Telemedicine Roadblock

As the United States struggles with healthcare reform, including trying to figure out how to provide healthcare coverage to all Americans without having an ample supply of providers, one possible remedy looms on the horizon. Telemedicine has proven to increase access to care and reduce costs via teleconsultations and remote patient monitoring. However, there are several barriers slowing its adoption throughout the U.S. Among those barriers, is the issue of physician licensing and the politics of “Interstate Medical Licensure.”

To be brief, physicians are licensed by the state in which they practice medicine. Under the traditional practice of medicine, this allows the doctor to care for a patient that comes into their office. With telemedicine, however, the patient may not be physically located in the same state as the provider who is rendering care and under the current rules, this means the provider must be additionally licensed in each state where these new patients are located. The proposed solution is to offer an “Interstate Medical Licensure” . . . but it is subject to approval by each state’s legislature. Additionally, each state considering such a licensure may edit the proposal to fit the desires of their state, meaning it is highly unlikely that the laws will be identical in each state that adopts the solution.

The Federation of State Medical Boards (FSMB) drafted the licensure solution in September 2014 and several states are currently taking it up for discussion. Thirteen states have formally introduced the proposed statute in their legislative chambers and more than twenty-five state medical and osteopathic boards have publicly expressed support for the compact. The three states that have passed the Interstate Medical Licensure Compact:

  • South Dakota
  • Utah
  • Wyoming

The ten states that have introduced Interstate Compact legislation:

  • Illinois
  • Iowa
  • Maryland
  • Minnesota
  • Montana
  • Nebraska
  • Oklahoma
  • Texas
  • Vermont
  • West Virginia

Additionally, sixteen U.S. Senators have endorsed the measure. This barrier to telemedicine is slowly being addressed and there are certainly many opponents to interstate medical licensure. What are your comments about allowing physicians to treat patients across state lines?


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