IJ: On Wednesday, the United States District Court for the District of Columbia struck down a D.C. law that barred therapists from other jurisdictions from doing online teletherapy visits with clients in D.C. The decision comes nearly six years after Virginia-based counselor Elizabeth Brokamp teamed up with the Institute for Justice (IJ) to file a lawsuit arguing the law violated the First Amendment.
“This decision is a victory for anyone who speaks for a living,” said IJ Deputy Director of Litigation Robert McNamara. “Elizabeth’s victory here confirms that the First Amendment protects useful speech, including counseling, and that licensing boards can’t censor speech simply because someone doesn’t have their permission to talk.”
Congrats to the IJ! Now, we need to get rid of all the other bans on patients hiring physicians from other states. As I wrote last year:
During the pandemic, many restrictions on telemedicine were lifted, making it far easier for physicians to treat patients across state lines. That window has largely closed. Today, unless a doctor is separately licensed in a patient’s state—or the states have a formal agreement—remote care is often illegal. So if you live in Virginia and want a second opinion from a Mayo Clinic physician in Florida, you may have to fly to Florida, unless that Florida physician happens to hold a Virginia license.
The standard framing says this is a problem of physician licensing. That leads directly to calls for interstate compacts or federalizing medical licensure. Mutual recognition is good. Driver’s licenses are issued by states but are valid in every state. No one complains that Florida’s regime endangers Virginians. But mutual recognition or federal licensing is not the only solution nor the only way to think about this issue.
The real issue isn’t who licenses doctors. It’s that patients are forbidden from choosing a licensed doctor in another state. We can keep state-level licensing, but free the patient. Let any American consult any physician licensed in any state. That’s competitive federalism—no compacts, no federal agency, just patient choice.
Hat tip: Joel Selanikio.
