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I would argue that occupational licensing is extremely overdone, even in the riskier professions like medicine and dentistry. Here is a recent article from the

I would argue that occupational licensing is extremely overdone, even in the riskier professions like medicine and dentistry. Here is a recent article from the NYT about the horrible situation of cosmetology licensing: https://www.nytimes.com/2018/12/26/business/cosmetology-school-debt-iowa.html https://www.nytimes.com/2018/12/26/business/cosmetology-scho... I'm not saying we don't need occupational licensing whatsoever. But there is no reason someone can't learn to drill a cavity in 6 months of training. $400k of dental school debt is not required.

opportune 8y ago
It’s just job security for the people who have already gone into debt / a way to keep the supply of specialized workers low. For example, the AMA limits the amount of doctors able to graduate from the US so much we are constantly required to allow foreign doctors to immigrate to meet our actual needs And doctors usually work very long hours too, suggesting there is still a shortage even with the immigration. But, I guess this keeps salaries high
miker64 8y ago
I think you underestimate the knowledge and training to do dental work safely.
- seibelj 8y ago
  Maine allowed a special license for hygienists to do extra procedures, including cavity drilling (if a real dentist is in the building). It is going fine so far. https://www.pressherald.com/2018/02/04/independent-dental-hygienists-may-fill-a-void-but-not-a-cavity/ https://www.pressherald.com/2018/02/04/independent-dental-hy... However, getting the law changed to allow this has been fought tooth-and-nail, so to speak: https://www.washingtonpost.com/politics/the-unexpected-political-power-of-dentists/2017/07/01/ee946d56-54f3-11e7-a204-ad706461fa4f_story.html?utm_term=.bf37fdd0b088 https://www.washingtonpost.com/politics/the-unexpected-polit... Like all licensed professionals, dentists are part of a cartel ("guild"). Some guilds are better than others for their members and/or consumers.
  - AmericanChopper 8y ago
    I think of those guilds more as the most effective unions in the world. The reason lawyers, doctors, pilots, etc... are paid so well is because they’ve successfully limited entry into their fields. They’ve all got arduous entry requirements, and you can’t operate without the unions blessing. It’s simple supply and demand after that point.
    - ghaff 8y ago
      Two of the three fields you mention are not paid especially well on average.
      - stochastic_monk 8y ago
        All three have median salaries of 6 figures.
        ghaff 8y ago
        Senior pilots for the major carriers are reasonably well compensated though not usually at levels that the typical FAANG developer would get out of bed for (likely $100-200K). Many regional pilots earn less than $50K and first officers less. Partners at big city law firms are obviously very well-compensated. But the glut of lawyers has been something of a story in recent years and employment difficulties/low salaries for graduates of second and third tier schools are the norm. Neither of these professions are examples of highly constrained supply except to the degree that there are only so many ex-military pilots and Ivy League law review grads.
        gowld 8y ago
        "Pilot" does not have median salary of 6 figures. "Commercial jet pilot" has median salary of 6 figures. That is not an entry-level pilot position.
      - loeg 8y ago
        Pilots have an extremely high hourly rate if you discount the time autopilot is engaged (and senior pilots make a lot more than junior pilots).
- function_seven 8y ago
  It's still possible to subdivide a broad field and allow less-skilled people to do individual parts. For a cavity, I could see a DDS diagnosing it and also determining that their Certified Carries Tech can handle it on their own. They pass the work off and move to the next patient. To keep things safe, require a dentist to be available if the need arises.
- roenxi 8y ago
  On the flip side, most people underestimate the knowledge and training required to do any work at all safely. Not 1 in 10 men I've seen climbing a ladder have done so in a safe manner. If someone has not done a procedure before, I don't trust them regardless of their qualification. If they have done a procedure 100 times, I trust them unless their track record is terrible. I certainly don't think the government needs to enforce these standards the way they do, occupational licensing is not the answer. Information and voluntary schemes would be a lot cheaper, and probably lead to similar quality.
CydeWeys 8y ago
I don't think it's fair to lump dentistry in with cosmetology. Performing surgery on someone's teeth and jaw can have lifelong implications if done incorrectly, and it's thus worth having real training and licensing. Even something as seemingly simple as drilling and filling cavities has all sorts of risks. We already have a much lower level of licensing than DDS for common procedures that can be done safely, i.e. dental hygienists. Actually drilling into the tooth is not one of those procedures. Cosmetology, by contrast, is mostly aesthetic, and the risks that need managed are relatively simple ones, e.g. learning how not to cut or stab someone with scissors or razors, proper use of dying agents to avoid chemical burns, hygienic practices to prevent spread of lice and fungus, and other stuff like that. So long as you don't make those kinds of errors the worst you can do is leave someone looking not great.
- seibelj 8y ago
  As I responded to another commenter, this has been accomplished successfully in Maine: https://www.pressherald.com/2018/02/04/independent-dental-hygienists-may-fill-a-void-but-not-a-cavity/ https://www.pressherald.com/2018/02/04/independent-dental-hy...
  - CydeWeys 8y ago
    Looks like new certifications have been developed that slot in between dental hygienist and dentist in terms of required training (independent practice dental hygienists and dental therapists). Neither can diagnose conditions themselves, though the latter can apparently drill and fill simple cavities under the supervision of an actual dentist. This hierarchy fits in pretty well with medicine, where there's nurse assistants, registered nurses, nurse practitioners, physician's assistants, DOs, and MDs. And of course dentist itself isn't as high as you can get; these are procedures they won't do that you have to be referred to an oral surgeon for. Anyway, point is, it's not nearly so simple as to just say that occupational licensing is extremely overdone in dentistry.

