Kels Charles G, Kels Lori H
Office of Health Affairs, Department of Homeland Security, 245 Murray Lane, Stop 0315, Washington, DC 20528, USA.
Mil Med. 2013 Mar;178(3):279-84. doi: 10.7205/MILMED-D-12-00390.
Licensure of medical professionals is an exercise of the states' police powers to protect public health and safety. Catastrophic events, however, do not respect state borders. Moreover, federal health care personnel routinely practice outside of states where they are licensed, and often must provide care across state lines in the course of their official duties. This article explores various modalities to reconcile both public health preparedness and federal medical services with the localized nature of medical licensure. It reviews the major initiatives undertaken to achieve expanded licensure portability, and offers policy prescriptions for respecting state sovereignty while enhancing flexibility in the mobility of health practitioners. The authors recommend a decentralized approach that incentivizes coordinated action among the states to resolve barriers to cross-border care, while addressing the situation of federal health care workers with explicit congressional recognition of their ability to practice nationwide on behalf of the U.S. government.
医疗专业人员的执照颁发是各州行使治安权以保护公众健康和安全的行为。然而，灾难性事件并不受州界限制。此外，联邦医疗保健人员经常在其获得执照的州以外的地方执业，并且在履行公务过程中常常必须跨州提供护理。本文探讨了各种方式，以协调公共卫生防备和联邦医疗服务与医疗执照颁发的本地化性质。它回顾了为实现扩大执照可携带性而采取的主要举措，并提出了在尊重州主权的同时提高医疗从业者流动灵活性的政策建议。作者建议采取一种分散化的方法，激励各州之间采取协调行动，以解决跨境护理的障碍，同时明确国会承认联邦医疗保健工作者代表美国政府在全国范围内执业的能力，以应对他们的情况。
