Physician licensing is, and always has been, a matter for the states.  But ease of travel from one state to another has long placed a strain on that approach, as physicians and patients alike move easily from one state to another for medical care.

The advent of telemedicine threatens the very theory that the care of even one patient can always be identified with a single state.  Why?  Because with telemedicine a patient may be in one state and the attending and consulting physicians may be in yet other states.  So which state is responsible for the license or licenses?

The Federation of State Medical Boards has an idea that may help with the problem.  The Federation has proposed model legislation creating a compact among participating states.  Through the compact a participating state would in effect agree to fast-track the licensing of a physician who was already licensed by another state in the compact.

The compact idea is consistent with the Federation’s policy position, adopted last April, that the place of treatment of a telemedicine patient is the location of the patient (as opposed to the location of the physician or the Ethernet).  So the state where the patient is located is responsible for licensure, no matter where the physician or physicians are located.

The American Medical Association has come out in favor of the compact proposal, praising it as a step toward modernizing state medical licensure.  Many observers join in the support, seeing the proposal as a practical step toward removing a legal obstacle to the advance of telemedicine.  Rural areas, in particular, are viewed as benefiting from an increase in the availability of telemedicine.