NCPA - National Center for Policy Analysis

Loosening Doctor Regulations

October 23, 2013

Doctors are shielded from the competition that animates much of the economy. A number of overlapping regulations restrict the number of foreign doctors, bar nurse practitioners from performing traditional doctor duties and keep telemedicine from replacing in-person doctor visits. The problem, critics say, is that it raises costs and limits access to doctors in certain regions. It's an issue of supply and demand, says the National Journal.

Loosening those restrictions could help push down health care costs by increasing the supply of medical services. Such a move would mesh with ObamaCare's focus, through new rules and incentives, on delivering the same or better care at a lower cost.

Many doctors in the United States already come from abroad.

  • Roughly 32 percent of all practicing doctors in the United States graduated from foreign medical schools, according to a May 2012 study in the Public Library of Science.
  • But they face a years-long slog of residency if they want to practice in the United States, no matter what their previous qualifications were.
  • Foreign-educated doctors are more likely to spread out to areas with a shortage of physicians, bringing down costs and expanding access to care.

Regulations also restrict nurses from alleviating some of the nation's care shortage.

  • In 2012, 32 states -- including California, Florida and Texas -- blocked primary care nurses from prescribing medication or diagnosing or treating patients without aid from a licensed physician.
  • But there's no evidence of a large difference in quality or even treatment course between physicians and nurse practitioners, at least in the primary care space.

Like nurses, practitioners of telemedicine face strict licensing rules, even as the demand for doctors who can work remotely grows.

  • Many hospitals now rely on companies to analyze scans offsite, the Advisory Board, a health care consultancy, found in a 2012 report.
  • The number of radiology practices offering off-hours teleradiology climbed to 55 percent in 2011, up from 15 percent in 2003.
  • And there are now 40 teledermatology programs in the United States, according to a 2012 report.

Many states restrict the practice of telemedicine by requiring doctors to hold special licenses to offer remote diagnoses.

Source: Darius Tahir, "Lifting Doctor-Licensing Restrictions Could Drive Competition, Lower Costs," National Journal, October 14, 2013.


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