Telehealth, also known as telemedicine, is the use of telecommunication technology to remotely deliver healthcare services to patients. This technology encompasses varied forms including live video, mobile medical applications, digital images, and remote patient monitoring using electronic devices. In a time where physician shortages are looming and thereby resulting in patients being unable to receive access to quality health care, telehealth has been emphasized to decrease the access gap. Furthermore, the physician shortage the United States is experiencing is expected to increase. Last year the Association of American Medical Colleges released a report forecasting a shortage in four areas: primary care, medical and surgical specialties, and other specialties. The study predicted a shortage of about 14,900 – 35,600 for primary care physicians and about 37,400 – 60,300 for non-primary care physicians. The problem of physician shortage raises the question of how to increase the supply of physicians to meet the demands of a growing and aging population. Many believe telehealth provides an answer to this question. The idea is that instead of investing in training more physicians, which may be a challenging task, the physicians should be able to utilize telecommunication strategies to reach patients across state lines. Such a practice enables physicians to remotely provide health services to both urban and rural areas experiencing shortages. The challenge, however, are physician licensure laws.
Under the United States healthcare system, physicians must obtain a license for every state in which they seek to practice medicine aside for a few exceptions. State physician licensure laws were partially enacted to protect patients against incompetent and unethical out of state physicians. Because each state’s medical board establishes its own guidelines on ethics and medical care, limiting the provision of services to physicians licensed in the state assured the public trust in the physicians’ compliance with state guidelines. Physicians state licensure laws can place various barriers in seeking a license including fees, further testing, additional coursework, criminal background checks, and more. This process can take several months to complete. Some claim the reason for having strict state physician licensure laws is outdated given the fact that in today’s day medical standards are evidence based and medical training guidelines are set nationally. As a result, instead of maintaining strict physician state licensure laws, states should pursue mutual recognition agreements honoring each other’s physician licenses. Although such agreements are not yet widespread across the country, steps are being taken to loosen the impact of strict physician licensure laws. For example, the Federation of State Medical Boards has created a “compact” of states (currently 17 states are part of the compact) agreeing to standardize and expedite the process for licensing physicians from other states that are part of the “compact.”
One jurisdiction that is considering joining the group of 17 states is the District of Columbia (D.C.). The measure enabling D.C. to join the other 17 states would allow physicians from those states to utilize telehealth to provide healthcare access to patients in D.C. especially to those in underserved areas. “Allowing practitioners to obtain an expedited D.C. license will supplement the physician workforce and increase access,” said D.C. councilman Vincent Gray. As other jurisdictions join the “compact” more physicians can utilize telehealth to reach patients in physician shortage areas. Telehealth provides the opportunity to conduct remote monitoring and virtual visits reducing travel and time expenses for patients and physicians. As healthcare technologies continue to advance, telehealth has the capacity to transform the healthcare delivery landscape and address the physician shortage crisis. Physician state licensure laws, however, hinder the process for physicians utilizing telehealth to access physician shortage areas. Therefore, any advancement in telehealth will need to be coupled with a modification in physician state licensure laws.
Faizan A. Khan is a third-year law student at DePaul University College of Law. Mr. Khan graduated cum laude from DePaul University with a Bachelor of Arts in Political Science and minor In Economics. He is a currently serving on the DePaul Journal of Health Care Law and will complete his J.D. in May 2017.