Time to End the State Medical Boards

[Outrigger]

---

Members do not see this ad.

What is the continued purpose of the state medical board? Every time you want to work in another state, you have to deal with the state medical board. You may have been a physician for 20 years in Missouri winning every award possible in your state but then you want to work a few miles away in Kansas and suddenly you are no different than an FMG who has never practiced anywhere in the United States. Depending upon the state, you may be required to send your college transcripts (Yes. College. Just in case you snuck into medical school and residency and passed the USMLE). You may be required to provide not only a letter from your medical school but also transcripts and a copy of your diploma. Some states want to know the beginning and ending (month day and year) of each school year from college onward. An AMA profile may be required (along with the requisite check to the AMA for said service). Every license you have ever had will need to be verified. Letters from each internship/residency will be necessary. Certain states want you to get letters of recommendation. That will be an awkward conversation when your partners are wondering why you need a license in another state and you don't have a job there yet. Some states have specific CME courses that you will need to dole out $$$ for in order to get your license. A few items can be stored in the FCVS database, but that will only save you a few letters and then cost you several hundred dollars just to establish your profile. It will cost $$$ to send that information to each state you want a license in. BTW, I've listed only a few of the requirements various state boards will want from you.

I can understand certain requirements needing to be met when you get your FIRST license. But why, other than to enrich the state boards, do you need to start from scratch every time you want to work in a different state?

Do you want to work in a VA Hospital anywhere in the country? No problem. Any state license will do. But what is good enough for our vets isn't good for the state medical boards.

Looking to find a job in a particular region? New England for example? Well you better start applying now for 6 different licenses, repeating the same information over and over, whilst paying close attention to the particulars of each board because they will all want something a little different. While you're at it, take out a loan because those licenses will be very expensive. Why not just wait to get a job first and then get your license? Because, unless the job really sucks, there will be 10 local people ahead of you ready to take the job. Why would your employer want to wait for you to get a license which could take 3 months followed by who knows how much facility specific credentialing time when 10 other people could start next week?

I hereby propose a national medical license that will allow one to practice medicine in any US state or territory.

 

[Law2Doc]

What is the continued purpose of the state medical board? Every time you want to work in another state, you have to deal with the state medical board. You may have been a physician for 20 years in Missouri winning every award possible in your state but then you want to work a few miles away in Kansas and suddenly you are no different than an FMG who has never practiced anywhere in the United States. Depending upon the state, you may be required to send your college transcripts (Yes. College. Just in case you snuck into medical school and residency and passed the USMLE). You may be required to provide not only a letter from your medical school but also transcripts and a copy of your diploma. Some states want to know the beginning and ending (month day and year) of each school year from college onward. An AMA profile may be required (along with the requisite check to the AMA for said service). Every license you have ever had will need to be verified. Letters from each internship/residency will be necessary. Certain states want you to get letters of recommendation. That will be an awkward conversation when your partners are wondering why you need a license in another state and you don't have a job there yet. Some states have specific CME courses that you will need to dole out $$$ for in order to get your license. A few items can be stored in the FCVS database, but that will only save you a few letters and then cost you several hundred dollars just to establish your profile. It will cost $$$ to send that information to each state you want a license in. BTW, I've listed only a few of the requirements various state boards will want from you.

I can understand certain requirements needing to be met when you get your FIRST license. But why, other than to enrich the state boards, do you need to start from scratch every time you want to work in a different state?

Do you want to work in a VA Hospital anywhere in the country? No problem. Any state license will do. But what is good enough for our vets isn't good for the state medical boards.

Looking to find a job in a particular region? New England for example? Well you better start applying now for 6 different licenses, repeating the same information over and over, whilst paying close attention to the particulars of each board because they will all want something a little different. While you're at it, take out a loan because those licenses will be very expensive. Why not just wait to get a job first and then get your license? Because, unless the job really sucks, there will be 10 local people ahead of you ready to take the job. Why would your employer want to wait for you to get a license which could take 3 months followed by who knows how much facility specific credentialing time when 10 other people could start next week?

I hereby propose a national medical license that will allow one to practice medicine in any US state or territory.

This isn't a new idea. Basically the notion of state sovereignty (currently embraced by the Republican Party) and state protectionism is what makes this impossible. Each state gets to regulate its professions (medicine, law, dentistry etc). That's for the benefit of the public in that state. People don't want someone who had an easy time getting licensed being their doctor. On top of that, the doctors in a given state want to limit competition. The docs in Florida don't want it to be easy to move down there and practice during your older years and steal their business. While I largely agree with your goal, focusing on the inconvenience is a losing argument.

 

[Outrigger]

This isn't a new idea. Basically the notion of state sovereignty (currently embraced by the Republican Party) and state protectionism is what makes this impossible. Each state gets to regulate its professions (medicine, law, dentistry etc). That's for the benefit of the public in that state. People don't want someone who had an easy time getting licensed being their doctor. On top of that, the doctors in a given state want to limit competition. The docs in Florida don't want it to be easy to move down there and practice during your older years and steal their business. While I largely agree with your goal, focusing on the inconvenience is a losing argument.

The Commerce Clause has been used in every other instance. Why not this one especially when the country is having Obamacare forced down their throat? It's not only inconvenient, it is a great waste of money. As physicians and voters, why can't we end our own state boards?

 

[Law2Doc]

The Commerce Clause has been used in every other instance. Why not this one especially when the country is having Obamacare forced down their throat? It's not only inconvenient, it is a great waste of money. As physicians and voters, why can't we end our own state boards?

The problem with the commerce clause is that, except perhaps tele radiology, medicine is by it's nature practiced within a local geography. So federal law doesn't really apply. Very hard to strip a state of a right it has had for hundreds of years without the thing which is being regulated being something actually interstate in practice.

Not to mention that the guys who penned the commerce clause were predominantly lawyers, another field that's licensed state by state, so it's hard to argue that the handling of this issue didn't play out exactly as the framers intended.

 

[Elisabeth Kate]

This will probably have to be addressed in the coming years when telemedicine becomes more common.

 

[colbgw02]

This will probably have to be addressed in the coming years when telemedicine becomes more common.

Telemedicine, by way of teleradiology, is already extremely common. It's done nothing to move the needle for license reciprocity or a national license. Why? Because physicians are a small, affluent minority (or at least so says the perception). No one cares if we have to spend a few extra hundred or thousand dollars a year to get or maintain multiple licenses. As someone who experiences the frustration of maintaining numerous licenses, I consider this just the cost of doing business. Better to use any remaining good will with respect to physician to solve bigger issues.

 

[Shikima]

The problem with the commerce clause is that, except perhaps tele radiology, medicine is by it's nature practiced within a local geography. So federal law doesn't really apply. Very hard to strip a state of a right it has had for hundreds of years without the thing which is being regulated being something actually interstate in practice.

Not to mention that the guys who penned the commerce clause were predominantly lawyers, another field that's licensed state by state, so it's hard to argue that the handling of this issue didn't play out exactly as the framers intended.

Interesting, social issues are easily overturned despite what local populations believe but commerce (money?) has tight reins?