I’m excited to share that, as of last week, I am now licensed to practice telemedicine in Florida. I took the step of obtaining this extra license because I have a number of patients who spend part of the winter in that particular state, and it seemed like it would be useful to be able to dispense health advice (not to mention medications!) via phone or Facetime without having to worry about running afoul of medical licensing laws.
As a quick aside, medical licensing in these United States is absurdly complex. Despite the fact that all licensed doctors have to attend a medical school that is nationally accredited; complete a residency that is nationally accredited; and take the same nationwide board exams to prove their competency; licensing is done at the state level. Thus even though I have the exact same training and have met the same standards as a doctor who practices in, say, New York or Oklahoma, I have no legal right to practice medicine in either of those states. If one of my patients is on vacation in one of those states and calls me to discuss a new medical issue, I am allowed to take their call and give them some basic guidance, but the line between giving them some general advice versus “practicing medicine” is murky, and in theory I could be exposing myself to liability for “practicing without a license” if I cross it.
On the other hand, I am licensed to practice fully in Massachusetts and Rhode Island and, as of now, on a limited telemedicine basis in Florida as well (but only for patients with whom I have an established, in-person, relationship here in Massachusetts/Rhode Island). If a patient of mine is standing on the Massachusetts/Connecticut border and calls me with their left foot in Massachusetts and their right foot in Connecticut, I can treat an issue with their left foot via phone, but have to refer them to an urgent care center in Connecticut for their right foot.
This patchwork system of licensing of course ensures an extra source of revenue for states, as it requires doctors to continually pony up money for the privilege of maintaining a medical license to any state we wish to be licensed in. Rhode Island, for example, charges a doctor over a thousand dollars every other year in licensing fees to maintain a current license; Massachusetts is a bit kinder, charging only half as much, though also every other year.
There are downsides to this system as well, such as making it harder for doctors to move around and fill needed positions, and forcing doctors to effectively pay an extra tax for the ability to practice our profession without legal penalty. It also creates uncertainty for doctors and leaves them vulnerable to inadvertently running afoul of the law simply for trying to help a patient of theirs who happens to be traveling out of state. But hey – who’s counting?
Rant over. The upshot is that I am now officially licensed to practice in three states, and look forward to being able to better serve my “snowbird” patients this coming winter.
