The Interstate Medical Licensure Compact: Making the Business Case

Abstract

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.

State Medical Licensure for Telemedicine and Teleradiology

“…21,22 The FSMB favors an interstate medical licensure compact to preempt federal interference in matters that have been traditionally addressed by the states. 21,22 Administrative interstate compacts allow member states to produce self-regulatory systems which are controlled by the member states. 22 An interstate compact would offer a much simpler pathway for a physician to obtain multiple state licenses using a single application.…”

“…21,22 Administrative interstate compacts allow member states to produce self-regulatory systems which are controlled by the member states. 22 An interstate compact would offer a much simpler pathway for a physician to obtain multiple state licenses using a single application. However, the interstate compact would not change a state's existing medical practice act.…”

“…The answer to this question is a complex mixture of constitutional and historical tradition coupled with distinct differences between the points of view of interested parties, several of which do not necessarily favor widespread, easy accessibility for state medical licensure. [18][19][20][21][22] State Medical Licensure Overview Primary medical licensure is state based, with no current recognition for differences among specialties. Allopathic (MD) and osteopathic (DO) physicians usually have separate state licensing boards.…”

What Can State Medical Boards Do to Effectively Address Serious Ethical Violations?

“…Interstate medical licensure compact initiatives can further support proactive monitoring and information sharing about physician conduct among groups of SMBs. 68 As mentioned in Recommendation 9, boards may consider license suspension or revocation when repeated instances of lesser acts of wrongdoing occur; however, such patterns may remain hidden when SMBs struggle to identify wrongdoing or complaints that occurred in other states.…”

A Data Model for Medical Schools and their Programs:

“…The growth in use of telemedicine has raised concerns about health professionals providing care outside the jurisdictions in which they are licensed. [5][6][7] Similarly, medical tourism raises a number of ethical and regulatory concerns for MRAs, both in establishing policies within their jurisdiction and in advising members of their communities who seek treatment outside their borders. 8,9 All of these global trends, combined with the everincreasing number of medical schools and physicians worldwide, 10,11 highlight the need for improvements in information collection and sharing among MRAs and educational institutions.…”