Medical Licensing: Piles of Paperwork and Much-Needed Reform

Andrew N. Wilner, MD


July 21, 2015

In This Article


One of my recent Medscape articles, Medical Licensing: Enough With the Paperwork Already, provoked literally hundreds more comments than any piece I have ever written: 876 comments as of this publication. The torrent of responses overwhelmingly concurred with my frustration at the time-wasting and expensive requirements of having to repeatedly document the same biographical information in order to obtain and renew state licenses and hospital privileges.

Absurd and Heartbreaking

Many readers offered personal anecdotes that ranged from the absurd, such as inability to get a state medical license despite successful practice in another state because a foreign medical school was in a war zone and unable to provide the requested documentation, to the heartbreaking—a pediatrician leaving medicine because he could no longer stomach the "insane" paperwork.

Among other adjectives, Medscape readers described the current situation as "absolutely ridiculous," "irrational," "painful," "preposterous," and "stupid." One physician calculated that it took her 80 hours to complete the required forms. A psychiatrist abandoned applications for hospital privileges after spending months in the effort. One doctor waited 8 months to obtain a license in Texas. Another physician waited 18 months to be credentialed at a hospital. A pediatric endocrinologist had to make three trips to the police station for repeated attempts at fingerprinting. A 60-year-old internist retired rather than pursue a locum tenens career when her college transcript from the 1970s was requested.

The sheer volume of these administrative misadventures boggles the rational mind. How many more stories are there from those who could not take the time to comment? There are many causes of human misery, but paperwork should not rank high among them. Physicians are a tough bunch, yet at least two of the above readers quit medicine rather than confront more paperwork. What a waste of time and talent, particularly when the country faces a physician shortage!

One reader articulated the consensus: "A centralized approach/clearinghouse should be implemented as soon as possible, be fair and transparent, and have a reasonable cost. High school graduation place and date are not relevant."


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