A Cartel of Doctors


In a new paper for the Cato Institute, Shirley Svorny takes on medical licensing. Here's an excerpt:


By almost all accounts, the quality of services consumers get from nonphysician clinicians is at least on par with what they would get froma physician performing the same services. Dozens of peer-reviewed studies compare outcomes in situations where patients are treated by a physician, a physician assistant, or an advanced practice nurse. Outcomes appear similar–an important factor, considering that nonphysician clinicians can provide many services at a much lower cost. There is also evidence that teams of clinicians outperform individual physicians. (Many physicians who are accustomed to working in teams are happy with the collaboration.)

Also worth quoting:

In the Federation of State Medical Boards' database, the nature of the investigation is not recorded in more than 65 percent of cases that ended in sanctions between 1994 and 2002. In those cases, the state board and the physician entered an agreement without the physician being found guilty. These dynamics deny consumers information that would help them avoid low-quality physicians….

If, as some suggest, concerns about financial and reputational consequences diminish efforts to discipline clinicians formally or publicly, or encourage confidential consent agreements, then one might conclude that licensure offers more protection to malfeasant clinicians than to consumers.

Read the whole thing.