The United States Constitution established and the Supreme Court has affirmed the proper role of states in regulating medicine throughout American history. However, the opportunities and mounting pressures of modern medical practice have called into question the viability of state-based regulation to address the increasing practice of physicians across state lines. This article will argue that the crossroads at which state medical boards find themselves provides an opportunity for an interstate compact as the best solution for adapting to the forces of current and future trends. A brief examination of the history of state-based licensing, and the dynamics that led up to the formation of the Federation of State Medical Boards will provide a basis for consideration of interstate compacts as a constructive response to critiques of the present regulatory structure. With a common understanding of the utility and widespread use of the interstate compact, we will turn our attention to how it emerged as a viable option, key specifics of an interstate compact for medical licensure, and the extent to which the model that has been crafted by the FSMB can complement the existing authority of state medical boards.

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