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To the Editor: In their Commentary on professional monopolies in medicine, Drs Baerlocher and Detsky¹ might have mentioned the institution of state licensure of physicians in the United States. Whatever its value in ensuring that only qualified, competent, and ethical physicians are licensed to practice medicine in each state, the current system hinders the mobility of many physicians, effectively circumscribing the geographic range of their practice.² Whether this narrowing of competition and choice distorts the cost of medical care is presently unknown because of a lack of useful data.

New technologies will furnish the means to challenge the prevailing scope-of-practice monopolies. Technological innovation may create new forms of interaction between patient and physician, including electronic interactions that are consistent with quality care. In-person examination and conference are essential for many but not all patient-physician contacts.³ The opportunities for more flexible and cost-efficient methods of health care delivery, unconstrained by state . . . [Full Text of this Article]

Rebecca A. Harris, BSc
rebecca.harris@jefferson.edu
Jefferson Medical College
Thomas Jefferson University
Philadelphia, Pennsylvania

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RELATED ARTICLE

Professional Monopolies in Medicine
Mark O. Baerlocher and Allan S. Detsky
JAMA. 2009;301(8):858-860.
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