“Telemedicine is growing as a solution for our Midwest states, where there are shortages of emergency physicians,” said Dr. House. “It’s attractive for those who practice telemedicine and need licenses in every state where patients are being seen.”
Explore This Issue
ACEP Now: Vol 34 – No 04 – April 2015Last year, the FSMB developed model interstate compact legislation, and to date, 13 states have drafted bills to adopt it. In order to work, the compact must be implemented in seven states, said Donald H. Polk, DO, chair of the FSMB, a family medicine physician, and chair of Tennessee’s osteopathic board.
Of the 70 FSMB member state medical and osteopathic boards, 27 have endorsed the compact, Dr. Polk said. Some are enthusiastic supporters, while others are waiting for more information or to see if it works in other states.
“Some don’t want to be first,” said Dr. Polk. “Others want to be in on it from the beginning.”
How It Would Work
The compact would involve the formation of an interstate commission composed of two representatives from each participating state to oversee compact activities. These could be physicians, members of the public, or state board executive directors.
A physician’s state of principal license would perform all of its traditional licensure duties, including verifying medical education, issuing licensing examinations, and conducting criminal background checks. States that join the compact would have access to that data, expediting the licensure process when qualifying physicians apply. The compact sets high standards for physicians wishing to participate in expedited interstate licensure. For instance, they cannot have been convicted of an offense or disciplined by a licensing agent.
Each state would, as in the traditional licensure mechanism, maintain jurisdiction over that license, and physicians would be held accountable to the states in which their patients live; however, a violation in one state would become the purview of all licensing states, and action against a physician could be taken in each.
This is one of the reasons the Minnesota Board of Medical Practice (MBMP) supports the compact and is eager to see the bill currently in its state legislature, which it did not introduce, signed into law.
“It’s a good solution to finding ways to enhance portability without jeopardizing state sovereignty, which is very important to Minnesota,” said MBMP Executive Director Ruth Martinez. “It’s a constructive, thoughtful solution to a problem a lot of states are experiencing.”
Like the compact between states that issue driver’s licenses and allow motorists from other states to travel through their borders, the FSMB recognized it was important for states to maintain control rather than attempt to move to a national process.
Some Reservations Remain
Some states remain concerned the compact will supersede their licensure requirements or worry about the costs of funding the interstate commission and the authority of the FSMB to set some rules, such as fees for licensure. The compact also does not address state-specific continuing medical education requirements, which can add up to hundreds of hours each year for physicians licensed in multiple states.
Pages: 1 2 3 | Single Page
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.