Rather to my surprise, I’ve discovered that licensing boards are taking a lot of heat recently. For example, just in the last month, there has been a Supreme Court decision upholding an anti-trust decision against a state dental board (see this Washington Post article). And across the country, there’s an increasing outcry against treating doctors as criminals for minor or nonexistent offenses — especially because, when doctors lose their licenses, their more fragile patients often commit suicide. You’d think that a medical board, consisting mostly of doctors, would consider what’s truly best for the patients, but this doesn’t seem to be the case.
My experience with licensing boards is that they have difficulty attracting the best and the brightest — most of a board’s tasks are tedious and unrewarding — and even when they do, the board members are not trained judges or lawyers. Nor does the system provide adequate backup to compensate for this. A doctor brought in front of a medical board, and at risk of losing his license, has fewer legal protections than he would for a simple speeding ticket!
This is bad, because medicine is big business. Not for doctors, particularly (doctors only receive about 8% of every dollar spent on medical care), but for all kinds big organizations. And if the system is broken, one way of pretending that you’re doing something about it is to make a big show of kicking doctors around.
And it’s not just about doctors. All licensing boards tend to be like this. Conventional medicine is big business and is probably under a lot more pressure than the calmer backwaters, such as psychology or counseling, where the lack of a direct tie-ins to drug and equipment sales lower the stakes. But if you’ve ever been to a homeowner’s association meeting, or gotten involved in small-town politics, you know that “smaller” doesn’t always mean “nicer”!
So there are reasons to avoid the bureaucracy, the rule-by-committee, the group-think, and the arbitrary power of a licensing board, if you can do it legally. If you’re a licensed practitioner, a random complaint can get your license pulled and destroy your ability to practice. If you operate under an exemption, a client has to do something more substantial than just send a poison-pen letter to a board — file a lawsuit or criminal charges. In either case, you’ll have a lot more due process than you would with a licensing board, and the penalty is far more likely to be consistent with your mistake (if any).
My father once claimed that everyone has to expect a certain number of bad things to happen to them during their lives, whether they deserve them or not — “occupational hazards of being alive” — a car crash, a lawsuit, an arrest, an illness, loss of loved ones. Having a license doesn’t protect you from any of these things, it just makes things worse. Clients can not only file criminal charges and sue you, they can complain to the licensing board as well. Since the licensing board observes less due process (that is, you have fewer rights) than the others, a license is more a liability than an asset.
Besides, boards are way too conformist, way too focused on doing what they always do, whether it works or not. They’re just committees, after all.