by Brenée Goforth
Communications Associate, John Locke Foundation
The Cato Institute recently released a report on education and credentialing of medical professionals. JLF’s Jordan Roberts examined some of the report’s finding in his research brief this week:
One area of our recommendations highlighted state licensing and scope of practice for health professionals. As it stands now, medical licensure and scope of practice regulations often reduce the supply and create barriers to health care for patients. They increase the cost of providing health care and inhibit the upward mobility of health care professionals. They give politicians and special interests too much control over the provision of health care.
The Report refers to “right-skilling” and “wrong-skilling.” Roberts explains:
Correct medical licensing requires the right balance of training and flexibility among health professionals concerning education and scope of practice. The report refers to this proper balance as “right-skilling”:
Maximizing access to quality health care requires right-skilling (i.e., striking a balance between too little and too much education and training). Requiring clinicians to receive more education and training than is necessary to do their jobs is wrong-skilling, which harms clinicians by unnecessarily restricting employment opportunities and harms patients by reducing access to care.
Decades of incumbent control and cronyism in health care, however, has shifted the balance shifted from right-skilling in favor of wrong-skilling.
A potential way to limit “wrong-skilling” is thirds party credentialing. Roberts writes:
[T]heir report calls for more flexible education and training processes for states using third-party organizations not subject to political influence. The report explains how the system would operate:
In such a system, states would not directly license individual clinicians, determine which clinician categories could exist, or delineate scopes of practice. Instead, states would rely upon third-party private and public organizations to accredit education, training, and certification programs that would perform these functions.
Degree- or certificate-issuing organizations would determine the categories of clinicians they would certify, including new categories (e.g., dental therapists, primary care technicians, community paramedics, and assistant physicians), and the education requirements and scopes of practice for each category.