“In 2009, I began treating a 9-year-old from New Jersey,” oncologist Shannon MacDonald recalls in a Wall Street Journal op-ed on the awful consequences of telehealth restrictions.
The 9-year-old had been diagnosed with a brain tumor. His New Jersey doctors referred him to Dr. MacDonald, who works at Mass General and is an expert at treating rare pediatric cancers.
“Though the boy and his family traveled between states for appointments, he remained my patient at all times,” Dr. MacDonald writes. “I fielded his parents’ questions, discussed his imaging, and proposed new therapies when others failed. He received state-of-the-art treatment and benefited from the continuity of care across state lines (though he relapsed and died years later).”
But while back then, Dr. MacDonald “never hesitated to pic k up the phone to call the boy’s parents,” she wouldn’t legally be able to do that today—”because New Jersey has decided that a simple phone call constitutes the practice of medicine,” Dr. MacDonald explains.
Giving medical advice to an out-of-state patient over the phone can put me at risk of losing my license, and, in states such as California and New Jersey, of criminal charges as well.
At the initiation of a telemedicine visit, doctors at some hospitals must now ask patients where they are, document the location in the medical chart, and end the visit if the patient is in another state. Hospital lawyers may even instruct physicians to avoid giving medical advice by phone to their in-state patients who are temporarily out of state for vacation or work, a scenario that could affect any of us. This is callous and in conflict with a physician’s ethical obligations.
At least 30 states restrict telehealth with doctors licensed out-of-state. These restrictions are bad for doctors and patients—especially those with rare diseases. That’s why Dr. MacDonald has joined several families and other doctors in a lawsuit challenging New Jersey’s regulations.
Dr. MacDonald explains:
I am challenging New Jersey’s rules that only physicians licensed in-state may care for patients using telehealth. The Constitution gives Congress the authority to regulate interstate commerce and prohibits states from erecting barriers on their own. The First Amendment also prohibits states from singling out certain speech for limitation. Calls with patients before and after treatment are simply conversations.
Military doctors have long been able to practice medicine across state lines. In 2018 it became legal for sports-team doctors to practice medicine during out-of-state away games. If we can make a law that allows treatment across state lines for a National Football League player, can’t we consider it for a child with a brain tumor?