Physicians Should Be Allowed To Practice Across State Lines—and Not Just During a Pandemic

“Medical professionals are typically licensed on a state-by-state basis, so a doctor licensed in one state can’t practice in another without receiving an additional license. The patchwork of licensing requirements across states is a major obstacle to the use of telemedicine because physicians are generally only permitted to provide telemedicine services to patients in states where they are licensed.

States are recognizing the cost of these onerous regulations in light of the current crisis. Over the past few weeks, governors and medical boards in every state except for Alaska, Arkansas, and Minnesota have temporarily suspended their licensing rules to allow out-of-state physicians to work in their state. Most of them have also waived restrictions on the use of telemedicine across state lines.”

“Some states are in greater need of physicians than others. On average, there are roughly 263 physicians per 100,000 people in the United States. But in Massachusetts, there are 449 physicians compared to just 191 in Mississippi. Moreover, the number of COVID-19 cases is expected to peak at different times in each state, so the peak demand for health care providers will vary. Allowing physicians to practice across state lines grants them flexibility to help where they are needed most.”

“Beyond the current crisis, telemedicine has the potential to connect patients with specialists across the country. Telemedicine may also reduce inefficiencies that result from schedule gaps, unexpected appointment cancellations, and the uneven geographic distribution of physicians.

A growing, aging population is expected to generate a national shortage of nearly 220,000 physicians by 2032. As with the current distribution of physicians, shortages will not be evenly distributed across states. Regional projections from the Department of Health and Human Services (HHS) indicate that the Southeast will have a shortage of approximately 13,860 primary care physicians as early as 2025, while the Northeast will have a surplus of around 810 physicians. Telemedicine offers a solution, but states will need to reform their licensing laws for the technology to reach its full potential.”

How Doctors Broke Health Care

“Nearly 18 percent of America’s economy is devoted to spending on health care, far more than the share in any comparable country. And although the U.S. medical system provides some of the best health care in the world, it does so only for those who can afford it. Moreover, fragmented service delivery undercuts overall quality. A decade after passage of the Affordable Care Act (ACA), health care spending is still eating up government and household budgets, nearly 28 million Americans remain uninsured, and costs continue bounding upward.”

“Too many of today’s policy “solutions” build upon the faulty insurance company model that currently organizes U.S. health care—a model that was concocted by the American Medical Association (AMA) in the 1930s as a way to protect the professional status and earning power of its members. It resulted in care that is expensive, bureaucratic, and frustrating for both patients and caregivers.”

The US needs foreign doctors and nurses to fight coronavirus. Immigration policy isn’t helping.

“Right now, the biggest worry is whether the medical system has enough ventilators and protective equipment to treat patients with Covid-19, the disease caused by the novel coronavirus.
But another troubling shortage is on the horizon: doctors, nurses, and other health care personnel.

As patient demand continues to ramp up nationwide and more health care workers are unable to show up for work, either because they contract the virus or because they have to self-quarantine, doctor shortages are a real possibility”

“One solution is to make it easier to bring in doctors and nurses from abroad.”

“even before the current crisis, the immigration system made it difficult for foreign doctors and nurses to work in the US and go where they’re needed. Doctors may face long wait times for green cards, restrictions on where they can settle geographically, and limitations on where they can practice while they’re waiting for a green card. Nurses, meanwhile, also face long waits for green cards and can’t come to the US under temporary skilled worker visas.

The implications of a shortage would be devastating, both to overworked personnel and to the patients for whom receiving medical attention could be a life-or-death matter. But it’s a problem that more immigration could easily fix”

“Not only does the current system make it exceedingly difficult for doctors to stay in the US long-term, but it also severely restricts where in the US they can go.”