Teleradiology and state licensing

I recently read this statement by the AAOMR regarding teleradiology and state licensing, which summarizes and exerpts the “Comprehensive ADA Policy Statement on Teledentistry,” ratified by the House of Delegates in November 2015, and ADA Technical Report No. 1060, “The Secure Exchange and Utilization of Digital Images in Dentistry,” from 2011.

These reports define what teleradiology is and include recommendations for treating and attempt to clarify in which state the provider should be licensed. A dentist should obviously be licensed in the state where a patient receives treatment, but with what has been called the “virtual patient”, it isn’t so cut and dry. The reports define this virtual patient as electronic information that is transferred to the provider who receives the referral. In that sense, the virtual patient is now being treated in the state in which the specialist lives and that provider should maintain a license and is held to the standards provided by that state. It is similar to when the actual patient travels across state borders to receive treatment by another provider; in that case it would not be reasonable to expect the receiving provider to maintain a license in the state which the patient came from.

What does this mean for Oral Radiology, specifically Oral Teleradiology?

I live in Massachusetts, I have an active Massachusetts dental license and everything I do as part of my practice falls under that license. Dentists referring to me from other states are “virtually” sending their patients to me across state lines, but without the patient actually having to travel. I am diagnosing the patient’s radiographs, which is undoubtedly practicing dentistry, but I am doing it within the state in which I hold an active license, and I am responsible to that state board.

In a way, this is better than expecting a radiologist, or other provider, to maintain licenses in several states at the same time. If a specialist had a Florida dental license and he didn’t use it very often because he didn’t get many referrals from Florida, would he be less worried about disciplinary action from the Florida dental board? If, on the other hand, he knows every patient he sees is covered under the state license from the state in which he resides, he will treat every case equally.

Can an oral radiologist provide a CBCT Report from any state?

It seems like that is the recommendation from these ADA reports and the AAOMR’s interpretation of them. But it is always best to check specifically with your specific dental board. They may not even have a specific answer so feel free to refer them to this blog and they can investigate the link and the reports themselves. This is still an evolving area, but this seems to be a logical and reasonable solution.

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