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Multiple State Medical Licenses

If you’re a physician with a single medical license then I want you to consider getting a medical license in another state even if you don’t foresee yourself needing it or using it.

My cheap ass is telling you to pay money for something so you know that I must have a good reason to do so.

Imagine you are 35 years old, have a family, a mortgage, and student loan debt. Your employer suddenly decides to take you off patient-care until they resolve an internal investigation. You then get investigated by the medical board and now have to check the box “Have you gotten/are you currently being investigated by a medical board?”. You are unemployed, with a hefty monthly overhead, and nobody will hire you in your state.


Insuring Your Income

You can insure your dog, car, house, medical practice, and your income. Well, you can insure your income against physical and sometimes emotional disability but you cannot insure your medical license directly.

There is unemployment and there is disability – neither of which is a rapid option.

If you have a medical license in Texas then you likely know how brutal they are when it comes to punishing physicians. Should your medical license get taken away or be suspended during a medical board investigation then you have no way of continuing to earn an income to pay for the legal fees.

Having a medical license in a nearby state means that you can hop the border physically or virtually and continue seeing patients in-person or via telemedicine.


2nd Medical License

I know a physician who has 40 state medical licenses, she is a director for a medical startup. Every year around her birthday she has multiple applications to complete and licensing fees to pay.

You don’t need 40 but you are too vulnerable with just 1 medical license.

Some states have reciprocity with their nearby states. If you are licensed in Oregon, for example, and apply for a Washington license then your application is often expedited.

Many of my friends have medical licenses in NV and AZ. Some have gotten their medical license in Alaska for locum tenens and maintained it ever since.


You do not need to be physically present in another state to apply for their medical license. The process is fairly easy to do online.

Even when you renew your medical license and they ask you where you’re practicing, there is nothing wrong with saying that you are keeping your medical license active without having seen any patients in the alternate state.

Organizations such as Interstate Medical Licensure Compact expedite the process for physicians seeking medical licenses in multiple states.

Why Not Wait?

Why not wait to apply until you need the 2nd medical license?

The problem is that by the time you are in the middle of a medical board investigation or a lawsuit it’ll be that much harder to get approved for a 2nd medical license.

Applying for multiple state medical licenses while your record is clean makes the process much easier. Once you have a DUI, a misdemeanor, a felony, a medical board complaint, an investigation, or a lawsuit, you’ll have to provide a ton of documentation which makes the process insurmountable.

Failing to disclose your investigation to a new employer can be a big deal because the medical board and other entities will look for this and that application you sign falsely would be considered perjury.


Writing off The Licensing Fees

Don’t just apply for another medical license and pay it out of pocket. Approach this matter strategically.

You can start a ‘business’ where you’re hoping to be a locum tenens physician. You do not need to file for a business license, you don’t need an EIN, or anything fancy. You simply become a sole proprietor while you’re working your regular job on the side.

Pursuing a 2nd medical license now can be written off on your taxes. You’d file a Schedule C and write off the related expenses against your income. Even if you have no income from the sole proprietor locum tenens business, you can still write it off against your job income.

You can continue to write off the licensing fees year after year until the time comes that you need to use it. As long as a business is considered viable by the IRS you can continue to have no income from it and still write off the expenses against other unrelated (job) income.


Getting Credentialed in Another State

I would urge my fellow physicians to take it a step further and get credentialed with another medical group in another state.

Your current employer may not allow you to work for another medical group but you are allowed to apply for credentialing.

Telemedicine companies are probably the easiest way to accomplish this.

Another important reason to do this now as opposed to waiting is because by the time you get investigated by a medical board or are dealing with a lawsuit it’s too late to apply for credentialing. Most medical groups will either not take you through the credentialing process or ask you to wait until the matter is resolved before credentialing you.


Practice or Not To Practice

I’m a rebel so take this bit with a grain of salt. Even if your current employer doesn’t allow you to work another medical job  it’s best to give them the middle finger and do it anyway.

I am not saying you should work part-time for 2 different medical groups – that is inefficient.

However, you could remain 100% employed by your current employer and pick up a very occasional shift with a non-competing medical group in the other state.

Your medical group is incredibly unlikely to find this out. Should they find it out then they’ll give you a warning. There is no easy way for them to monitor your practice habits if you’re doing it in another state.

Employer Loyalty

I wish I could continue to believe that my employers are loyal to me but this has proven false in my case. When shit hit the fan my medical group kicked me to the curb without hesitation.

I can’t blame them – it was the right thing to do as a business. But as a multibillion dollar business they aren’t going to put themselves at risk for one individual. Cutting me loose was the logical thing to do.

You should be as loyal to your employer as they are to you. Should the time come, will your employer choose the business and the money or the employee?

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