Need for State Licensure

California (and 47 other states) requires that physicians engaging in telemedicine are licensed in the state in which the patient is located and follow the medical practice act regulations of that state.1 At the time this research was performed by Resneck and colleagues,2 multistate reform offered by the Federation of State Medical Boards (FSMB) was not in effect in California. The FSMB has created an Interstate Medical Licensure Compact that has already been enacted by 12 state legislatures, and is under consideration in many others. For states that join, the Compact will offer a voluntary expedited pathway for eligible physicians without existing medical board disciplinary histories to obtain licenses to practice in multiple states without having to resubmit extensive eligibility and credentialing paperwork. Each state will retain its role in regulating the practice of medicine and protecting patient welfare, and the Compact enhances the ability of states to share disciplinary information. Implementation is still under way, and this new option for licensure is not yet in effect.