Vote ‘No’ on the Interstate Medical Licensure Compact

Interstae Medical Licensure CompactAs of July 2017, the Interstate Medical Licensure Compact (IMLC) is in force in 22 U.S. states. Developed by the Federation of State Medical Boards (FSMB), the IMLC is a legally binding agreement that was created to facilitate the licensing of physicians across state lines. It establishes qualifications for licensure and defines the process by which an experienced physician can obtain a license to practice medicine in a state in which he or she is not currently licensed. The stated aim of the IMLC is to increase access to healthcare for patients in rural and underserved areas, giving them the ability to connect with medical experts at a distance through telemedicine.

State legislators who are called to vote on the IMLC have several reasons to be wary, however. Opposition to the Compact comes from a wide range of parties, a red flag indicating that – while it may sound good in theory – the Compact is rife with problems as it is currently written. Perhaps most alarmingly, the IMLC by its very language and without justification prohibits a large population of otherwise well qualified doctors from applying. Specifically, only physicians who belong to the American Board of Medical Specialties (ABMS) or the American Osteopathic Association’s Bureau of Osteopathic Specialists (AOABOS) are allowed to participate in the Compact. By joining the IMLC, a state thus actively put tens of thousands of doctors in America at a competitive disadvantage. The ABMS and the AOABOS are private organizations that should not be permitted to engage in monopolistic practices at the expense of many perfectly well qualified doctors and other established physician credentialing bodies. Indeed, it is a common complaint among state legislatures currently considering joining the IMLC that it is written too self-interestedly. Physicians with ABMS or AOABOS credentials should not be the only ones who can practice telemedicine across state lines. The IMLC’s goal of broadening access to healthcare for inhabitants of rural areas is undercut by the inherently exclusionary language of the legislation.

The 28-page Compact has other serious deficiencies. For example, it erodes state sovereignty by reducing each member state’s control over physician licensing. The IMLC establishes a Commission made up of two representatives from each adopting state. This Commission yields considerable power and even has the authority to promulgate rules that supersede a member state’s medical practice act. The American Legislative Exchange Council (ALEC), an influential coalition of state legislatures, has voiced strong opposition to the IMLC for its ability to trample on well-established areas of state concern. The text of the IMLC – contrary to claims proffered by its supporters – significantly undermines a member state’s ability to govern the practice of medicine within its borders.

State legislators are urged to see the IMLC for what it truly is. Though seemingly a welcome development, the IMLC will have the effect of weakening a member state’s legislative powers. And, it will do so completely without proof that it will achieve its goal of increasing access to care for rural area inhabitants. The creation of yet another highly bureaucratic private organization does not benefit doctors, nor states, nor patients. Voting “no” on the IMLC when the opportunity arises is a vote against an ill-considered agreement that produces far more questions than answers.

Save the Date
House of Delegates & Annual Scientific Meeting
Innovation & Overcoming Challenges
June 10-15, 2022
Patient Care Is Our Priority

Medical organizations throughout North America understand that our rigorous certification standards prove that ABPS Diplomates are capable of delivering the best patient care possible.

I feel truly blessed and grateful to be an internal medicine board-certified diplomate with the American Board of Physician Specialties. Their ongoing, steadfast commitment to physician board(s) enhancement, forward focused vision, and tenacity is second to none. ABPS has become a recognized choice in Physician Board Certification.

Adam Rench, MD
Internal Medicine
To be the best, you must measure yourself against the best. Achieving Board Certification in Emergency Medicine by the ABPS gave me the opportunity to demonstrate mastery of the art of EM in an objective way. The high bar that ABPS sets for candidates to be allowed to take both the written and oral exam is a testament to ABPS's rigorous vetting of one's ability to practice Emergency Medicine at a high level. By maintaining these credentials, I've been able to instill confidence in my abilities at the department/employer level and ultimately with the patients that choose to seek emergency care at the facilities at which I practice.

Royce Mathew Joseph, MD
Emergency Medicine
The American Board of Physician Specialties has supported the entire field of Integrative Medicine in sponsoring our board. It has been so validating of the importance of prevention-oriented and holistic approaches to care while emphasizing the scientific basis of this specialty to have it recognized by ABPS. I am proud to have been one of the first groups to be board certified by ABPS in Integrative Medicine, leading the way for others committed to training in this specialty.

Myles Spar, MD
Integrative Medicine