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Proposal would allow eligible physicians to obtain expedited licenses in multiple states


Interstate licensure compact could lessen the burden on physicians seeking licensure in multiple states, promote the use of telemedicine and ease the physician shortage

A proposed interstate medical licensure compact would make it easier for physicians to become licensed in multiple states, a move many experts believe can pave the way for greater telemedicine use and ease the physician shortage.

If approved, the compact developed by the Federation of State Medical Boards (FSMB), would create a legal agreement between participating states that would allow a physician licensed in one state to obtain an “expedited license” from other participating states, so long as the physician meets various criteria, including:

  • The doctor must designate a member state of principal license, which will be determined by one of the following: the physician’s primary residence, the state where at least 25% of the practice of medicine occurs, the location of the doctor’s employer, or if no state qualifies, the state of residence for federal tax purposes.

  • The doctor must be board-certified in a medical specialty.

  • The doctor must have no history of disciplinary action against him or her by medical boards, courts, or the Drug Enforcement Agency (DEA). In addition, a physician currently under investigation cannot obtain an expedited license.

A physician would apply for the multi-state license through his or her state of principal licensure. That state will evaluate whether the physician is eligible, and issue a letter of qualification to an interstate commission, according to the proposal.

NEXT: Preserving state-based licensing



FSMB officials have been working on an interstate compact since at least April 2013, when the federation’s house of delegates voted to explore creating  a new system that uses an interstate compact to increase efficiency in the licensing system.

Humayun J. Chaudhry, DO, the FSMB’s president and chief executive officer, said at the time that medical licensing should remain state-based, and that the compact would improve the process.

“An interstate company could address the need for efficiency and speed in licensing, while not compromising the inherent value of a state-based system, and most importantly, patient safety,” he said.

The use of telemedicine-which many proponents say is key to providing medical care to physicians in under-served areas and dealing with the national physician shortage-requires that physicians be licensed in the state where the patient is located. This rule has been a barrier to greater telemedicine usage across state lines.

“In order to strengthen access to healthcare and in recognition of the advances in the delivery of healthcare, the member states of the Interstate Medical Licensure Compact have allied in common purpose to develop a comprehensive process that complements the existing licensing and regulatory authority of state medical boards, ensures the safety of patients, and enhances the portability of a medical license, providing a streamlined process that allows physicians to become licensed in multiple states,” reads the draft agreement by the FSMB.

David Fleming, MD, FACP, president of the American College of Physicians (ACP), told Medpage Today that the ACP believes the interstate agreement is a positive step that could help ease the physician shortage, but that questions concerning encroachment on other physician’s patient bases, medical liability and insurance remain.

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