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elf-Care
 
Deregulating Doctors

© Tom Ferguson MD

A change in the present medical licensure laws would allow our physicians to step out of the parental role that has been forced upon them. They could—as one physician put it— begin shedding their Superman suits at last.

The medical licensure laws also give organized medicine very tight control over the practice of local physicians. Physicians who wish to follow experimental or nonstandard treatments are often severely disciplined and may be threatened with the loss of their licenses. Deregulating medicine would break the hammerlock that organized medicine has on the practice of physicians.

Quacks. The argument for medical licensure assumes that consumers are too ignorant to protect themselves from fraudulent claims, thus their range of choice should be limited to licensed physicians. In fact, the risk of injury from orthodox medicine's surgery, invasive diagnostic tests, X-rays, and powerful prescription drugs is substantially higher than the risk from alternative practitioners' herbs, vitamins, homeopathic remedies, massage, and spiritual healing.

Medical licensure laws assume that unrealistic claims and false hopes occur only outside the medical profession. Yet the sick and injured may be even more vulnerable to exploitation by M.D.s. Thus medical licensure does not in itself protect consumers from quackery. It only helps to cover up quackery among licensed physicians.

Paramedics. Present laws also limit the range of services non-MD health workers can provide. But these paramedics (dental hygienists, nurse practitioners, and others) could, in many cases, provide adequate services on their own—and at substantially lower cost.

Deregulating medicine would allow consumers to consult an experienced nurse practitioneer directly. It would free acupuncturists, herbalists, faith healers, nutritional consultants, and traditional native healers of all cultures to offer their services openly. This would increase the quality of care and decrease health costs without in any way limiting consumers' access to physicians. Indeed, it could only increase communications and encourage partnerships between orthodox and alternative healers.

Medical licensure laws protect physicians from all outside competition. They allow physicians to be authoritarian and patronizing, to set inconvenient clinic hours, and to be chronically late in keeping appointments— because their customers have nowhere else to turn.

Under a deregulated system, there would be more alternatives. Physicians would still receive the same training and have the same credentials. Consumers who wished to do so could continue to consult them. But physicians would not be granted an exclusive license to provide health services. Such an unrestricted health care system would force physicians to be more responsive to consumer preferences.

Health Literacy. Existing medical licensure laws have created an expensive and ineffective over-reliance on physicians. They have seriously undermined many laypeoples' confidence that they really can take care of themselves. A change from a license based, monopolistic system to a credential-based, deregulated system would help transfer power and responsibility for health to the informed consumer.

A necessary element in such change would be a national commitment to universal health literacy. A good school-based health education program could turn out high school graduates with a level of health knowledge comparable to that of some paramedics.

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About The Author
Tom Ferguson, M.D. (1943-2006), was a pioneering physician, author, and researcher who virtually led the movement to advocate informed self-care as the starting point for good health. Dr. Ferguson studied and wrote about the empowered medical consumer since 1975 and about online health resources for consumers since 1987. He founded the influential journal Medical Self-Care and the......more
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