Doctors and patients are calling for more telehealth. Where is it?

By Isabel Ruehl. Originally published in MIT Technology Review on February 21, 2025.

Carmel Shachar is quoted in this article.

Maggie Barnidge, 18, has been managing cystic fibrosis her whole life. But not long after she moved out of her home state to start college, she came down with pneumonia and went into liver failure. She desperately wanted to get in touch with her doctor back home, whom she’d been seeing since she was diagnosed as an infant and who knew which treatments worked best for her—but he wasn’t allowed to practice telemedicine across state lines. The local hospital, and doctors unfamiliar with her complicated medical history, would have to do. 

“A lot of what Maggie needed wasn’t a physical exam,” says Barnidge’s mother, Elizabeth. “It was a conversation: What tests should I be getting next? What did my labs look like? She just needed her doctor who knew her well.”  

But doctors are generally allowed to practice medicine only where they have a license. This means they cannot treat patients across state lines unless they also have a license in the patient’s state, and most physicians have one or two licenses at most. This has led to what Ateev Mehrotra, a physician and professor of health policy at the Brown University School of Public Health, calls an “inane” norm: A woman with a rare cancer boarding an airplane, at the risk of her chemotherapy-weakened immune system, to see a specialist thousands of miles away, for example, or a baby with a rare disease who’s repeatedly shuttled between Arizona and Massachusetts. 

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