Interstate Licensing and the Quest to Expand Health Care Access
Imagine you were away from home and on vacation in Florida, and while you were out having a great time water skiing, you fell from your skis and broke your wrist.
Oof.
Aside from the pain of the injury and the interruption of your holiday, I don’t think that most of us would be overly concerned about the quality of the care we would receive in Florida, just because we weren’t home; even though you might be distant from your own doctor in, say, Missouri, you would probably have little concern about the level of expertise you’d from a doctor in the state you’re visiting. Whether you broke your wrist in Florida, Missouri, Texas, Michigan, or wherever, I think we can all agree that a doctor in one state is trained close to the same way as, if not identically to, a doctor in another state.
Now imagine if your state prohibited doctors practicing in good standing in other states from practicing in your state. If your state needs doctors, this would seem like an unusual decision, and yet licensing laws across the country tend to do achieve precisely this end — making fewer practicing doctors available to patients. While most of us recognize that doctors do pretty much the same things from one state to the next, our state licensing regimes can make it difficult to expand care options to their own citizens by, in my view and others’, keeping physician supply away from patient demand.
Unnecessary restrictions on doctors who could practice in multiple states don’t just impact those who could be physically present in a state. In fact, technological advances, like what we’re seeing in telemedicine, have opened the door to letting doctors hundreds of miles away to promptly and accurately diagnose the problems a patient might be having while they’re in their own homes.
And depending on the situation, a patient may prefer telemedicine with a doctor, wherever that doctor might be and for all sorts of good reasons. The patient may live in a rural area without easy access to a hospital. They may be uncomfortable immediately bringing their medical problem to an emergency room for fear of unnecessary expense. They may simply prefer talking to a doctor at a distance rather than up close and personal.
Whatever the advantage, however, I think we can all appreciate that the location of the doctor and his license is usually irrelevant — just as where we are when we see the doctor is largely irrelevant. Whether I’m in Florida seeing a doctor or the doctor in Florida is seeing me in Missouri, my care is going to be about the same, and chances are solid that my care will be pretty darn good whatever the state is where the doctor is licensed.
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