During the COVID-19 pandemic, state emergency orders allowed physicians to practice medicine across state lines using telemedicine. That meant that a physician in one state could consult a physician in another, or that a patient stuck in quarantine on vacation could consult their regular doctor. As these orders expire, however, it leaves many physicians, and patients, in an ethical and legal limbo. 

With limited exceptions, doctors can only practice medicine in the state where they are licensed and where their patients are present. At the outset of the pandemic, when states first began allowing physicians to practice interstate telehealth, many were concerned that this would allow urban physicians to poach patients from rural practitioners; in practice, however, these urban providers act more as resources to rural and non-urban doctors, giving them access to specialty knowledge and advice that is potentially life-saving. Rural residents, after all, require the same specialty care that urban residents do. 

Now that certain states, such as New Jersey, have declared that phone calls between doctors and patients constitute the practice of medicine, patients on vacation or traveling from work find themselves cut off from their regular doctors. Some patients even drive to in-state “telemedicine parking lots” to consult specialists, forcing sick people out of their homes and onto the road, merely for the sake of conversing with their doctor. Though physicians can become licensed in multiple states through the Interstate Medical Licensure Compact, the process is so ungainly that less than 1% use it. 

In states like California, giving medical advice over the phone can lead to criminal charges. Some question the constitutionality of this, as states are prohibited from regulating interstate commerce, and certain doctors argue that this violates their First Amendment rights to free speech. 

Military and sports-team doctors have been able to practice interstate medicine for years. Though state emergency orders gave regular physicians this ability during the COVID-19 pandemic, the time has come to modernize state licensure and afford patients the critical care they require, whether it is in the state they reside in or not.