Arkansas is a rural state that suffers from a shortage of medical professionals.  One oft-discussed idea would assign advanced nurse practitioners a greater role.  A lesser-known idea allows medical professionals to volunteer across state lines.


It's early on a recent Saturday morning at Manassas High School on Memphis' near-north side.  Remote Area Medical (RAM), a Tennessee non-profit founded in 1985 has attracted more than 200 medical professional volunteers to a free clinic for the needy.  By day's end about 350 patients receive free dental, medical or vision care.  Hundreds more receive care on Sunday at the portable clinic.


One volunteer said she'd been participating in RAM clinics for eight years.  Another traveled with a group from Buffalo, N.Y.  Interest in the idea has grown as media including The N.Y. Times, Wall Street Journal and Sixty Minutes have reported on RAM and its septuagenarian founder, Stan Brock.


RAM's core values are compassion, integrity and respect.  The group's mission is to "prevent pain and alleviate suffering by providing free, quality health care to those in need."  To serve the needy, some medical volunteers cross state lines.


A free medical clinic with out-of-state professionals can occur in Memphis but not across the Mississippi River in Arkansas.  Only 13 states allow medical professionals to volunteer across state lines to help the needy, and Arkansas is not among them.


Demand is especially great for dental and vision care, which the Affordable Care Act does not mandate for adults.  The act has not reduced clinic demand, according to Brock.  Dental care was the most sought-after service in Memphis.


The needy face shortages when restrictive licensing laws reduce medical supply.


Policymakers in three nearby states recognize the problem.  Tennessee was the first, passing the Volunteer Health Care Services Act in 1995.  The measure allows physicians from other states to visit Tennessee and provide free charity care "without having to go through an onerous re-licensing process," reports Steve Ishmael of the Show-Me Institute, a Missouri think tank and fellow State Policy Network member.  The measure also provided liability protections similar to those under Good Samaritan Laws.


"Tennessee was suddenly able to leverage the services of doctors licensed in other states to meet the needs of some of its most vulnerable and underserved citizens," Ishmael explained, noting RAM's role in the reform.


Missouri's policy changed after RAM sent a mobile eyeglass laboratory after the 2011 Joplin tornado.  Missouri law prevented its operation, leading lawmakers to later allow medical license portability.


Oklahoma also allows medical volunteers to cross state lines to serve the needy.


Other regional states that have acted are Virginia, Kentucky and North Carolina.


Medical groups have also acted.  The Federation of State Medical Boards includes 70 licensing and disciplinary boards in the U.S. and its territories.  In 2000, the group created a license portability panel that encouraged state boards to "implement systems to improve license portability that foster cooperation and consistency" among members "with a sense of urgency."


The idea that medical professionals should be able to volunteer across state lines to serve the needy warrants serious consideration in Arkansas.



Author: Greg Kaza (Policy Foundation Executive Director)

Editor's Note: He attended the Memphis RAM clinic.

Jonesboro Sun

November 1, 2016