State Licenses and MPN Specialists or Treatment Across Borders

[gvibes]

Hi Everyone,

My MPN doc just told me that he may not be able to continue treating me in the manner we have grown accustomed to after February 2022. I have p-vera and he has been supporting my care for almost a year with email exchanges and zoom calls. He is in NYC and is licensed in NY. I am in Connecticut. I guess Connecticut relaxed its licensing requirements during COVID so we have been using telehealth to provide specialized consulting for my p-vera. I also work with a local hematologist who does not have expertise in MPN, but is flexible and works with my MPN doc.

I guess the rules are going back to what they were - (unless they extend them). He can not treat me in Connecticut because he is not licensed in Connecticut. I think the rules allow me to drive a couple of hours and see my doc in NYC (out of network) or I could cross the border into NYC and find an internet connection and do a zoom call (really?). I'm sure I can find a solution to this as I am not that far. But then I thought of national MPN docs who should be advising patients who maybe can't because of licensing and state laws. Curious how it works across borders of countries as well...

Are there any exceptions for rare diseases? Does anyone have any experiences with these kind of political boundaries?

thanks

[EPguy]

I inquired about cross state appointments last year, and even with the Covid rules some states cannot have it, Calif is fussy.

You're right, you can do a Zoom from you car at the state border to qualify.

The Cornell (Silver) group in NY at one time at least offered continuing out-of-state visits if you had a 1st one in-state. The MD Anderson in Texas did not offer this option.

[gvibes in reply to EPguy]

Thanks. I'm involved with the Cornell group. So it sounds like its a decision by the particular hospital/practice probably complicated by state laws.

[Inclement]

Hope you resolve your problem. Here in UK there are not as far as I know such restrictions - at the moment I have opted for a MPN specialist in adjoining county for example - but if the reports of possible further reorganisation of NHS into 'academies' or whatever I wonder whether we might be going down the same US style format in the future? Hopefully not.

[gvibes]

Yeah, not that I know much about yours, but hopefully you won't be modeling it after US system.

[hunter5582]

You do have it right. This is a matter of State licensing code and States have been going back to the traditional rules, unfortunately. The only legal work-around is to drive just over the border and find a place to use an internet link. One would think the States would extend the flexibility a bit longer given the Omicron outbreak, but sadly it may not be so.

Perhaps the States will someday work out something better. For now, we just have to deal with how it is.

[BlastedKnees]

The fact that you can drive over the state line and connect through Zoom is ridiculous.

I'd be tempted to use a virtual background of Central Park. "Eyyyyy doc, I'm just a regulah guy callin from the pahk."

What prevents a person from using a VPN with a server in New York? To anyone on the other side the connection originates from within NY.

Can only laugh at the attempts to control virtual services in an environment without borders. Clearly I don't advocate for breaking any laws.

[gvibes]

I like your virtual background idea.....I guess your IP address locates you. is that right? not that I know anything or would break the law. In the detective stories and criminal tv shows, it seems that criminals are located that way or the real hackers send their origin somehow to foreign servers.