On professional power and conflict of interest: state licensing boards on trial

Licensing of the health professions is an issue of public policy which has been under fire for years. Economists argue that licensing stifles competition and increases health care costs. Manpower specialists contend that statutory scopes of practice create arbitrary barriers to both geographic and career mobility, and contribute to the reduced utilization of newer, emergent categories of health personnel. This paper addresses a subject that is often overlooked in the literature on licensing: the inherent conflict-of-interest in professional licensing boards, where the predominant voice on the boards is that of the regulated profession and, more directly, of practitioners who have a vested interested interest in their own policy making. A number of seminal court decisions are examined that address this issue and a new model for licensing boards is proposed. While this model would do away with the present structure of the boards, it would not sacrifice the critical role of technical information that only the licensed professions can provide.