Senators Roy Blunt, R-Mo., and Chris Murphy, D-Conn., recently introduced legislation that would allow licensed medical professionals to provide treatment in any state through the remainder of the …
Senators Roy Blunt, R-Mo., and Chris Murphy, D-Conn., recently introduced legislation that would allow licensed medical professionals to provide treatment in any state through the remainder of the pandemic.
That’s a good idea. But its existence sheds light on a bigger problem within our healthcare system. Even under normal circumstances, doctors’ ability to provide care often stops at the state border. That prevents medical professionals from moving where their skills may be in higher demand -- or delivering care remotely to patients in other parts of the country.
Our leaders should roll back regulations on where people can practice medicine -- not just for the duration of the pandemic but indefinitely.
To acquire a license, a doctor must graduate from an accredited medical school, complete a medical residency, and pass a series of tests. Physicians must provide an array of documents, including exam scores, references, and any past licenses.
Under current law, doctors typically can’t provide in-person or virtual care to patients outside their state of licensure. They can apply for multiple licenses. But requirements vary dramatically. The cost of a license can fluctuate too, as does the amount of time it takes to receive it.
In the early days of the pandemic, government officials recognized that this system was locking doctors into place. At the federal level, they relaxed rules around telemedicine. Many states permitted doctors licensed elsewhere to practice within their borders.
Waivers like these should become permanent. A truly national labor market for medical professionals, where states essentially recognize licenses issued by other states, would have huge benefits.
Such moves could help address our country’s uneven distribution of doctors. Twenty percent of Americans live in rural regions, but just 10 percent of physicians practice there. In contrast, the densely-populated Northeast has a surplus of 24,000 doctors, according to the Association of American Medical Colleges.
Of course, not all doctors may want to move. And many specialists are best suited to urban areas where they’ll have the opportunity to treat the greatest number of patients. But telehealth technologies could bring them to rural areas. A heart disease patient in rural West Virginia, for example, could visit a local clinic and have a specialist in Pittsburgh check his vital signs and imaging results remotely.
Relaxing state “scope of practice” rules could also increase the supply of care by freeing up doctors to focus on more complicated cases -- including those that might be out of state.
These rules limit what nurse practitioners, physician assistants, and other “non-doctors” can do for patients. Many states prevent clinicians from prescribing medications and making diagnoses without supervision from a physician -- even if they’re capable of doing so independently. Florida, Texas, and California have particularly stringent limitations in place.
UnitedHealth Group, an insurance company, estimates that expanding the scope of practice for nurse practitioners could decrease the number of people without a primary care provider nationwide from 44 million to 13 million.
Millions of Americans need access to health care. Thousands of doctors, nurses, and other healthcare professionals stand ready to deliver it -- if government officials will let them.
Sally C. Pipes is President, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on Twitter @sallypipes. This piece originally published in the Boston Herald.House of Representatives for 34 years).