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He argues that private certification organizations (think Consumer Reports, but for doctors) are a more reliable and versatile way to see how competent a doctor
by karzeem 15y ago
He argues that private certification organizations (think Consumer Reports, but for doctors) are a more reliable and versatile way to see how competent a doctor is, and also that hospitals and clinics have an incentive to only hire competent people.
The rebuttal would be "Fine, but certainly state licensure can't hurt. It's just a backup." He says that it does in fact hurt, by allowing the AMA to control the supply of people who get to practice medicine. This limits patients' options w/r/t how, from whom, and for what price they can get medical care.
E.g. suppose I find a competent, well-trained nurse to remove a mole for me. The nurse and I agree to go ahead for $100. Friedman says that it's a) morally wrong and b) inefficient for the government to barge in and say, "No, for your own safety, you're not allowed to make this voluntary agreement. You have to have a doctor do this. Oh, and it'll cost $300." That's the effect of a law that says only licensed physicians are allowed to remove moles.
- pyre 15y agoMy rebuttal: private certification organizations that, over time, reduce the effectiveness (strictness) of their testing because they are (e.g.) afraid of getting sued (libel, slander, discrimination, etc) by people that have been denied.
- Symmetry 15y agoOn the other hand, there seems to be a big shortfall in the supply of doctors, in the US at least, so less strict testing than we have now might be a good thing. http://theincidentaleconomist.com/wordpress/why-cant-we-have-more-doctors/ http://theincidentaleconomist.com/wordpress/why-cant-we-have...
- Symmetry 15y agoAlso, there's a countervailing ratchet effect where if anyone is harmed by someone with a licence who should have known better the standards become more strict. We've seen a lot of this in medicine over the years.
- dpatru 15y agocan you provide examples of this?
- eftpotrm 15y agoAnd, because they're paid by those they certify, they have an economic incentive to have certification standards as low as they can without the public rejecting them completely; not a good idea. We have much the same situation with examinations boards for school leavers in the UK. A competitive market for examinations providers and schools incentivised to maximise pass rates has unsurprisingly led to grade inflation as each board tries to 'best serve their customers'....