California doctor’s license law creates unfair burden
Out-of-state doctors must be licensed in California, even for telehealth
I meet a friend at noon at my home in rural northern California. We hop into my car and drive two hours north to Brookings, a coastal town just across the border in Oregon. Driving around town, I search for a quiet parking lot with good phone reception. Using a hot spot on my laptop, I sign into MyChart, an online medical records portal, and then begin a virtual appointment with my hematologist, because I have hemophilia A.
The internet signal and video quality is better at home, but unfortunately, I’m not legally allowed to speak with my hemophilia specialist, who is based in Portland, if I’m in the state of California. This is because of a California law that requires anyone practicing medicine on patients in California to be licensed in California, even for telehealth appointments.
Together with the Pacific Legal Foundation, last year, I joined a federal lawsuit as a plaintiff to try to declare this law unconstitutional.
Why I think it’s unfair
I lived outside California for 17 years. When I moved back to the state, I sought treatment at the hemophilia treatment center (HTC) closest to my home, a six-hour drive, but still in the state. But that particular HTC didn’t specialize in treating women with hemophilia, so I had to look for one that did. While I found one, it was eight hours away in Oregon. Still, a phenomenal hematologist at that HTC changed my life, so it was worth the effort to get there.
According to the U.S. Centers for Disease Control and Prevention’s Community Counts project, I am one of 1,587 women with a hemophilia A diagnosis being treated at an HTC. If women were split evenly among the 141 HTCs in the U.S. (we’re not), it would total about 11 women per treatment center. With such small numbers, it can be hard for doctors to learn how to treat the nuances that are unique to women with hemophilia. This is why the Foundation for Women and Girls+ with Blood Disorders was formed. This organization helps guide physicians and supports the creation of specialized centers for women with bleeding disorders to ensure better care.
People with rare diseases have limited options for specialized care. As patients, we have the right to choose who we utilize for that care. We also have the right to follow up with highly skilled and specialized healthcare providers that we trust. But California law prevents patients from speaking to an out-of-state doctor unless they are licensed in California. Many aren’t. I think it’s unrealistic to ask every rare disease specialist across the country to obtain a medical license in California so that a few patients located here can access their expertise.
“Limiting access to medical specialists benefits no one,” Caleb Trotter, an attorney at Pacific Legal Foundation, said in a press release announcing the lawsuit in May 2024. “There is no excuse for Californians — or anyone — to suffer simply because a member of their care team is in another state.”
If I have a serious, active bleed and need to seek guidance from my team, having to drive two hours to cross a state border seems to me an insane requirement. Forcing rare disease patients and their families who live in California to travel across state lines every time they need to consult their doctors is an unfair burden. People struggle with travel expenses, stress, and time away from work. It’s unfortunate that some patients with the most serious medical needs are denied convenient access to telehealth appointments with their chosen specialists.
Unfortunately, a federal judge didn’t agree and dismissed the lawsuit last November. In an email to me, Trotter said the Pacific Legal Foundation would appeal the ruling.
I’m thankful for the Pacific Legal Foundation’s support as I continue to represent rare disease patients in California in this lawsuit. I’m hopeful the outcome of an eventual appeal will give rare disease patients in California the ability to consult with out-of-state specialists from the comfort of their own homes. The burden this would alleviate is huge.
Rare disease patients in California — and everywhere else — should have the opportunity to seek out the specialists they believe are best-suited for them, no matter where they are located.
Note: Hemophilia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Hemophilia News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to hemophilia.
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