Features: All change for US healthcare?
28 September 2009
Martin Crane, MD, Chair of the Federation of State Medical Boards, reports on the challenges US health regulators face as the country looks to reform its healthcare provision.
As the United States engages in a vigorous debate about the future of healthcare, some commentators have recently been comparing the US and British health systems. At the heart of America’s debate is a centuries-old tension between the economy-of-scale benefits of nationwide programmes and the long-held mistrust Americans have about ceding local control to a federal bureaucracy.
The one thing that is beyond dispute is that the US system is less centralised than the UK’s. The merits of centralisation are open to debate, and it remains to be seen whether health system reform will move us toward a more centralised system.
Whatever the outcome of this debate, a US medical regulatory system utilising technological advances and data standardisation will play a vital role in contributing to solutions that improve the quality of our country’s healthcare. Here are a few of the challenges US medical regulators face as our nation moves toward reform:
Portability of licences
In the US system, licensure of physicians is a responsibility of state authorities; not our national government. That means that each of the 50 states has its own licensure process. State regulators struggle to identify strategies that allow US physicians to practise in multiple states while respecting the autonomy of each jurisdiction.
The regulatory lines are further blurred by the technological advances in telemedicine; procedures ranging from remote reading of radiological studies to robot-assisted surgery make it possible for physicians to practise in multiple states at the same time. Uniform application and credentialing (registration) processes acceptable to different state jurisdictions are currently being developed to respond to this need.
Efficiency of credentialing
The credentialing process can be laborious, expensive and time-consuming. State medical boards are exploring uniform application and verification processes to ‘fast track’ and share credentialing from state to state.
Assuring continuous quality development: The medical profession as a whole is facing increased public demand for greater accountability and transparency. Medical boards are exploring methodology to improve the quality of healthcare, patient safety and physician practice by integrating professional development programmes into the licensing process.
While our licensure issues may be vastly different than those faced by U.K. physicians, we are certainly united by one thing – our mutual concern for the safety of patients, and ensuring that they have full trust in the qualifications of their physicians to practise medicine.