With the most recent and final domestic RAM clinic of the year just completed in Bradenton FL, it is worth taking a look at the state of the union with respect to states permitting doctors to cross state lines to help those in need at free medical clinics.
This means looking at states which have, individually, passed laws to permit volunteer doctors to cross state lines for free medical clinics, as well as those which have signed up for a relatively new “Interstate Medical Licensure Compact” being promoted by the Federation of State Medical Boards (FSMB) with the AMA.
According to the FSMB, this compact is meant to be “an expedited licensure process for eligible physicians that improves license portability and increases patient access to care … and represents a national solution built upon, and reinforcing, a system of state-based regulation proven to protect patients and ensure the safe delivery of health care.”
According to Stan, this compact could do a lot more. Elsewhere, Mark Green, a practicing physician who represents Clarksville in the Tennessee state Senate, has described a California Medical Board rep’s fears about licensing standards in California versus other states as ill-founded, provincial and self-righteous of many state licensing bureaucrats. In his Knoxville News Sentinel Op/Ed entitled ‘Let doctors cross state borders for free medical clinics’ he adds: “there is no justification for keeping a duly licensed, practicing doctor from volunteering to become a ‘Good Samaritan’ to the needy patients in another state.”
Is this a state boards revenue issue or more likely a turf issue?
The very same topic is covered in a 2009 Joan Brusnwasser interview with Stan for OpEdNews.com entitled Talking with Remote Area Medical Founder, Stan Brock. When asked whether the issue of state lines is a “turf issue” he replied:
Yeah, a case in point. August 16th, in the David Lazarus column in the Los Angeles Times, during that interview, I raised the issue of doctors not being able to cross state lines and therefore we had a shortage of providers. And that we could have seen many more patients if we had been able to bring them in from out of state.
Well, Mr. Lazarus subsequently, I suppose, interviewed a lady by the name of Candis Cohen, who is a spokesperson for one of the state boards of health and she made the statement which appears in that article in the newspaper tantamount to, if not the exact words, that we don’t want doctors here from places like Texas or Alaska or somewhere. We have very high standards in California.
Well, the truth of the matter is, that everybody expects to have very high standards but to make such a disparaging remark was a slap in the face to medical practitioners throughout the country and I wonder what Ms. Cohen would have thought if she had perhaps been traveling through Texas, which she singled out along with Alaska, and suffered a serious motorcar accident and had her life saved in an Emergency Room by a Texas licensed doctor. So, the argument just doesn’t make any sense.
Ironically, California has since passed a law allowing doctors to cross state lines. Stan, who played an important role in helping Tennessee to its 1995 Volunteer Health Care Services Act (in some quarters called ‘the Stan Brock Law’, the first such US law) now closely monitors where legislation is headed. He says the states which have passed laws to allow the poor and indigent to receive free care from volunteer doctors across state lines, are as follows:
Illinois – Adopted Interstate Medical Licensure Compact as well.
Nevada – Adopted Interstate Medical Licensure Compact as well.
Ohio allows dentists only.
A look at the map for the Interstate Medical Licensure Compact, tells a different story. BLUE states have enacted (11), ORANGE states have introduced (9), and GRAY states have no status. Of states which have organised individual plans, only Illinois and Nevada have also adopted the FSMB plan.
Which approach will hold sway and ultimately be most effective remains to be seen. But it would seem that one problem with the Compact is that practitioners have to pay various fees and Stan thinks that those fees and the greater time required to obtain licensure represents a disincentive for the vast majority of volunteers who would otherwise be prepared to venture across state lines. The need is too great and far too urgent.
Which makes the recent clinic in Manatee County seem all the more impressive for numbers served inasmuch as Florida has neither individual state or FSMB scheme status!
Read the Brusnwasser interview at: http://ow.ly/VspqG
Read the Green Op/Ed at: http://ow.ly/VspCD
Read a FSMB Compact Interstate Medical Licensure Compact PDF at: http://ow.ly/VsqU8
Thanks to RAM’s Law Clerk & Aviation Assistant Dakotah Brown for liaising with us on this article.