Consider two bits of regulatory logic concerning the medical treatment of animals and humans: (1) If I email advice on what to feed a cat to someone overseas, that’s constitutionally protected speech; if a veterinarian does the same, he may be fined and stripped of his license to practice. (2) If a doctor has an office his patients don’t visit, he’s welcome to make house calls; if he gives up the office, those house calls may prompt demands that he surrender his license to practice.
Ron Hines, a disabled Texas veterinarian, unsuccessfully challenged the first conundrum. Carroll Landrum, a Mississippi physician, successfully fought the second.
Hines was disabled by a work-related accident in 1973, but he has maintained his veterinary license and practiced ever since. In 2002, an aid worker in Nigeria needed advice on feeding the cat she and her husband brought from Scotland. Lacking commercial foods and local veterinary care, she emailed Hines, and he offered nutritional information. His Internet reputation spread, and for 11 years, he helped hundreds of pet owners around the world — many in remote areas where care was difficult to obtain. Hines gave the advice for free or for a flat fee of $58. No complaints were ever issued against his advice.
In 2013, the Texas State Board of Veterinary Medical Examiners learned of his charitable endeavor; they fined and reprimanded him and suspended his license to practice. The board, he learned, forbids vets from proffering advice to specific owners unless they have personally examined the animals — even on routine matters like food recipes. (Of course, there was no possibility of Hines examining animals in remote parts of the world.)
The Institute for Justice, a D.C.-area legal practice that defends economic liberties, took Hines’ case and argued that the regulations violate his First Amendment right to free speech. A federal court ruled in Hines’ favor, but the decision was overturned on appeal. The Supreme Court declined to hear the case, leaving the boundary between constitutionally protected speech and unprotected occupational actions unsettled. Another legal case may soon resolve the issue.
Jeff Rowes, an IJ senior attorney who argued the Hines case, sees the matter as critically important: “The internet has made it possible for experts to provide helpful tele-advice to people around the world, and it is essential for the courts to protect that speech — which is currently caught in a web of state-based licensing laws — by recognizing that one-on-one advice is protected by the First Amendment.”
In Mississippi, Landrum faced a different charity-care issue. Landrum had closed his office because of drug-related crime in the vicinity. Like Hines, he maintained his license. Semi-retired, he began making three to four house calls a day for those in need — usually for free. He operated from his car, driving to remote, often impoverished areas. He met patients at their homes, by the sides of a road, wherever they wished.
After receiving an anonymous complaint about Landrum’s mobile practice, the Mississippi State Board of Medical Licensure sent an investigator to visit Landrum and ordered him to surrender his license. While the board didn’t clarify the nature of the complaint, it seemed to revolve around his lack of a bricks-and-mortar office (which, presumably, few of his patients would visit).
Landrum defiantly refused to surrender his license. The Arizona-based Goldwater Institute came to his defense, and a legal tug-of-war over records on the investigation ensued. After a sometimes-hostile process lasting nearly six months, Landrum was allowed to keep his license and continue practicing from his car, in exchange for a promise to centralize his record-keeping.
The attorney who defended Landrum, Christina Sandefur, noted that he was fortunate; such legal struggles can often drag out for years. She believes the quick and positive conclusion stemmed from multiple factors: Landrum had never harmed any patients; he had, in fact, saved lives; and the nature of his work generated a groundswell of publicity and public support.
The Hines and Landrum cases share a common thread: regulators restricting the supply of care by forbidding older professionals from using their knowledge and skills on a part-time and low-cost basis — consigning them to watch television rather than helping others.