In response to a June 29 New York Times article, Dr. Strong submitted the following letter. In it, he notes the positive benefit of removing complexity that affects underserved health facilities and their patient communities.
To the Editor:
As the chief medical officer of vRad, the nation’s largest telemedicine practice, I am encouraged by the move to create an interstate licensing compact that reflects the impact of technology on our practice of medicine. (Medical Boards Draft Plan to Ease Path to Out-of-State and Online Treatment, Robert Pear, June 29, 2014)
Our 450 US board certified radiologists will collectively read over 7 million client studies this year – diagnosing via a patented cloud-based network to provide critical clinical care to patients in over 2,000 healthcare facilities in all 50 states (plus Puerto Rico and the District of Columbia). On average, each of our radiologists has 14 state licenses and credentials to read for 175 different facilities. I am personally licensed in all 50 states and read for over 900 facilities.
The complexity of current state licensure processes means time and money for our practice – and that means delays in getting doctors up and running quickly for patient care. Once hired, it takes an average of 4 months (as many as 9 months, depending on the state) for a radiologist to be fully operational because of the current state licensing model. Processes vary by state (paper-based vs. online), as well as required information. For example, to be licensed in certain states, our physician-applicants must appear in-person solely to present a photo ID – and sometimes their original medical school diploma. That’s onerous for our practice and a disservice to underserved healthcare facilities and their patients.
While the bar for certification must be high in any interstate compact, the consolidation and simplification of investigatory and certification processes would be welcome to reduce the time required for licensing board and credentialing committee approval, lower processing costs, provide greater mobility for physicians – and ultimately, deliver exceptional patient care by matching patient to physician as quickly and as efficiently as possible. At 3AM in an emergency room when an ED physician is waiting to have an image read to determine if a patient is having a stroke, does it really matter if the radiologist is reading and diagnosing from the basement of the hospital, an in-state office or a home office equipped with state-of-the art diagnostic tools across the country? Seconds count. With today’s cloud-based tools, geography should no longer be a barrier to excellent clinical care.
Benjamin W. Strong, MD (ABR, ABIM)
Chief Medical Officer, vRad