To the Editor: 

In the October 2015 issue of The Journal of the American Osteopathic Association, Maresh¹ commented on the Interstate Medical Licensure Compact (IMLC). As representatives of the osteopathic physicians and surgeons in Washington State, we do not support entering into the IMLC and offer counterpoints to a couple of Maresh’s “myth and fact” statements. 

First, concerning Section 13 of the IMLC, the actual costs of the Compact and its implementation needs are unknown. Utah’s Fiscal Note assumes a cost of $74,000 in fiscal year 2016.² This is an estimate only; a positive fiscal impact on the state of Utah is predicted, not calculated or appropriated. Washington State’s initial legislation³ would place responsibility for IMLC cost overruns specifically on osteopathic and allopathic physicians through required license fees. Potential cost overruns include the following³: 

Second, referring to Section 21 of the Compact, Maresh¹ argues that it would be simple for a state legislature to repeal the IMLC. However, partisan gridlock is an unfortunate reality nationwide and here in Washington State. Our legislature meets relatively infrequently and many routine legislative actions are falling by the wayside, so a hypothetical withdrawal from the IMLC would be onerous and expensive. 

Our organization does not support our state entering into the compact as it currently exists because of the unpredictable costs and unintended policy consequences that could be imposed upon our members. We are not against the idea of the IMLC and appreciate efforts to protect individual states’ ability to govern medical licensure. We encourage all osteopathic physicians and state associations to carefully compare the broad language of the Compact to the specific language in their individual state legislation; only then can individual states and medical associations make the objective decision as to whether to support joining the IMLC.