When most states have adopted the Interstate Medical Licensure Compact and a handful have not, the holdouts owe their physicians and patients an explanation. The usual one — protecting the integrity of the state's medical board — no longer holds up. The compact does not weaken board authority. It streamlines verification for physicians who are already fully licensed and in good standing elsewhere.
So what is actually keeping the remaining states out? Usually some combination of legislative inertia, fee-structure concerns, and a general reluctance to cede any piece of a state-run process. None of those are reasons. They are obstacles, and obstacles can be moved.
The cost of staying out is real. Holdout states make themselves harder to staff, slower to fill shortage areas, and less attractive to the exact telehealth and locum physicians who could close gaps fastest.
PLG tracks compact adoption bill by bill and makes the case to the holdouts in terms their legislatures respond to: workforce, access, and competitiveness. If your state is on the outside of the map, there is a path in — and it runs through the statehouse.