By Jenny Lower

Benjamin Strong, MD, Chief Medical Officer, vRad

Benjamin Strong, MD, Chief Medical Officer, vRad

A new plan proposed by the Federation of State Medical Boards aims to simplify the process for physicians seeking to acquire licensing in multiple states. The agreement, in the form of a legally binding interstate compact, would enable a physician in New York to simultaneously apply to treat patients in suburban Boston, rural Arkansas, and downtown Salt Lake City.

Representing 70 state medical boards across the country, the Federation aims to streamline the current state-by-state licensing process, an arduous, time-consuming task that can take several months to complete. The association plans to complete revisions to a draft agreement in time for states to begin formal consideration in early 2015. According to the Federation, several states have already embraced the concept and recommended the agreement to their legislature.

According to the compact, each medical encounter occurs in the state where the patient resides. States would still have the authority to govern the practice of medicine based on their own laws, but would be required to share information about disciplinary action against physicians with other members of the compact.

The proposal comes at a time when millions of new patients are entering the healthcare system as a result of the Affordable Care Act, with telemedicine increasingly viewed as a potential solution to meet the physician shortfall.

Though the plan would apply to physicians in all specialties, it also would have a major impact on teleradiology companies like Virtual Radiologic (vRad), whose 450 physicians hold an average of 14 state licenses and read for more than 175 facilities. vRad is the largest radiology practice in the United States.

Benjamin Strong, MD, vRad’s chief medical officer, holds a medical license in all 50 states and currently reads for about 900 facilities. He says the company devotes significant resources to managing licensing applications and renewals for its physicians and has appointed a department of 37 employees to oversee the process.

According to Strong, each state licensure application costs approximately $2,000 in fees and total man-hours, many of which must be completed by the physicians. Renewals cost around $500 annually. Scheduling for the practice’s 2,400 client facilities requires careful matching of modalities and available hours with a checkerboard of state licenses to ensure adequate coverage.

Interstate licensure would ease that burden considerably. It also would lead to enhanced patient care, Strong said. “Expanding that access increases the likelihood that a study will be read by a specialist particularly well suited to that interpretation, and it will enable any given study to be read in a much shorter period of time.”

Despite the apparent benefits, Strong cautions against too much optimism. States derive modest income from medical licensing application and renewal fees and may be loath to forfeit those funds in the current economic climate. Given that many emphasize different points of the application process, it also may prove difficult for all or most states to come to an agreement.

However, that inconsistency may also offer the best justification for a unified approach. “The standard of care to which we hold our physicians should be uniform across the nation,” Strong said. Under an interstate licensure compact, “you would essentially have a greater, more robust, more thorough investigation of the qualifications of every physician, but it could be done once and in a more consolidated, streamlined fashion that ultimately would save on cost.”


Jenny Lower is the associate editor for Axis Imaging News.