Crossing Boundaries: A Comprehensive Survey of Medical Licensing Laws and Guidelines Regulating the Interstate Practice of Pathology
Matthew C Hiemenz, Stanley T Leung, Jason Y Park. UT Southwestern Medical Center, Dallas, TX; Metropolitan Medical Laboratory, PLC, Davenport, IA; Children's Medical Center, Dallas, TX
Background: There are few specific guidelines or publications that address the interstate practice of pathology. Understanding the complexity of interstate licensure is critical for consultant pathologists as well as pathologists practicing in laboratories serving patients in multiple states. This is a timely topic because of recent malpractice and criminal judgments against pathologists involving interstate licensure issues.
Design: We performed a survey of the medical boards of all 50 states. For all 50 states we examined state medical practice acts, state medical board websites, and contacted each medical board for information regarding specific legislation or guidelines related to the interstate pathology practice. Based on this information we grouped states based on similarities in legislation and medical board regulations.
Results: The practice of medicine for pathology is based on the location where the specimen is obtained. The majority of states (n=30) allow for limited out of state consultation with a physician licensed to practice in the specific state although numerous restrictions were identified. A minority of states (n=6) allow for the limited practice of medicine without consultation but require the out-of-state physician to be temporarily present within that state when practicing medicine. Several states (n=5) prohibit physicians from consultation without a license for the specific state; exceptions including the military and emergencies. This category of prohibition of consultation includes South Carolina which was one of the few states to specifically describe the role of the pathologist in the interpretation of laboratory data.
Conclusions: Increasingly the primary or consultative practice of pathology reaches across multiple state boundaries. Licensure requirements among states are heterogeneous and pathology practitioners of both anatomic and clinical pathology need to become proficient in the legal requirements governing the sending and receiving of specimens and consultative material. The legal risk lies with both pathologists that provide the primary interpretation to surgical specimens as well as consultants receiving cases in consultation. Furthermore, there is risk for pathologists interpreting not only surgical specimens, but also emerging esoteric tests (e.g., mutation analysis, FISH, flow cytomerty, genomics). Ignorantia legis neminem excusat – “Ignorance of the law excuses no one”.
Category: Quality Assurance
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 271, Tuesday Morning