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One doctor, 50 licenses? Yes. De facto national licensing becoming a reality through telepractice

As remote delivery of professional services through telepractice becomes increasingly common, the prospect of national licensure, so long feared by many, is looking more likely all the time. But it’s not happening through a targeted federal program; in medicine, it’s popping up where licensees in one state decide to pursue licenses in all the rest.

With the surge in telemedicine, some physicians have sought and secured a license in all or nearly all U.S. jurisdictions. The companies CirrusMD and Lemonaid are examples of virtual primary care providers that have hired or contracted with doctors who have 50 licenses and can offer, via the Web and smartphone apps, essentially a nationwide practice.

Though complete nationwide coverage is still rare—there were only six 50- licensed physicians in 2016, the Federation of State Medical Boards reports—it is on the rise. In 2018, FSMB found the number had risen to 14.

In many cases, the process of obtaining the full gamut of state medical licenses can be jump-started with FSMB’s Interstate Medical Compact which has 24 states signed on.

For the remainder of the states, licensing companies such as MedSpoke, based in San Antonio, Texas, offer credentialing as a service; they will complete all of a customer’s license applications and keep the licenses current. A 50-state license order could cost on the order of $90,000, according to the company.

Other professions have organized multi-state licensure programs at lesser cost. Licensed engineers, for example, can use a service of the National Council of Examiners for Engineering and Surveying (NCEES), which lets them apply for an NCEES record by submitting their college transcript, employment verification, professional references, and exam results.

With the NCEES record, their credentials can be electronically far and wide. It’s an easier and faster way to obtain a license in all U.S. states plus the District of Columbia, Northern Mariana Islands, Puerto Rico, Guam, and the U.S. Virgin Islands, the NCEES says.