In consequence, the nation's state-based medical licensure system now finds itself challenged to facilitate the growth of telemedicine over wide geographic areas while maintaining a high standard of medical care and ensuring public protection. Because the state licensure procedures can be both costly and daunting, physicians are typically only licensed in a small number of jurisdictions. Generally, physicians who practice medicine across state lines without physically being located in the state where the patient encounter occurs are required to have a full and unrestricted license in that state. As a result, a physician providing medical services over the Internet could be guilty of the unauthorized practice of medicine if the physician is not licensed to practice medicine in the state from which the patient logs on. Complicating matters further, states differ significantly in dealing with the practice of medicine and licensure issue in connection with telemedicine activities.
Some states prohibit unlicensed telemedicine explicitly.
Other states have enacted a limited telemedicine exception to their licensing statutes while a few others have proposed that physicians obtain limited licenses for telemedicine practice only. Many industry leaders and policymakers have called for a national licensing system to replace the patchwork of state law. The Model Act defines the practice of medicine as the rendering of either a medical opinion or treatment. Under the Model Act, the conduct of the practice of medicine would be considered to occur in the state in which the patient is located. It has already been stated that one of the advantages of telemedicine over the Internet is that it provides greater access to medical records.