I’ve previously written here about my telemedicine practice; this is part of what I do as a burn surgeon in a rural and frontier region that I believe provides an important service to our patients, and I honestly find this a very satisfying part of my practice.  I also recognize that our Burn group’s use of technology to deliver care in this manner is innovative, pushing boundaries in the delivery of care.  Again, I believe this is a good thing.

One of the greatest frustrations and limitations of delivering telemedicine care in our region is just that- 99% of the care I deliver via telemedicine as a burn provider is outside of the state of Utah.  In order to deliver this care to the residents of our region, I now carry medical licenses in Oregon, Idaho, Montana, Wyoming, and Colorado, in addition to my Utah license.  While I have nothing to hide from these licensure boards, I assure you that this has been a costly process both in terms of money and time expended.

This week, a Viewpoint in JAMA thoughtfully addresses the potential impact of a recently proposed Interstate Licensing Compact.  While this Compact demands ongoing rigor in the review of physicians seeking licensure in multiple states, it also facilitates the process through which this happens for physicians who meet very clear eligibility criteria.  My Colorado license was the one I acquired most recently, and I appreciated that they did have in place a pathway for physicians who meet many of the proposed Compact criteria.  It expedited my licensure, which in turn has allowed us to expedite a partnership with Community Hospital in Grand Junction for delivery of teleburn services.  The Colorado licensure process was a stark contrast to that of Oregon, which was arguably the most cumbersome of my out-of-state licenses to acquire.  Again, I understand the idea behind a rigorous licensure process and value the protection of patients.  It just seems a bit silly for someone with a spotless record who is already licensed in four other states in the region, as I was at the time.

So, apparently, I am part of the 1%:  the 1% of physicians who carry licenses in 5 or more states.  I’m happy to do it because of the value I place on delivering teleburn care to patients in the Mountain West, but I would be even happier to do it if the process were eased going forward.  I mean, what if someone decides they want me to do frostbite consultations in Alaska? I’m not licensed there…yet, anyway.