156: Should State Licensing in Healthcare Go Away?

Note: This podcast and video were originally published on our website here on 05/14/2025.

Rethinking State Licensure in Healthcare for the 21st Century

State-based licensure for healthcare professionals has been the status quo for over a century. But in an era defined by digital health and telemedicine, is this 19th-century solution still fit for purpose? In this episode, I explore the historical context of state licensure, the modern-day challenges it poses to telehealth, and practical solutions for breaking down regulatory barriers.

Drawing insights from my experience as a state licensing board member and recent academic research, we dissect the structural flaws that limit patient access, drive up costs, and stifle innovation in healthcare. Here’s the original post on state licensure in healthcare that fueled this episode.

What we cover in this Episode:

• The origins of State-Based Licensure

• How Technology has Changed the healthcare Regulatory Landscape

• The Real-World Impact of State Licensing in healthcare & the Barriers it places to providing/receiving care

• Possible solutions or alternatives for State-based healthcare licensing

• How value-based care and regulatory policy are intertwined

Referenced Articles:

• Jeffrey David Iqbal, Nikola Biller-Andorno, The regulatory gap in digital health and alternative pathways to bridge it, Health Policy and Technology, Volume 11, Issue 3, 2022, https://doi.org/10.1016/j.hlpt.2022.100663.

• Gershuni O, Orr JM, Vogel A, Park K, Leider JP, Resnick BA, Czabanowska K. A Systematic Review on Professional Regulation and Credentialing of Public Health Workforce. International Journal of Environmental Research and Public Health. 2023; 20(5):4101. https://doi.org/10.3390/ijerph20054101

• Roy CG. Patient Safety Functions of State Medical Boards in the United States. Yale J Biol Med. 2021 Mar 31;94(1):165-173. PMID: 33795994; PMCID: PMC7995940. https://pmc.ncbi.nlm.nih.gov/articles/PMC7995940/

For More:

Join Rafael E. Salazar II, MHS, OTR/L (Rafi), principal of Rehab U Practice Solutions and host of The Better Outcomes Show as he explores the possibilities of a new healthcare. Guests range from clinicians trying new techniques and treatments to executives and entrepreneurs exploring new technology, innovative service delivery methods, business models, and organizational structures. Grab a copy of the book: Better Outcomes: A Guide to Humanizing Healthcare. Or, hire Rafi to speak at your organization or event.