Medical Practice at a Distance May Be Illegal IV: ME, AK

Continued from: Medical Practice at a Distance May Be Illegal III

Maine:

When I called the Medical Board for the State of Maine I explained that a patient planning to travel during the summer might be in the state at the time of the next appointment, and I asked whether the Board might deem that I would be practicing without a license if I were to a) have a telephone conversation or b) conduct a medication management session via Internet teleconference with the patient. Both of the representatives with whom I spoke referred me to the applicable statutes which of course indicate that one must be licensed by the state in order to legally practice medicine there. However, I detected at least some suggestion that the Board might tend to adopt a lenient view of such practices. I was also told that Maine has not entered into reciprocity agreements with any other state, including New Hampshire and Canada.

Alaska:

(No Sarah Palin jokes, please.) I started with a phone call, but the representative asked me to switch to email. I indicated that a patient might work on a fishing boat harbored in Alaska during the time of the next expected monthly contact. I asked whether the Board might deem that I would be practicing without a license if I were to a) have a telephone conversation or b) conduct a medication management session via Internet teleconference with the patient.

Perhaps the most interesting aspect of the response was the suggestion that if the contact occurred while the boat was in waters beyond the 3 mile limit, Alaska would have no jurisdiction. This might solve the problem with (I count) 21 states. Of course the physician has no way of knowing exactly where the patient is, much less exactly how far from the coast of a given state, and neither the patient nor I have any idea whether the boat will have a broadband connection.

I wonder too about jurisdiction at anchor or a dock. Would the state of VA, for example, claim medical jurisdiction over a German physician attending to a French patient on an Italian cruise ship anchored in Hampton Roads? And is the 3 mile rule universal, or does it vary from state to state?

In the end the Board's representative told me, "if the patient is only here temporarily..., you’re fine." Alaska takes first place for most rational, informative, helpful and reasonable response thus far. So if you plan to boycott AZ this summer because of the immigration law, switch your itinerary to AK and need to talk to your physician, remember that he may not have to say, "Sorry, but I'm not licensed there. You'll have to find a physician who holds an AK license."

A good bet: Send Your Patients to Michigan