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Thursday Sep 11, 2014

FSMB Offers Licensing Solution for Docs Looking to Practice in Multiple States

My home state -- Iowa -- shares its borders with six other states. With my state-issued driver's license, I can drive not only in all six of those states but in any other state in the nation. As part of this system, a longstanding interstate compact allows the vast majority of states to share information regarding license suspensions and traffic violations of nonresidents. The states where infractions occur may forward information to a driver's home state, which then applies its own laws to the out-of-state offense.

That system makes sense. Unfortunately, the same can't be said of the way states view medical licenses. I've been in practice for more than 20 years, but the second I drive across one of those state lines, my Iowa medical license is invalid.

On Sept. 5, the Federation of State Medical Boards (FSMB) took a major step toward solving this problem when it finalized model legislation(www.fsmb.org) to create an Interstate Medical Licensure Compact that would expedite the process of issuing licenses for physicians who wish to practice in multiple states.

The key word here is "expedite." Under the current system, physicians who wish to practice in more than one state have to navigate a fairly burdensome process that involves paperwork, fees and three to six months of waiting.

Expediting the process would benefit physicians who live near a state line, are licensed to practice on one side of that state line and seek privileges at a hospital or other facility on the other side of that line. The change also could help alleviate physician shortages in rural and underserved areas and pave the way for greater use of telemedicine. (It's worth noting that earlier this year, FSMB adopted new guidelines for telemedicine(www.fsmb.org).)

Under the terms of the model legislation, a physician would apply for a multi-state license through his or her home state. That state would determine whether the physician meets the following eligibility requirements for the compact:

  • Possession of a full and unrestricted license in a compact state;
  • Successful completion of a graduate medical education program approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association;
  • Specialty certification or possession of a time-unlimited certification recognized by the American Board of Medical Specialties or the American Osteopathic Association Bureau of Osteopathic Specialists;
  • A clean disciplinary record;
  • No discipline from any agency related to controlled substances;
  • No pending investigations by any agency or law enforcement entity.

The proposed legislation would make it easier for states to share information and improve tracking and investigation of physicians who have been disciplined or are under investigation. Physicians who do not meet these criteria may still be able to receive a license in multiple states but not through the expedited process.

The model legislation has the potential to help put more physicians in the areas where we are needed most, but, ironically creating an expedited process could take time. Now that the model legislation has been finalized, state legislatures and medical boards can begin to consider its adoption(www.fsmb.org). Each state must pass the compact to participate. That means family physicians who want this proposal to succeed should talk to your state chapters, who could help move this issue forward, or your state medical boards. Better yet, share your opinion directly with your state legislators.

Robert Lee, M.D., is a member of the AAFP Board of Directors.

Posted at 02:31PM Sep 11, 2014 by Robert Lee, M.D.

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