Ten States Join Interstate Medical Licensure Compact

Iowa has become the tenth state to enact the Interstate Medical Licensure Compact. This is a great achievement for the medical profession and state sovereignty. For almost a year now, I have been supporting this effort, and I am glad to see it succeeding.

Licensure itself is problematic, because it confers monopoly power on a profession. A better solution is certification, which prevents unqualified practitioners from using a title claiming certification but does not prevent them from practicing. However, physician licensing is not going away, and as long as it is with us we should applaud developments that facilitate the practice of medicine across state lines.

On June 24, I attended a briefing held after seven states joined the compact. That milestone started the wheels turning to establish a commission that will execute and administer the interstate licensing of physicians. At the meeting I learned a few things, a couple of which surprised me:

First, the impetus for the interstate compact was growing anxiety among physicians that Congress would assert a federal power to license physicians. If state medical boards did not solve the problem of interstate licensing, then they would lose the initiative. This did not surprise me.

Second, they do not need legislation in Congress to authorize the compact. The states that have signed on can move right ahead. This surprised me a little.

Third, the compact is not about telemedicine. This surprised me a lot. I had thought it was all about telemedicine. On the contrary, doctors sometimes visit patients across state lines, and they want easy and responsible licensing in many states. One group at the meeting was from the University of Pittsburgh Medical Center. Its affiliated physicians will sometimes have cause to practice in, for example, West Virginia.

This made me think the compact is not just for physicians in rural areas. There are plenty of physicians who cross state lines between, for example, Virginia, the District of Columbia, and Maryland; or New Jersey and New York; or New York and Connecticut who would benefit from the compact.