One of the key elements of disaster response is having qualified medical personnel available to deal with medical surge. The ability to quench increased demand for health services during a disaster will stave off needing to move to contingency or crisis standards of care. There are several resources available and include the Medical Reserve Corps (MRC), National Disaster Medicine System (NDMS) teams, and calling in all medical staff to assist on a facility-by-facility basis. While these systems have been effective during some disasters, they are limited.
One method to improve response and resiliency that has been mentioned time and again in strategy documents and reports on the topic is to remove the barrier of state-specific medical licensing laws. Currently, a physician is solely licensed to practice medicine in the states they hold a license in. For example, I am exclusively licensed to practice medicine in Pennsylvania. Most physicians are licensed in just one state as the fees the government assesses for licensure as well as the bureaucratic paperwork required are prohibitive. In a post-Katrina study of the issue, fully 35% of states had no ability to expedite or exempt licensure during an emergency response to out-of-state physicians.
One group of physicians, however, has managed to get a special exemption from this oft-noted obstacle in 22 states—no small feat.
So who comprises this rarefied group?
One would think that the most vital and uniquely talented physicians such as neurosurgeons, transplant surgeons, or infectious disease physicians (I can hope) would be granted an exemption.
However that would make too much sense.
It is physicians for professional sports teams who have achieved interstate license portability—a feat many in my field believe is an impassable bridge.
I understand the preference sports teams have for their sideline physicians and the need for them to be involved in the care of their players no matter the location. But surely if a carve out can be made for Ben Roethlisberger’s doctors, this policy change could be made available for the purpose of improving disaster response.
As we have seen in recent weeks, adept management of mass casualty incidents requires many resources, most critically, well trained healthcare providers. Let’s give disaster response physicians nationwide the same license portability as professional sports team physicians.