Occupational Licensing Used to Intimidate
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CALIFORNIA: WHERE RIGOROUS INQUIRY GOES TO DIE
It smothers innovation and silences debate. These have been principal criticisms of occupational licensing over the years, and nowhere is innovation and debate under greater attack than in California.
Last year, lawmakers there passed a bill tasking the state’s regulator of real estate appraisers to apply lopsided scrutiny to valuations that come in “low” (a friction point with the state’s powerful Realtors, lenders and homebuilders). California lawmakers now want to use the state’s medical board to intimidate physicians and surgeons who might be tempted to deviate from the official script on Covid-19.
Assembly Bill 2098 would instruct the board to discipline licensees when they publicly question existing patient-care standards. It provides no better illustration of how occupational licensing promotes groupthink and intolerance to differing viewpoints. Its author is Assembly Member Evan Low of Campbell, California.
The California bill would classify the dissemination of “misinformation” related to Covid as unprofessional conduct and compel the medical board to bring disciplinary actions against physicians and surgeons caught engaging in the practice. What precisely is “misinformation”? The bill leaves that open to interpretation. The bill sets the stage for medical boards to become launching pads for personal and political vendettas.
In the early days of the pandemic, much was learned through trial and error. Thanks to rigorous inquiry and robust debate, we now know that too great a focus was initially placed on early intubation and mechanical ventilation. Outcomes improved when certain patients were kept off a ventilator and placed in a prone position instead. We now know that the relatively inexpensive steroid dexamethasone has been administered to great effect in extremely sick patients.
But these therapies, which are now part of standard treatment, would have initially been considered “misinformation” under the California bill. Lawmakers want the state’s medical board to take action against doctors who peddle “misinformation” about Covid-19 related to the “nature and risks of the virus, its prevention and treatment; and the development, safety and effectiveness of Covid-19 vaccines.”
“State occupational licensing boards can become backward-thinking fiefdoms on their own,” said author Jeremy Bagott. “The involvement of self-interested lawmakers during election years supercharges weaknesses already inherent with these boards. They can become politburos and the damage they do stifles innovation with incalculable costs to society.
“[AB 2098] is a classic example of how occupational licensing can be used to intimidate and shut down discourse,” said Bagott.
The use of licensing boards to silence objectionable but potentially important discourse is not unique to California. Recently, the Illinois Department of Financial and Professional Regulation placed a Sword of Damocles above the heads of physicians and surgeons in that state by issuing a notice to remind them that any advice or treatment provided to a patient must “conform with evidence-based medicine and standards of care and that failure to do so may subject the individual to disciplinary action under the Medical Practice Act.”
The Illinois notice contains a handy link for practitioners to report each other for spreading “misinformation.”
Signed into law last year was Assembly Bill 948, which requires California’s real estate appraiser enforcement bureau to earmark complaints by principally sellers and their agents over putative low appraised values with no equivalent attention to the complaints of buyers who might complain of high values. The law will inevitably cow many appraisers into thinking twice before concluding a value that threatens to upset the seller.
Bagott is not optimistic about the future of free speech as occupational licensing proliferates in the states.
“This is a threat to commercial speech and, in the case of physicians, scientific advancement. States need to find ways to move beyond this antiquated structure,” he said.