Abstract
Access to health care in the United States is undermined by a maldistribution of physicians, and state medical licensure remains a barrier to correcting this issue, despite legal reforms that attempt to streamline physician licensure pathways. Geographic distribution gaps can have serious consequences in rural areas, such as poor health outcomes, reduced access to care, and further entrenchment of health disparities.
On the bright side, physicians can potentially use telemedicine to help improve geographic distribution gaps through the provision of clinically appropriate, virtual care across state lines. But states have traditionally required physicians, even those who are currently licensed in other states, to complete their respective licensure pathways. These licensure requirements generally hinder telemedicine expansion by forcing physicians to repeat substantively similar licensure processes in each state.
This Article envisions and addresses the need for medical license reciprocity where the physician’s license from her state of domicile is recognized across state lines and is portable, like a driver’s license. Congress has the authority under the U.S. Constitution’s Full Faith and Credit Clause to require medical license reciprocity through this Article’s Proposed State Medical Licensing Reciprocity Act. The Full Faith and Credit Clause empowers Congress to determine the extraterritorial effect of, among other things, a state’s “public Acts” (namely, state laws). Because medical licenses indicate a physician’s privilege to practice medicine conferred by applicable state law and are based on compliance with statutory requirements, these licenses should be understood as extensions of state “public Acts” for full faith and credit purposes. Therefore, Congress can mandate that medical licenses receive full faith and credit in other states, while leaving the states ultimately responsible for issuing and regulating licenses and medical practice within their borders.
This Article makes three principal contributions to existing legal scholarship. First, it provides a fresh analysis of how various state reforms to the traditional medical licensure pathway (for example, specific waivers, the Interstate Medical Licensure Compact, and the Uniform Telehealth Act of 2022) have failed to fully address this barrier. Second, it identifies the legal problem of nonreciprocity and proposes a novel federal solution under the Full Faith and Credit Clause. Finally, it enriches the ongoing discourse on federalism and health care regulation, specifically in the context of physician licensure.
Repository Citation
Meighan Parker,
State Medical Licenses Without Borders
, 104 N.C. L. Rev. 1339
(2026),
Available at: https://digitalcommons.law.uga.edu/fac_artchop/1799
Previously posted on SSRN.