Addendum: Medical Licensure Reciprocity in Missouri

Executive Summary 

The U.S. is expected to fall short of the required physicians needed to meet its growing healthcare needs. Policies allowing medical professionals with out-of-state licenses to practice (or gain an expedited license) vary greatly between states, but are one method being explored by states to address the growing physician shortage. Some policies are one-way, some are two-way (“reciprocal”), and others seek alternatives to federal action by creating multi-state agreements. Introduced in the 2022 Missouri legislative session, two bills (HB 2343 and SB 1002) seek to grant any person holding a valid and current physician or surgeons license (issued in another state and held for at least one year) an exemption on any examination, education, and experiential requirements when obtaining a reciprocal license in Missouri.  

Highlights 

• Licensure agreements, when combined with digital technologies, may help increase overall medical access, reduce costs, and improve patient outcomes in emergency situations where local expertise is unavailable.

• Several states have used limited purpose licenses, mutual recognition licenses, and streamlined procedures through interstate compacts to allow flexibility in obtaining medical licensure.

Limitations 

• Comparative studies on the overall efficacy of one licensure model over another in decreasing medical shortages are not available.

• Most recent studies focus on interstate compacts and their effects on medical licensures and health care rather than other methods of license reciprocity.