Doctors are trying to prescribe antidepressants in parts of the state that are restricted by law.

Shortly after Dr. Mrs. finished. During his medical career in San Francisco Bay Area, Fleming worked on his Texas medical license. The family medicine doctor had no plans to move there but spent nine months studying Texas medical law, put in retrospect, got a fingerprint, and paid hundreds of dollars. in license fees.

It’s a process that was completed for more than a dozen other states – most recently New Mexico, in February.

“Where I live, it’s a place where abortion can be had,” said Fleming, a worker in San Francisco, California. “My way is to make the way bigger than my stomach.”

Fleming is on a wave of doctors, nurses, and health care providers who are licensed in many states so they can use telemedicine and telemedicine to help. more women to receive medications.

But they are being perpetuated by state regulations. Many states restrict the ability of physicians to communicate with patients online or by phone and / or to dispense medications via email. A result of the new law could replace them out, which prosecutors have demanded to oppose and argue the drug cannot be prescribed without scrutiny. to man.

This year, 22 states introduced 104 joint proposals that are trying to curb the ban on prescription drugs, such as banning the shipment of prescription drugs and / or demanding prescription drugs. to them to be given the body, according to the Guttmacher Institute, an organization that researches and advocates for lethal rights. Four of those proposals were decided by South Dakota.

In Georgia, lawyers are considering where to demand the release of prescription drugs and prevent anyone from sending them via email. The bill, which passed one of the two chambers of Georgia’s legislature, also requires pregnant patients to go through physical tests to look at minor complaints and gather more information, a plan said. commonly used by anti-abortion lawyers to be very difficult. have got.

“We don’t visit telemedicine and teach a woman how to perform an abortion,” said Bruce Thompson (R-White), the Georgia state senator who introduced the measure. “Why do we have to deal with drugs if, in fact, there are so many doctors or clinics around the state?”

If it passes, Georgia will join 19 other states that ban telemedicine in order to save medicine.

In antidepressant medication, people up to 10 weeks pregnant can end their pregnancy by eating two fruits over 48 hours: mifepristone, which eliminates pregnancy. pregnancy, and misoprostol, which expels. The method has become very popular, with more than half of all controversies in the U.S. by 2020 being prescription drugs.

Over the past year, the FDA has made it easier for health professionals to prescribe over -the -counter medications by removing the requirement to be delivered in an office or hospital. It opens the door for patients to consult with a certified physician online or by phone and receive a prescription sent by a licensed physician.

Dr. Lester Ruppersberger, a retired OB-GYN and president of the Catholic Medical Council in 2016, has opposed telemedicine abortion, saying patients should decide to face a doctor.

Women need to get tested first, she said, and see a doctor or OB-GYN in case of complications later.

“If someone really wants to have a baby, whether it’s a surgery or a medicine, and the nearest house where you can safely enter that procedure is three hours away, then you have to go to your car, very healthy, and drive three hours. make good use of the health system, ”said Ruppersberger, who is the medical director of two emergency pregnancy centers in Pennsylvania that provide pregnancy care while minimizing miscarriage.

But some providers have seen the FDA change as an opportunity to increase access for people in states that restrict extermination procedures and / or restrictions. medicine.

For nearly two years, Fleming flew to Texas a few days a month to undergo dismissal procedures, but that ended in September 2021, when SB 8 was enacted, which Texas law prohibits all divorce proceedings after six weeks. Since then, different laws have been enacted in Idaho and Oklahoma.

This summer, the U.S. Supreme Court is likely to pass a 15 -week ban on Mississippi, a case that could end the state’s right to confiscation. Roe v. Wade and leave the question to the states.

In the meantime, Fleming first used telemedicine to try to take the guts to other people, despite the abuses. Most of her patients come from states with permitted regulations but live in rural areas or other areas where it is difficult to get a cure.

“The end result of this approach is to increase participation for people who have no other choice,” Fleming said. “But it doesn’t really solve the underlying problem and the fixers don’t have to stay in the first place.”

At the heart of Fleming’s argument: Regardless of how many providers licensed in the states allow telemedicine and email in the argument, they can’t provide those services. in most states it is not.

“We’re coming to a time when states are being served with better regulatory standards,” said Elisa Wells, founder and director of Plan C, which helps patients access medications. .

When the FDA approved the new rules last year, Wells offered research grants to a number of providers to complete their telemedicine operations. They used the money for criminal insurance, licenses, and other costs.

One of those doctors, Drs. Detroit -based Razel Remen has licenses in several states. Remen performs injuries at a Michigan hospital and can serve patients in Colorado, Illinois, Minnesota, and New York and through telemedicine.

Remen said he was encouraged to get into telemedicine when he saw Dr. Rebecca Gomperts, founder of a group called Aid Access.

Aid Access is relying on nine U.S. -appointed doctors to provide medications in states that allow it through telemedicine. To serve patients in the remaining states, the company works through a physician and pharmacist outside the US; Nor subject to U.S. laws. Gomperts practices in Austria and prescribes pain medicine through Indian medicine.

Joanne Spetz, director of the Philip R. Lee Institute for Health Policy Studies at the University of California-San Francisco, said physicians interested in providing medications across state lines could do a lot. of the states to replace the operation.

“These efforts to validate and train and educate additional physicians can help reduce pressure on the system,” Spetz said. But “if someone doesn’t want to try to circumvent those state laws, it won’t help.”

This story was created by KHN, which publishes California Healthline, an independent editorial service of the California Health Care Foundation.

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