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Donald Trump: Friend or Foe of Telemedicine?


Will Donald Trump be a friend to the field of Telemedicine?

Healthcare was one of the central themes in the 2016 “Presi-Trump-tial” campaign.  The advancement of healthcare in this country is dependent on whether it can adapt and evolve to meet the needs of our growing and changing society.  Telemedicine is a major key to this evolution, and the executive branch of our government has tremendous power to influence and incentivize the growth of telemedicine.

In this article, Orbit Health Telepsychiatry examines some of the barriers to the advancement of telemedicine.  We will explore how Donald Trump could (if he wanted to) advance telemedicine to help save our healthcare system- including how the medical licensure process needs a facelift.

Medical Licenses: Yes, we need to be more like the DMV!

Imagine if your state driver’s license didn’t allow you to drive in other states?  You wouldn’t be able to drive while on vacation or business trips to other states.  Just think of the adverse effect this would have on business, tourism, and the economy!

The sad truth is that the medical licensure process has these very restrictions.  These limitations create a detrimental impact on the health of Americans and the U.S. economy.

Doctors must possess a medical license in order to practice medicine.  Medical licenses are issued and regulated via the medical boards of each individual state.  Contrary to how it works with driver licenses, most medical licenses only allow doctors to assess and treat patients who reside physically in the state where the doctor is licensed.  Therefore, the care that doctors provide to patients cannot cross state lines.

The purpose of telemedicine is to connect healthcare providers to patients, regardless of their geographic location.  The absence of a national medical license is a major barrier to the advancement of telemedicine.  Doctors and healthcare organizations must spend considerable time and money obtaining licenses from multiple states in order to have a presence across state lines.  Many are unwilling to incur that additional expense, which results in firewalls that cut off access to care for millions of patients in underserved communities.

There is a massive shortage of physicians in this country, making it more crucial than ever to implement innovative healthcare strategies like telemedicine.  According to the 2015 State Physician Workforce Data Book from the Center for Workforce Studies, the states with the highest number of physicians per 100,000 population are concentrated in the Northeast, whereas southern states tend to have the most severe shortages of physicians.

One of the keys to solving the problem of physician shortages is to allow states with the worst shortages of physicians to tap into the services of physicians located in other states.  The U.S. Department of Veterans Affairs (VA) boasts an example of the benefits of a license that has national reach.  At the VA, only one active, unrestricted state license is required to practice in every VA facility across all 50 States, the District of Columbia, and U.S. Territories.  This policy saves costs and increases access to care for millions of veterans.

The Federation of State Medical Boards (FSMB) has also recognized the importance of reciprocity of medical licenses between states.  To that end, they have established the Interstate Medical Licensure Compact.  According to the FSMB, the Interstate Medical Licensure Compact offers a voluntary expedited pathway to licensure for qualified physicians who wish to practice in multiple states, increasing access to health care for patients in underserved or rural areas and allowing them to more easily connect with medical experts through the use of telemedicine technologies.

The Trump administration has the opportunity to help the FSMB to expand the Interstate Medical Licensure Compact through Federal Grants.  Alternatively (and preferably), Mr. Trump can work with Congress to pass legislation to create a National Medical Board.  This board would be responsible for issuing a national medical license.

Although many would support a national medical license, there would be some detractors.  Republicans tend to favor principles of small government.  A National Medical Board would represent an expansion of government that some republicans may resist.  On the other hand, sometimes republicans do support the creation of new government agencies and programs (case in point: the Department of Homeland Security).

Furthermore, the election of Donald Trump may have redefined Republicanism.  Many have proffered that Mr. Trump’s positions on many issues have been contrary to traditional republican values.  For the sake of our Nation’s health, we hope that Mr. Trump works with Congress to create a National Medical Board despite the fact that it is a slight expansion of government.

Some of the individual States may also oppose a national medical license.  For example, individual states generate significant revenue from medical license fees.  A national medical license would potentially cut into these revenues.  However, measures could be put in place to maintain the same fees depending on where the doctors decide to practice.

In his official website, Donald Trump states that his healthcare vision includes innovative programs.  He indicates a desire to work with Congress to create a patient-centered health care system that promotes choice, quality, and affordability.  A national medical license would go a long way toward achieving these goals.

Mr. Trump, the ball is in your court…


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