One place it has worked very well is health care. To limit unnecessary exposure for patients and providers during the pandemic, hospitals and clinics have encouraged those who can to get care virtually. For the first time, millions of Americans have used their computers or phones for health-care appointments. But too often, if they’re not communicating with a doctor or nurse in the same state, they’re out of luck.
Since March, Johns Hopkins Medicine has conducted an average of more than 71,000 telehealth visits per month; before the pandemic hit, that number was fewer than 100 per month. Virtual medicine has become a lifeline for millions of patients who would otherwise have delayed or gone without needed care. Our surveys also suggest that both clinicians and patients believe that virtual medicine is effective.
Yet restrictive licensing laws severely hamper telemedicine. A patchwork of state and local laws prevents clinicians from providing virtual care to patients in states where they are not licensed. Before the pandemic, patients could drive or fly across state lines to see their chosen provider. Now public-health experts recommend not traveling, and staying at home as much as possible. And many physicians have limited in-person visits, emphasizing online consultations as much as possible.
What kind of person needs to see a doctor in another state? Many people, for many reasons: a patient with kidney disease who needs a transplant and whose donor lives in another state; someone who has just received a devastating cancer diagnosis and wants a second opinion from a specialist who practices in another state; a college student dealing with depression, now hundreds of miles away from a trusted campus therapist. The stakes in these situations can be extremely high. Or it might simply be a matter of someone who lives in Kansas City, Mo., but whose longtime physician maintains an office a few miles away, in Kansas City, Kan.
Early in the crisis, Health and Human Services Secretary Alex Azar responded to this issue by asking governors to temporarily suspend out-of-state licensing restrictions. While most states took some action, the changes varied widely, and many of the orders have since expired. When the Cares Act passed last spring, Congress eliminated licensing restrictions for Homeland Security clinicians. But civilian clinicians were left out.
Fortunately, a bipartisan group of lawmakers in the House and Senate has introduced the Temporary Reciprocity to Ensure Access to Treatment Act to address this critical gap. The Treat Act would allow physicians and other clinicians licensed anywhere in the United States to practice in all states for the duration of the public-health emergency. This no-cost, temporary legislation retains state-based licensing but ensures reciprocity to ease access during the crisis.
The legislation would also help overstretched health-care providers. With covid-19 rates surging everywhere, many hospitals across the country are facing workforce shortages, staff exhaustion and burnout. To ensure that overextended health-care facilities can get help if they need it, we must make it easy for doctors and nurses to treat patients anywhere in the country, whether virtually or in person. At this crucial moment, health-care institutions desperately need this flexibility.
This pandemic has been challenging for everyone, and tragic for too many. The unprecedented adoption of telehealth in the past few months has been one of the few bright spots, born out of necessity. But swift action on the Treat Act is needed so that Americans can make the best use of this transformative technology, helping to better protect patients, clinicians and communities.
