Standing between Patients and Free Medical Care: Big Brother
The founder of the Knoxville-based charity Remote Area Medical Volunteer Corps says his nonprofit is hamstrung by laws preventing medical volunteers from crossing state lines.
Stan Brock…said the group recently went to Joplin, Mo., with a mobile eyeglass lab. But they were not allowed to make free glasses because their volunteer optometrists and opticians were not licensed in the state.
Events in California have had dozens of empty dental chairs as patients were turned away — not for lack of willing volunteers but because state law creates impossible hurdles for out-of-state providers.
“Before Georgia told us to stop, we used to go down to southern Georgia and work with the Lions Club there treating patients,” he said.
Source: The Tennessean. HT: Jason Shafrin.
This is just another example of how state regulations can prevent competition (or volunteers) from crossing state lines to work.
While legislators and regulators are creating more restrictions, the actions of good volunteers are being constrained.
Most occupational licencing occurs on a state level.
Is the best solution more federal licencing, no licencing, or easier to obtain licences?
State licensing for medicine doesn’t seem to make much sense if the rules and regulations are the same in every state (or close enough that they could be combined). For lawyers I understand state licensing because state laws can vary significantly, but I’m not sure I see the advantage for doctors. Though I’m sure if we adopted national physician licensing, some people (probably on this blog) would complain that the federal government is taking too much control, and that this matter should be left to the states.
I can only speak to the California Medical Board – which licensed me in 1979. I know first hand the MBC is the best in the nation. MBC is honest and free of corrupting political influence. The rights of California patients and physicians are really protected when it is frankly an impossible job. Look no farther than the quick and successful Conrad Murray MD prosecution. . . surely not a matter for the feds.
The LAST thing orphan patients, such as my patients who are immunology outliers, need is a federal board. It would end up being another IPAB. Instead, the CMB told me that my outlier patient protocol would simply be the standard for the state – and as a direct result hundreds of lives were saved and thousands had improved quality of life in the past 30 + years. It could never happen under a federal board. . . a committee that would be politicized and unduly influenced by the powerful with their own agendas.
Diversity and competition are the lifeblood of medicine. That is what our medical board protects. the central authority is vested with retired surgeons whio know every dirty trick doctors play in our endless turf wars and they know when a doctor is impaired and need to re-examine in their specialty.
There is no difference between lawyers and doctors responsibility falling under state law jurisdiction. . . in our case – the California Business and Professions code. . . another excellent piece of legislation.
And nothing prevents physicians from holding multiple state licenses.
In 1979, a guy pretended to be a doctor at UCSF Medical Center for YEARS and was slated to be the DIRECTOR of high risk neonatal transports. He never even went to medical school. he used his cousin’s sheepskin without his cousin’s knowledge. Barry was doing procedures like heart catheterizations. Fake doctors abound when you can just show up and volunteer. That’s how Barry learned his skills volunteering at Mt. Zion in SF learning how to commit this outrageous fraud.
During Katrina, all licensed out-of-state doctors were welcomed because it was a national emergency. Many of my senior colleagues were sleeping on cots in gyms for weeks. Even then, we have enough phenomenal physician reservists ready to roll and they are best suited for national emergencies.
The Texas Medical Board is the opposite of the MBC and has been outed as corrupt. The Association of American Physicians and Surgeons sued in Texas and Andy Schlafly made personal appearances in Austin for hearings. This is how it needs to be. . . state by state.
There is no question that state physician jurisdiction complicates the progress of telemedicine. But if we as physicians are smart enough to practice telemedicine, we need legitimate state reciprocity – not federal jurisdiction.
States rights are the lifeblood of excellence in medicine. Medicine is a sacred trust: doctor, patient and state medical board. . .and God.
Dorothy Calabrese MD
San Clemente, CA
The public are always the ones to suffer, when state regulations fail to keep order of licences and medical board certifications.
I think the answer, Corey, is a combination of easier-to-obtain liscenses and no liscenses.
If you think about it, there really aren’t that many professions that ought to require liscenses.