AcuteCare Telemedicine Blog

Dissolve the Debate. It’s Time to Solve the Individual State Licensing Issue

The past few decades has seen a once regional, state and national economic model evolve into one of global proportions. Industries once accustomed to conducting commerce at the state and perhaps national level now freely explore the world’s markets with ease, thanks to an explosion of telecommunication technology that permit even the most remote locations complete global across to products and services. At the turn of the 20th century, the rapid expansion to a national and interstate commerce model required significant change to a myriad state regulations in order to better accommodate the transition to a new national economic order. The changes of that era were not realized without some push-back from the well-established enterprises that sought to preserve their own economic and competitive positions.

Today, the practice of medicine, once the purview of localized practitioners and institutions, is evolving into a national and even international network of medical care givers and healthcare organizations. Telemedicine, the practice of medicine utilizing electronic communication, is revolutionizing the medical care delivery model throughout the nation and the world, crossing state lines and international borders to allow access to advanced medical care to patients once isolated by geography and social economic barriers. In an era of rising healthcare costs, physician shortages and increasing numbers of underserved patients, telemedicine looks to be a viable vehicle to lower cost, improve efficiency and expand access to once isolated populations. While many in the medical industry look to accelerate the trend toward telemedicine and telehealth, some formidable administrative obstacles to the rapid expansion of telemedicine continue to elude solution.

In the era when the practice of medicine almost always took place in face to face meetings and examinations with healthcare givers, the topic of individual state licensing of doctors rarely came to a discussion. But today, the application of restrictive state laws to telemedicine is creating a dampening effect on the practice of telemedicine and increasing the cost of its implementation.  Despite widespread agreement that something needs to change to overcome barriers to interstate practice of telemedicine, a clear consensus has failed to be realized. Some advocate a national licensure scheme and others support various forms of endorsement, mutual recognition and reciprocity. But despite all the debate, a workable and acceptable solution remains elusive. All the talk and seemingly endless study may be coming to an abrupt end.

The Federal Trade Commission (FTC) has announced that it is looking at taking a broader role in the interstate practice of telemedicine. Currently, individual states have jurisdiction over the licensing of physicians and medical caregivers. But if the FTC rules that interstate restrictions are anti-competitive, they have a right to intervene if out-of-state telemedicine professionals meet the same standards as those licensed within the state.

Regardless of their respective positions, most in the industry do not support a federal licensing system but, unless all participants in the debate quickly move beyond the talking and posturing stage, federal intervention may just preempt the process of arriving at alternative solution for all involved.

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