Telemedicihe trouble ahead.

AuthorOrient, Jane M.
PositionMedicine & Health - Telemedicine

While Americans have been preoccupied with the political theater of the presidential race, special interest groups are toiling to pass legislation that radically could transform your medical care. One example is the Interstate Medical Licensure Compact, which has passed in 11 states and is in the pipeline in a number of others, including Pennsylvania. IMLC purports to provide "remote communities with access to high-quality care through telemedicine" and "address a shortage of medical personnel in underserved rural and urban regions," according to an article in Pennsylvania Business Daily.

However, its real purpose is likely to be very different from the stated one, and the result may be the opposite of the one that is promised. When the same law surfaces simultaneously in a number of states, some vested interest wants to make money from it--a lot of money; getting laws passed can be very expensive.

So, what does the Compact do to bring telemedicine to underserved areas? By itself, nothing. It is about a bypass to state control of licensure, not about providing care. If telemedicine were the real object, the way to expedite it would be to define the location of medical care as the location of the doctor, not the patient. The doctor would need a license in only one state. Compact proponents oppose a telemedicine bill in Congress that would do just that.

Some physicians already hold a license in several states--they just apply to each state. Under the Compact, they would apply to a private interstate commission, which would have its own rules, possibly overriding rules of the states, and which would have no public accountability. This would add costs, not eliminate them. It also could allow doctors to evade state laws meant to protect patients. For instance, a carpetbagger abortionist could fly in to do late-term abortions forbidden by the state, under his Compact license.

Only "eligible" physicians need apply. The organization spearheading the push for the Compact is the Federation of State Medical Boards. Contrary to the implications of its name, FSMB is a private corporation, which, despite being tax-exempt, brings in tens of millions of dollars in revenue by selling forms and physician data. The Compact redefines "physician" to mean someone who is participating in proprietary "Maintenance of Certification."

There is no evidence that MOC improves patient...

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