Lifeline vs. State Line

“Oregon fixed it.” She says, “They got to the root of some issues, believed me, [and] saw that when I said I was bleeding, I really was. They figured things out.”

Shellye has now been receiving treatment from this dedicated team for six years but still has to jump through hoops and fight red tape. California law says that speaking with her medical team via phone or Zoom could result in fines or jail time for physicians unless the provider pays the state for a California license to practice medicine. This isn't simply signing a form and paying a fee, though these are part of the process. There are background checks, fingerprinting, document gathering, renewals, and continuing education that take time and energy away from providing care.

This telemedicine ban means she can either drive seven hours, one way, to meet with doctors in person or drive two and a half hours to get over the border into Oregon. Even then, she sits in a parking lot and makes the same call she could have made from the comfort of her own home with better internet.

In either case, she says, “Any time I want to talk to my doctors, it’s a full day off work to get there and back.”

It wasn’t always this way. During the COVID-19 Pandemic, physicians and hospitals simply stopped following California’s rules.

“For a few months! It was this little wonderful period.” Shellye exclaims, “And I have to tell you, I got to sit on my couch and legally talk to my hematologist and we solved a major issue.” She says, “It was fantastic. It was so easy, and it seems so logical, and then the next time I tried to reschedule they said no, you need to drive all the way to Portland.”

The burden is so overbearing, so absurd andunnecessary, that Shellye, along with New York radiation oncologist Sean McBride, is challenging the prohibition in court, suing to ensure she, and others, can speak with their doctors without running afoul of the law.

Challenging Barriers

Shellye’s lawsuit, brought with the help of nonprofit law firm Pacific Legal Foundation, claims the prohibition on communication with out-of-state doctors is a Constitutional violation, both because “the government cannot erect such high barriers to the interstate practice of specialized medicine without demonstrating significant local benefits” and because “the U.S. Constitution prohibits the government from restricting conversations between patients and their physical-specialists based on the content of their discussions.”

In other words, government officials aren’t welcome by either party in the doctor-patient relationship but are using the force of law to the detriment of those they are supposed to serve.

For Shellye, the matter is both personal and far-reaching.

“I have a rare form of a rare disease that’s even more rare in women, and I feel like I have it easy because I’m not dying,” she says, “I can’t imagine the parent of a child with a rare form of cancer that’s being told they can’t consult with someone who might save their child’s life, and I find that disturbing. And the fact that our elected representatives will not stand up for that? It’s absurd.”

Such an intrusion would be bizarrely inappropriate in any other setting, but with the power of statute, legislators don’t seem to care. Shellye says legislators and bureaucrats in California who could change these restrictive policies may suffer from a lack of basic understanding.

“I do wonder how much they understand that these decisions have strong implications on the lives of patients who need the capacity to connect with outside individuals,” she says, “We have a completely taxed system right now. We have physicians who are drowning. This [telemedicine access] seems like a viable solution to make sure that everyone who needs healthcare gets it.”

Shellye is also concerned about the chilling effect the current policy could have on her care in an emergency. “My fear is that if I’m in an emergency situation where I’m bleeding profusely, will [a California hospital] call my treatment center? Will they then be able to direct my care?”

In other words, an emergency could land her in the care of a medical center who botched her care in years past. The California rule she is challenging could rob her of medical expertise when she needs it most.

“What if I don’t have three hours to drive across the border to make a phone call?” she says, “I don’t want to be in that position, and I shouldn’t have to be.”

An Overloaded System

As a California resident, Shellye’s desire to seek out-of-state medical care is especially relevant.

“The reason I got up to my specialist in Portland is because I had a horrific experience where the doctors here didn’t get it right,” she says, “The irony is that they are forcing you to use California doctors, but in my case, the California doctors failed me.”

She also points to the broader problems with the California medical system right now:

“One of the things I don’t understand is with California having a shortage of medical professionals in some areas, why on earth would they be stopping people like me from accessing care? It actually takes some pressure off an overloaded system. It’s mind-boggling.”

When asked why the Medical Board of California, whose Executive Director is the named defendant in the lawsuit, isn’t advocating for easing telemedicine regulations, Shellye’s Attorney, Caleb Trotter, clarified that they, too, are stuck between a rock and a hard place. “The relationship with the medical board is kind of awkward… essentially, this isn’t their decision to make.” he says, It’s the legislature that has to do it… [the medical board] ultimately has to enforce the state law that the legislature makes.”

“I would love to see them stand up and protect any Californian who needs care,” Shellye says of her elected officials, “[these policies] really infringe on our ability to choose. It is my body. It is my health. It is my life.”

Following COVID-19, Florida, Delaware, and Arizona each kept and expanded their pandemic-adjusted telehealth laws, allowing for easier access to medical experts. Shellye is ready to bring about positive change in California as well.

“I am asking for permission to connect with the healthcare provider I believe can do the best job for me. And I should have that right.”