The Case Against Licensing Health Professionals

Licensing confers a special authority, both literally and figuratively, which increases the likelihood of dependency on licensed personnel. The inequality of information available to the public, compared to the professional, creates a sense of mystification that supports the dependency. This dependency creates unrealistic expectations for patients about possibilities and about the power of the professional to rescue them. For example, they may fail to ask questions and blindly accept treatments, procedures, and medications not in their best interest because they believe the professional knows better than they do.
What the public needs and does not get is sufficient information, effective alternatives, accountability, reduced cost, and protection against those who may exploit their lack of knowledge. The goal of professional efforts should be an educated public able to discriminate between confusing and conflicting claims by professionals and taking responsibility for its own choices. The public tolerates its present dependent position since most of the public believes that professional licensing protects them. Information needed for decision making is difficult to obtain, thus the public sees professionals as bringing order to an otherwise chaotic and dangerous world. An educated and responsible public does not seem to be a goal of professions or state governments. The consumer movement appears mystified by the professions. There is no opposition to counter the dependency. Although these circumstances may account for the current state of affairs, they also contain the seeds of change. Increasing public knowledge and self determination are the keys to a reform in which self protection could replace licensure.

Stanley J. Gross

Sexual Abuse: A Journal of Research and Treatment

July 1998

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