It wasn't Mother Nature that delayed some volunteer medical teams from responding quickly to Hurricane Katrina late last month, but concerns over medical licensing.

The response by doctors and nurses from Northwest Medical Teams, based in Portland, was delayed by four days as the licensing issues were resolved, said Dr. Dan Diamond and Dr. Tom Hoggard, two volunteers who provided aid.

"That's just tragic in my mind," said Diamond, who practices medicine in Silverdale, Kitsap County.

Medical practitioners are licensed by individual states, so a doctor licensed only in Washington can't legally practice in Louisiana unless an exemption is granted.

Louisiana Gov. Kathleen Blanco issued such an exemption after the hurricane, but the process took a few days.

There are similar requirements for responders to international disasters. But Hoggard, who lives near Portland and has responded to more than a dozen disasters, said the licensing process overseas isn't as complex and moves faster than in the United States.

"It's sort of like the old-fashioned handshake on a deal," he said, "It's not as legalistic as we have in the United States."

Barbara Agnew, a spokeswoman for Northwest Medical Teams, said the organization responded to December's tsunami in South Asia within 48 hours.

Before Blanco issued the exemption, Northwest Medical Teams was considering having its doctors work under the licenses of Louisiana physicians, something the state allows for emergency purposes.

The only medical professionals who can sidestep state licensing requirements are members of the Disaster Medical Assistance Teams (DMATs) organized through the Federal Emergency Management Agency (FEMA). When activated by FEMA, team members have federal-employee status that allows them to practice outside the state where they are licensed.

"Many people in charge don't realize that hours make the difference between life and death" in disasters, Hoggard said.

Hoggard and Diamond said they plan to introduce resolutions to the American Medical Association for a type of national licensure for professionals trained in disaster response. Hoggard said the resolutions will be mindful of states' rights to regulate medical practice.

"It's not 'to hell with state laws,' it's how can we amend this and fix it," Hoggard said. "We just have so many laws and so many hindrances that make it difficult."

Vanessa Renée Casavant: 206-464-2761 vcasavant@seattletimes.com