![]() “The process in some states is extremely tedious, time-consuming, and expensive, and it hampers patient care,” says one New York provider who requested anonymity as he works on his out-of-state licensing. Getting physicians additional medical licenses is no simple matter. “I’m getting emails from doctors who aren’t licensed in neighboring states, saying, ‘I can’t believe we need to return to the past. For example, we have a lot of patients with heart failure who need frequent monitoring, and we want to keep them safely at home,” he says. “They come for medical expertise that’s just not available near them. “Over one-third of our patients are from surrounding states,” says Hollander. Those rules already ended in nearby Delaware. In Pennsylvania, Thomas Jefferson University telehealth leader Judd Hollander, MD, is watching the clock as licensing flexibilities in neighboring New Jersey are set to expire in early 2022. The aim is to increase the current number - roughly 300 - to the hoped-for 1,500. Meanwhile, Utah has two staff members working full-time to get doctors licensed in Wyoming, Idaho, and several other surrounding states. “An eight-hour drive from Nevada to Salt Lake City caused my patient’s blood pressure to drop so low that she had to visit an emergency room along the way,” he says. ![]() ![]() He still recalls one disturbing incident from a few years ago. Reddy particularly worries about patients reverting to long - and potentially dangerous - trips. Utah neurologist Vivek Reddy, MD, is helping his department figure out how to handle patients from states where loosened rules are ending. At least half have already done so, and others are soon to follow.Īt University of Utah Health - which conducted some 100,000 out-of-state telemedicine visits in 2020 - that reality has left doctors scrambling. Now, states are beginning to retighten their licensing rules. Previously, doctors had to complete lengthy forms and pay steep fees to get a license in every state where a patient received remote care. “There’s just no way to sugarcoat it.” The licensing labyrinthĪs COVID-19 blazed across the country, nearly every state relaxed their licensing rules so outside physicians could provide telemedicine. “By making telehealth difficult to access, we’re making it harder for many patients to get adequate care for many diseases, and that’s just a travesty,” says Nate Gladwell, RN, MHA, senior director of clinical operations for University of Utah Health’s Office of Network Development and Telehealth. And some patients are driving to nearby states and doing televisits roadside to avoid breaking rules regarding out-of-state doctors. Meanwhile, some doctors are weighing whether to drop patients or risk practicing without payment or a license. In Boston, Mass General Brigham was forced to cut off telehealth services to thousands of patients this summer because of shifting rules in multiple states. Senior director of clinical operations, University of Utah Health Office of Network Development and TelehealthĪll this is impacting hundreds of thousands of patients across the United States.įor example, when Virginia’s public health emergency (PHE) ended this summer, some 1,000 patients of Maryland’s Johns Hopkins Medicine could no longer receive remote care. “By making telehealth difficult to access, we’re making it harder for many patients to get adequate care for many diseases, and that’s just a travesty.” And federal agencies that relaxed payment and platform rules may again curtail how telemedicine is delivered. But now, many states are stopping emergency regulations, including those that allowed doctors to provide remote care across state lines. During the pandemic, patients and providers hailed the rapid expansion of telemedicine. “I honestly just don’t know if I can physically do more than I’m doing already.” “I don’t know how I’m going to get Michelle to Baltimore,” says Missy, who also cares for two other family members with disabilities. And when she’s anxious, she picks at her skin, causing sores all over her body.ĭuring the pandemic, telemedicine allowed Michelle to connect often with her care providers at Johns Hopkins Medicine, according to her sister, Missy, without traveling two hours to Maryland from their hometown of Chambersburg.īut now Missy worries that changing rules will end the remote visits. The 52-year-old Pennsylvanian has a rare genetic condition that has left her with the IQ of a young child and makes it tough for her to walk.
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