee should be reduced from $200 - the highest in the nation - to $25.

Michael Weisser, who represents an association of the three New Jersey dispensaries that are open and the three that are planned, said the dispensaries had more cannabis than customers.

The "stringent rules of the program" make it difficult for patients to find a doctor to approve them for marijuana, and then to pay the $200 registration fee and the cost of having a doctor recertify them for the drug every three months, he said.

Weisser, who is also the chief operating officer of the Garden State Dispensary in Woodbridge and who operates eight dispensaries in Colorado, said many New Jersey doctors "are reticent" about having their names appear on a public list of registered marijuana doctors.

This creates a shortage of doctors who may approve the drug, he said. Making this registration voluntary would address the problem, he said.

He also suggested adding chronic pain to the list of ailments that are eligible for marijuana treatment, saying it was a "real, real problem and it ruins people's quality of life."

To avoid potential abuse, Weisser said, a patient with this condition could be required to get approval from two doctors.

Ken Wolski, a nurse and executive director of the Coalition for Medical Marijuana New Jersey, said patients were frustrated that they had to drive for hours to purchase the drug because so few dispensaries are open. He and others have urged the Health Department to allow other operators to apply for a license to open a dispensary.

"The goals of the Department of Health should be for the patients to have timely, affordable access to medical marijuana," Wolski said.

He also said there was "a great deal of ignorance and misinformation in the medical community that needs to be addressed" so more patients could get the pain relief they needed.

Health Commissioner Mary E. O'Dowd said in a statement read at the committee hearing that her department was "currently finalizing two reports" that will outline the program and provide statistics on how it has been implemented.

So far, she said, there are more than 1,700 patients, and "nearly 80 percent of them have been served" by the three dispensaries that are open. Two of the dispensaries that are planned are undergoing background checks. The sixth is in the process of building, she said.

"A clear priority of the program has been a focus on customer service," she said, adding that the department has responded to more than 16,600 calls and e-mails.

A department representative said that about 47 percent of patients and caregivers qualified for a reduced registration fee of $20 after providing documents showing they could not afford the $200.