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May 20, 2015 01:00 AM

Interstate medical license compact becoming a reality

Andis Robeznieks
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    Alabama Gov. Robert Bentley may have helped advance the cause of telemedicine Tuesday by signing a bill (PDF) that enters Alabama into an interstate compact that will make it easier for physicians to have licenses in multiple states. Minnesota Gov. Mark Dayton also signed his own state's bill on Tuesday.

    Seven states were needed to bring the compact to life, and Alabama and Minnesota joined Idaho, South Dakota, Utah, West Virginia and Wyoming whose state legislatures had already passed bills to be on the compact roster. The states passed versions of model legislation drafted by the Federation of State Medical Boards, which has a policy stating that the practice of telemedicine occurs in the state where the patient—not the doctor—is located.

    The policy has been criticized as a means to perpetuate state medical boards' authority since it fends off calls for a national license, but no one has put up a legal challenge. The American Medical Association endorsed the FSMB's interstate compact and said it “aligns with our efforts to modernize state medical licensure.”

    The compact will help reduce redundant licensing requirements by creating one place where physicians submit basic information such as their education credentials. The FSMB reports that 20 states have introduced bills that would authorize their medical boards to enter into the compact, including Minnesota which Tuesday became the eighth state included after Gov. Mark Dayton signed a bill the Legislature approved last week.

    With eight states in the fold, the FSMB reported that an Interstate Compact Commission, consisting of two voting representatives appointed by each state, will meet “later this year” to hammer out management and administration details.

    “We can begin the real work of establishing the compact to ensure patients have access to quality healthcare services, while maintaining the highest level of patient protections,” Larry Dixon, Alabama Board of Medical Examiners' executive director, said in a news release (PDF). “The Interstate Medical Licensure will ease the physician shortage in rural and other underserved areas.”

    Telemedicine has its critics, such as those who say it too easily facilitates controversial practices, such as telemedicine abortion, where a woman confers with a doctor through an Internet video connection to receive drugs that will induce an abortion.

    Jonathan Linkous, president of the American Telemedicine Association, said he doesn't oppose the compact, but added that he didn't think it will necessarily do what the FSMB said it will do—namely speed access to care to underserved areas.

    "We want patients to receive medical care regardless of their location," Linkous said, noting that physicians will still have to pay additional fees to the individual states they receive licenses from. "I don't know if the compact will speed up the process or reduce costs."

    Linkous said the compact is designed to perpetuate the autonomous authority of FSMB's 70 member boards, which include state medical and osteopathic boards and the boards in U.S. territories.

    "They're a trade organization, that's what they're supposed to do," Linkous said. "We're a change-agent organization, We're not here to protect the status quo."

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