by Charles Katebi
Governor Mead is by no stretch of the imagination a visionary government reformer. However, he took a big step towards expanding healthcare access in Wyoming by signing the Interstate Medical Licensure Compact into law. This will allow out-of-state physicians to practice medicine in Wyoming and lower healthcare costs for patients.
Physicians that wish to practice in Wyoming must receive a license from the Wyoming Board of Medicine. However, every state has virtually identical requirements for a doctor to receive a license. Prospective physicians must graduate from a medical school approved by the American Medical Association and they must pass the US Medical License Exam. If every state requires doctors to have the same basic credentials, why not let out-of-state doctors practice in Wyoming?
The Interstate Medical Licensure Compact does just that. The Compact allows physicians licensed in any state within the compact to apply for an "expedited" license to practice in any other member state. Since Governor Mead entered Wyoming into the compact, 9 other states have joined. While there are only 1,102 physicians currently licensed in Wyoming, there are a total of 53,618 physicians in compact states now free to practice here. If nine other state legislatures with pending Compact legislation joined in, Wyoming patients would have 247,470 doctors at their disposal. More doctors mean greater choices, shorter wait times, and lower costs.
Why does Wyoming need more doctors? Because we are chronically short of them. There are currently 191 physicians per 100,000 residents in Wyoming, compared to the national average of 260. According to Dr. James Bush, Medicaid Medical Office for the State of Wyoming, the problem in Wyoming when it comes to seeing a doctor is the "paucity of providers." As a result of this shortfall doctors earn on average $226,000 per year, the fifth highest physician salaries in the country. Allowing out-of-state doctors to practice in Wyoming and relieve this shortage will go a long way towards improving access and reducing healthcare costs.
Indeed, expanding Wyoming's access to physicians could not have come at a more pressing time. Since 2011, 10,000 "Baby Boomers" retire every day and will likely impose enormous demand on hospitals and doctors in the future. In addition, an estimated 26 million more individuals will be acquiring health insurance through Obamacare over the next few years and are expected to put even greater pressure on the healthcare system. Giving doctors the freedom to practice where they are most needed (like Wyoming) starts to address this doctor shortage.
But lawmakers could help reduce this "paucity of providers" even more. Wyoming should also join the Nurse Licensure Compact. A review of 26 studies showed that the health outcomes of treatments performed by nurses are identical to those of physicians. Patients even report having higher satisfaction with nurses than physicians. Nurses can also enter the workforce more easily than doctors. The education and training required to become a registered nurse is only six years, compared to 12 years required to become a physician.
Luckily for Wyoming, there is an interstate Nurse Licensure Compact signed by 25 states. Any nurse licensed in one of these states can apply for a "multistate" license and is free to practice in any of the participating states.
Patient access to healthcare can improve if Wyoming also joins the Nurse Licensure Compact. Joining the compact would give the people of Wyoming access to 1,347,312 nurses that work in compact states. Best of all, nurses are free to perform all the tasks that physicians can. They can initiate tests, diagnose patients, perform treatments, and prescribe medication all without the supervision of a doctor. Lowering Wyoming's barriers to outside nurses would build off of the Interstate Medical Licensure Compact and make our healthcare system more responsive to the needs of patients.
Governor Mead took a crucial step towards improving healthcare access by entering Wyoming into the Interstate Medical Licensure Compact. Lawmakers in 2016 should make additional reforms to our healthcare system to broaden patient choices and lower costs.