special report
Gotta catch 'em all (Medical licenses version?)
Thumỹ Phan for STAT
Historically, doctors have gotten their medical license — singular — in whatever state they live and practice in. A doctor with a handful of licenses was an anomaly, and someone with licenses for all fifty states and the District of Columbia was almost unheard of. But that's changed in the years since Covid began driving patients online, STAT's Katie Palmer reports. In part 2 of The Virtual Rx Boom, she explains how the number of physicians seeking multi-state licensure has ballooned to support the growing field of telehealth.
To be clear, these doctors don't max out on licenses just to practice in every state. Often, they own the medical groups affiliated with nationwide telehealth companies. "The telemedicine clients I work with, they can't get into enough states fast enough or hire people fast enough because there's such a big push right now," attorney Bradford Adatto told Katie. By 2024, 172 doctors held active licenses in all 50 states, and another 356 doctors had acquired at least 45 — significantly outpacing the profession's overall growth. Read more in this fascinating story, and don't forget to go back to part 1 of the series if you haven't read it yet.
public health
What school-level vax rates tell us about the Texas measles outbreak
This year, a measles outbreak concentrated in West Texas and surrounding states sickened more than 760 people and killed two young children. Ninety-three percent of those who got infected were unvaccinated. While Texas kindergarteners are, on average, more vaccinated against measles than kids in other states, a study published yesterday in the Annals of Internal Medicine shows that county- and school-level coverage rates can tell a different story.
School districts and private schools with "alarmingly low" MMR vaccination rates are often situated within counties where overall coverage is close to or even meets the 95% public health target to maintain measles elimination, the study found. For example, the epicenter of this year's outbreak was Gaines County, which has 82% coverage. But within that county, school vaccination rates ranged from 46% to 94%. Nearby Terry County had a vaccination rate of 95.5%, but individual school rates ranged from 46% to 97%.
Kids carry and pass along germs like it's their job. A single measles case inside of a school with 85% vaccine coverage is likely to create a school-based outbreak, per the study. The CDC only publishes state-level vaccination data, but the authors argue that more granular information should be collected and distributed in order to identify at-risk communities and better address localized vaccine hesitancy. Meanwhile, Texas has made it even easier for parents to opt their children out of state-required immunizations.
science
Federal science and bioethics advisers, cast aside
Since January, President Trump's administration has terminated nearly four dozen committees that provide advice to various agencies within HHS. These groups worked on hospital infection control, made recommendations for long Covid research, assessed which genetic conditions newborns should be screened for, and more. More than half of the terminated panels are groups of outside experts assembled by the NIH to review grant applications for specialized topics unique to individual institutes.
"It's really more about people that measure up to the qualifications by their obedience to a political orthodoxy, rather than based upon science and evidence," said Lawrence Gostin, who was dismissed from a position on an advisory board to the Fogarty International Center. Just weeks before being let go, he met with Bhattacharya at a dinner for the center and tried to make a case for continued funding. Read more from STAT's Megan Molteni, with, once again, Anil. (Newsletter hat trick for Anil today!)
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