opportune 8y ago

It’s just job security for the people who have already gone into debt / a way to keep the supply of specialized workers low. For example, the AMA limits the amount of doctors able to graduate from the US so much we are constantly required to allow foreign doctors to immigrate to meet our actual needs And doctors usually work very long hours too, suggesting there is still a shortage even with the immigration. But, I guess this keeps salaries high

miker64 8y ago

I think you underestimate the knowledge and training to do dental work safely.

seibelj 8y ago
Maine allowed a special license for hygienists to do extra procedures, including cavity drilling (if a real dentist is in the building). It is going fine so far. https://www.pressherald.com/2018/02/04/independent-dental-hygienists-may-fill-a-void-but-not-a-cavity/ https://www.pressherald.com/2018/02/04/independent-dental-hy... However, getting the law changed to allow this has been fought tooth-and-nail, so to speak: https://www.washingtonpost.com/politics/the-unexpected-political-power-of-dentists/2017/07/01/ee946d56-54f3-11e7-a204-ad706461fa4f_story.html?utm_term=.bf37fdd0b088 https://www.washingtonpost.com/politics/the-unexpected-polit... Like all licensed professionals, dentists are part of a cartel ("guild"). Some guilds are better than others for their members and/or consumers.
- AmericanChopper 8y ago
  I think of those guilds more as the most effective unions in the world. The reason lawyers, doctors, pilots, etc... are paid so well is because they’ve successfully limited entry into their fields. They’ve all got arduous entry requirements, and you can’t operate without the unions blessing. It’s simple supply and demand after that point.
  - ghaff 8y ago
    Two of the three fields you mention are not paid especially well on average.
    - stochastic_monk 8y ago
      All three have median salaries of 6 figures.
      - ghaff 8y ago
        Senior pilots for the major carriers are reasonably well compensated though not usually at levels that the typical FAANG developer would get out of bed for (likely $100-200K). Many regional pilots earn less than $50K and first officers less. Partners at big city law firms are obviously very well-compensated. But the glut of lawyers has been something of a story in recent years and employment difficulties/low salaries for graduates of second and third tier schools are the norm. Neither of these professions are examples of highly constrained supply except to the degree that there are only so many ex-military pilots and Ivy League law review grads.
      - gowld 8y ago
        "Pilot" does not have median salary of 6 figures. "Commercial jet pilot" has median salary of 6 figures. That is not an entry-level pilot position.
    - loeg 8y ago
      Pilots have an extremely high hourly rate if you discount the time autopilot is engaged (and senior pilots make a lot more than junior pilots).
function_seven 8y ago
It's still possible to subdivide a broad field and allow less-skilled people to do individual parts. For a cavity, I could see a DDS diagnosing it and also determining that their Certified Carries Tech can handle it on their own. They pass the work off and move to the next patient. To keep things safe, require a dentist to be available if the need arises.
roenxi 8y ago
On the flip side, most people underestimate the knowledge and training required to do any work at all safely. Not 1 in 10 men I've seen climbing a ladder have done so in a safe manner. If someone has not done a procedure before, I don't trust them regardless of their qualification. If they have done a procedure 100 times, I trust them unless their track record is terrible. I certainly don't think the government needs to enforce these standards the way they do, occupational licensing is not the answer. Information and voluntary schemes would be a lot cheaper, and probably lead to similar quality.

CydeWeys 8y ago

I don't think it's fair to lump dentistry in with cosmetology. Performing surgery on someone's teeth and jaw can have lifelong implications if done incorrectly, and it's thus worth having real training and licensing. Even something as seemingly simple as drilling and filling cavities has all sorts of risks. We already have a much lower level of licensing than DDS for common procedures that can be done safely, i.e. dental hygienists. Actually drilling into the tooth is not one of those procedures. Cosmetology, by contrast, is mostly aesthetic, and the risks that need managed are relatively simple ones, e.g. learning how not to cut or stab someone with scissors or razors, proper use of dying agents to avoid chemical burns, hygienic practices to prevent spread of lice and fungus, and other stuff like that. So long as you don't make those kinds of errors the worst you can do is leave someone looking not great.

seibelj 8y ago
As I responded to another commenter, this has been accomplished successfully in Maine: https://www.pressherald.com/2018/02/04/independent-dental-hygienists-may-fill-a-void-but-not-a-cavity/ https://www.pressherald.com/2018/02/04/independent-dental-hy...
- CydeWeys 8y ago
  Looks like new certifications have been developed that slot in between dental hygienist and dentist in terms of required training (independent practice dental hygienists and dental therapists). Neither can diagnose conditions themselves, though the latter can apparently drill and fill simple cavities under the supervision of an actual dentist. This hierarchy fits in pretty well with medicine, where there's nurse assistants, registered nurses, nurse practitioners, physician's assistants, DOs, and MDs. And of course dentist itself isn't as high as you can get; these are procedures they won't do that you have to be referred to an oral surgeon for. Anyway, point is, it's not nearly so simple as to just say that occupational licensing is extremely overdone in dentistry.