Unbiased Analysis of Today's Healthcare Issues

Physician licensure and quality: Part II

Written By: Jason Shafrin - Nov• 22•06

When traveling from San Diego to Milwaukee for Thanksgiving, my flight was delayed two hours.  While this was an inconvenience, it did provide me with the opportunity to finish the book Capitalism and Freedom by Milton Friedman.  The book espouses a libertarian point of view; this point of view is one which is currently held by many economists but one which at the time of publication (1962) was revolutionary in the face of the growing sympathy towards socialism and the Soviet Union. 

The book also examines the merits of the system of licensure which is practiced in the field of medicine.  Below are some excerpts:

“In practice, the major argument given for licensure by its proponents is…a strictly paternalistic argument that has little or no appeal.  Individuals, it is said, are incapable of choosing their own servants adequately, their own physician or plumber or barber.  In order for a man to choose a physician intelligently, he would have to be a physician himself.  Most of us, it is said are therefore incompetent and we must be protected against our own ignorance.  This amounts to saying that we in our capacity as voters must protect ourselves in our capacity as consumers against our own ignorance, by seeing to it that people are not served by incompetent physicians or plumbers or barbers.”

“If ‘medical practice’ is to be limited to licensed practitioners, it is necessary to define what medical practice is, and featherbedding is not something that is restricted to the railroads.  Under the interpretation of the statutes forbidding unauthorized practice of medicine, many things are restricted to licensed physicians that could perfectly well be done by technicians, and other skilled people who do not have a Cadillac medical training.”

“If you are a member of the profession and want to stay in good standing in the profession, you are seriously limited in the kind of experimentation you can do.  A ‘faith healer’ may be just a quack who is imposing himself on credulous patients, but maybe one in a thousand or in many thousands will produce an important improvement in medicine.  There are many different routes to knowledge and learning and the effect of restricting the practice of what is called medicine and defining it as we tend to do to a particular group who in the main have to conform to the prevailing orthodoxy, is certain to reduce the amount of experimentation that goes on and hence to reduce the rate of growth of knowledge in the area.”

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