The Federation of State Medical Boards (FSMB) has appointed a workgroup to consider the questions concerning appropriate regulation of telemedicine. FSMB’s model policy about telemedicine states that even if there is no existing physician–patient relationship prior to the telemedicine encounter, the physician must be licensed by the medical board of the state where the patient is located.6 The policy also states that the physician–patient relationship may be established using telemedicine technologies.
According to René Quashie, senior counsel at the law firm Epstein, Becker & Green in Washington, D.C., FSMB wrote the model policy hoping to loosen some of the restrictions involved in telemedicine. In a presentation at the Cato Institute in May about removing barriers to online medical care, Mr. Quashie says some state medical boards have adopted some or all of the recommendations of the FSMB, but there has not been enough support to pass the policy.
The Interstate Medical Licensure Compact could help eliminate that barrier in states that choose to participate. In July, the FSMB received an award from the Health Resources and Services Administration to establish the Interstate Medical Licensure Compact Commission, which will create bylaws, rules and processes to be used by participating states when they begin expediting licensure for eligible physicians. The Interstate Compact will establish a voluntary pathway to streamline the licensing process for physicians who want to practice medicine in participating states, thus eliminating one of the significant barriers to multistate practice and telemedicine.
Free Speech Issues
The vet’s case, according to Mr. Rowes at the Institute for Justice, has implications for other free speech issues that are affecting physicians, ones that are “forcing physicians to say certain things or prohibit them from saying certain things that the doctor thinks are useful for the patient to know.”
As an example, some states have passed laws compelling doctors to tell their patients seeking an abortion about the age, size and other details about the fetus. He says there are a number of cases unfolding in the U.S. about whether or not doctors actually have a right just not to do that, not to become spokespeople for the ideological perspective of the government. If the doctor doesn’t feel that it is necessary to provide that information and the patient doesn’t want that information, does the doctor have the right not to say it?
“The outcome of these abortion cases depends on how courts treat the First Amendment rights of doctors in the doctor–patient relationship,” Mr. Rowes says.