Dean Wilkerson, JD, MBA, CAE, tells of a physician who recently moved from New York to Texas and sought a medical license in her new home state.
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ACEP Now: Vol 34 – No 04 – April 2015The physician, also licensed in Pennsylvania, had been sued twice, but the suits were dropped each time, said Wilkerson, Executive Director of ACEP and a former corporate attorney in Texas. Yet in the process of applying for her third medical license, she was required to track down original documentation to prove she was fit to practice and dredge up her medical education records from the 1970s. For now, she is on a six-month waiting period.
“They’re putting her through hell,” said Wilkerson. “She has a license in New York and Pennsylvania, and Texas is acting like she just got out of prison.”
Practical Solution to a Multifaceted Problem
The anecdote highlights one of the numerous barriers physicians may face when seeking medical licensure in a new state. A new interstate licensure compact created by the Federation of State Medical Boards (FSMB) aims to simplify the process, reducing the hurdles physicians must surmount while improving access to care for patients and maintaining their safety. Several states are now considering draft legislation to adopt it, while others remain wary.
“Medical boards want to protect the public from unethical practitioners, but it seems very burdensome, time-consuming, and expensive to get a license in a new state,” Wilkerson said. “It creates barriers to expanding physicians’ service and access to care for patients.”
If adopted, the compact would allow states to access background and credential checks, disciplinary histories, investigative actions, and more from the state in which a physician holds a principal license rather than putting the onus of primary documentation on the individual physician. All compact states in which a physician seeks licensure could then share that information, reducing inefficiencies, expediting the approval process, and enabling innovations like more widespread adoption of telemedicine.
“Iowa’s doing all this work to make sure I’m a good physician,” said Hans House, MD, FACEP, ACEP liaison to FSMB, professor of emergency medicine at the University of Iowa, and ACEP Board member. “Illinois shouldn’t have to reinvent the wheel.”
“Emergency physicians can and do move from state to state, unlike a family medicine doctor who develops a bunch of patients, and it may not be as easy to pick up and move to California,” said Wilkerson. “We would really like to see a more streamlined interstate licensing system to account for the movement of our members over time.”
“Emergency physicians can and do move from state to state…We would really like to see a more streamlined interstate licensing system to account for the movement of our members over time.”
—Dean Wilkerson, JD, MBA, CAE
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One Response to “Interstate Compact May Simplify Getting a Medical License in a New State”
April 19, 2015
Louise B Andrew MD JDSome states, such as California, put physicians who have been sued by the justice system through the “hell” Dean mentions again, just as soon as the litigation is over, and even despite a defense verdict. This extended scrutiny and judgment by peers is for some more painful than that by a lay jury of non-peers.
It would make a lot of sense if boards which inflict this double jeopardy on their physicians would formally (at least in those cases where the board has determined that there was no fault or no negligence) allow the physician to not report the existence of a case at all on future licensure applications, without fear of censure for non-disclosure.
This is similar to what a physician health program does with a physician who has a medical condition that could impact patient care if not monitored, but is either cured or fully compliant with treatment.
Like the Interstate Compact, this idea is something that we, through our quite informal representation at FSMB and through those ACEP members who are actually active on or head state medical licensure boards, could promote. We could also through our formal AMA representation get that body behind such a move.
We are uniquely vulnerable as emergency physicians to these stressors, because we moreso than many other practitioners are likely to practice in several states over a practice lifetime, or even during a single career with certain companies.