# Lawyers vs. Patients: How New Mexico’s Legislature Blocks Health Worker Compacts

New Mexico hospitals are bleeding staff while the Legislature debates. Forty-three states already use interstate compacts to bring in doctors and therapists faster. Why are we still waiting?

By Patrick Darnley Hudson, MD

I once worked on a surgical service where credentialing a new doctor could take half a year. The papers stacked up. Committees circled. Background checks dragged. A single missing signature froze everything. Meanwhile, the patients kept coming. Trauma does not wait. Cancer does not wait. Babies certainly do not wait.

That memory returned when a colleague from rural New Mexico called. Their hospital had one emergency physician left. One. Everyone else was a locum from out of state. Each one caught in licensing delays while the ER filled with what any ER fills with: chest pain, broken hips, premature labor, fear.

There is a remedy. Not exotic. Not experimental. Adopted by forty-three other states already. Interstate licensure compacts.

What Compacts Do

Compacts are simple.

If you are licensed in one member state, you can be cleared to practice in another without the marathon of paperwork. Standards remain. Competence is not lowered. Only the timeline changes.

That means a physician in Colorado can start here in weeks instead of months. A psychologist in Arizona can see patients in Farmington by telehealth. A physical therapist in Oklahoma can treat a post-op hip in Clovis without waiting for Santa Fe’s mill of forms to catch up.

This is not theory. The Interstate Medical Licensure Compact already links forty-three states plus D.C. and Guam. Similar compacts cover psychologists, social workers, physician assistants, therapists. They exist. They work.

Why Not New Mexico?

If they can do it, why not us?

The answer is not medicine. It is politics.

Our Legislature is lawyer-heavy. Senate Majority Leader Peter Wirth is an attorney. Senator Katy Duhigg, set to lead the new “work group,” is a practicing attorney. Many committee heads are trained in law. And the profession most threatened by compacts is law itself, especially trial law.

Compacts often include provisions that shield their commissions from broad lawsuits. They create uniform rules that cannot be altered piecemeal. For trial lawyers, that narrows future litigation. For patients, it opens doors.

Seven compacts passed the House this year. They died in the Senate. Amendments piled up. Language was rewritten. By the end the bills were disqualified by the compact commission or quietly buried.

Now leadership tells us they want to “study” the issue until January. It sounds like caution. It is not. It is delay, and delay here is certain denial.

• Federal money lost. Rural hospitals could have scored higher on federal grants if we joined four or more compacts. Waiting until January forfeits those dollars.

• Workforce kept out. Dentists, psychologists, social workers, audiologists, EMTs. All professions where we are short. All still locked out.

• Permanent exclusion. Rewrite a compact and you are out. These are contracts. They must be identical. Forty-three legislatures are not going to rewrite their laws for three senators in Santa Fe.

The Partisan Divide

To their credit, Republicans have pressed to act. They asked Governor Lujan Grisham to put compacts on the October agenda. They created a malpractice task force to highlight how litigation costs drive doctors away. Senator Craig Brandt called it straight: “trial attorneys in Democratic leadership” are blocking progress.

The GOP framed it in a way every physician understands: doctors over lawyers.

Where I Stand

I write this as an independent. I carry no partisan loyalty. But I am a doctor. I am a patient. I am a New Mexican. That means I have skin in this game. I know what it is to wait too long for care. I know what it is to watch colleagues pack up and leave because the system here makes practice impossible.

The stakes are not abstract. They are your dentist in Las Vegas. Your counselor in Gallup. The ER in Tucumcari — or any rural ER — that may or may not be staffed on Saturday night.

What We Are Choosing

By rejecting the compacts, New Mexico is choosing lawyers over patients. It is giving up federal funding, extending wait times, blocking telehealth, and keeping rural hospitals understaffed. All so a small circle of attorneys can protect their leverage.

Other states, red and blue alike, have already chosen patients. They chose access. They chose to set aside legal turf in favor of human need.

It is time New Mexico did the same.