I saw a recent post by a psychiatrist who treats patients for addiction problems.

From time to time, his patients, like all patients, travel from one state to another. They may call him and ask for advice – or a prescription refill. The psychiatrist wondered if speaking and/or treating traveling patients ran counter to that state’s Board of Medicine policies.

Why the concern?

When patients travel from another state and see you in your office, the practice of medicine is deemed to occur in your office – in your state – where you are licensed.

But, if the patient is geographically in another state, the answer is less clear.

To clear up the ambiguity, the psychiatrist did a survey. If a patient was planning a trip to another state, and he suggested he wanted to keep in touch, the psychiatrist called that state’s Medical Board to see what the rules were. What he learned surprised him. It surprised me.

First, the good news. Most states he called gave the rational, reasonable answer.

For example, California said: “You can call in prescriptions. You can talk to them on the phone and it doesn’t matter where they are because you have that patient physician relationship so there are no issues with you calling your patient while there in California or prescribing the medication.”

Michigan seemed a little more restrictive: “The physician does not need a Michigan license provided the patient stays in the state for 30 days or less and the physician writes a letter to the Bureau of Health Professions prior to the visit.”

And now, select examples of less reasonable states:

“According to Board attorney: prohibited, but violation results only in a letter to the licensing board of the state(s) in which you have a license. § 54.1-2902. Unlawful to practice without license.

Exception for emergencies:
§ 54.1-2901. Exceptions and exemptions generally.
(7) The rendering of medical advice or information through telecommunications from a
physician licensed to practice medicine in Virginia or an adjoining state to emergency medical personnel acting in an emergency situation”

And the worst:

Nevada: “Even telephone contact with a patient visiting the state is illegal practice without a license, regardless of whether the patient is charged a fee.”

A telephone call? Really?

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