Turf Wars in Occupational Licensing

Enemies stare each other down from their respective sides of the battlefield. Each hoping to achieve victory over the other. 

For many, the imagery that those sentences draw upon is that of war or a battle. It probably doesn’t make you think about the state’s regulatory system. However, the description provided above accurately depicts the term “turf wars.”

This term often is used to describe fights over the creation of occupational licensing legislation between two competing professional groups where the battlefield is the legislature and the weapons are legislation.  Such turf wars create a significant negative impact on the economy and individuals seeking to enter the workforce.

But what exactly are turf wars, and why do they pose a problem?

Turf wars arise when different professions or industries compete over who has the right to perform certain tasks or offer specific services. This competition can be fierce, and each side seeks to undermine the other’s credibility and legitimacy as professionals capable of performing certain duties.

The result is the imposition of unnecessarily strict licensing requirements, making it difficult for individuals to enter certain fields and for existing practitioners to expand their offerings.

For example, consider the case of nurse practitioners and physician assistants seeking to gain the ability to prescribe medication. Both of these groups, in many states, have a very limited scope of practice, activities they are permitted to perform, that do not grant them the ability to prescribe medications. This scope of practice is not commensurate with their abilities, meaning these professionals are often not authorized to provide care to their highest ability. 

What is the reason for this limited scope of practice?

It certainly isn’t their knowledge or professional capacity. Instead, it is professional groups, like physicians, working to block other professionals from gaining the ability to perform duties like prescribing medication. Blocking professionals from performing such duties stifles competition, and as a result, allows established professionals to charge exorbitant prices for their services, knowing that there are no new entrants to challenge their dominance.

In this example, other consequences of turf wars are also obvious. When medical professionals cannot provide care to their highest ability, consumers may not be able to get timely care, may experience more costly care, and may be limited in their choices of who can provide them with care.

Despite these negative effects, there is hope for reform. Occupational licensing reform can alleviate the consequences of turf wars and create a more prosperous future for all. The key to reform is to shift the focus of licensing away from protecting established practitioners and towards protecting consumers.

One potential solution is using alternative regulatory models such as voluntary certification. Voluntary certification allows practitioners to differentiate themselves based on their level of training and expertise. This approach provides consumers with greater choice and flexibility while also allowing practitioners to specialize in areas that they are passionate about. Additionally, voluntary certification reduces the cost of entry for new practitioners, making it easier for them to enter the market and compete with established players.

Another Potential Solution

We might also consider passing legislation that expands professionals’ scope of practice or professional duties. That could have a significant impact on reducing the negative effects of turf wars in occupational licensing. By expanding the scope of practice, professionals can offer a wider range of services, reducing the need for consumers to seek out multiple practitioners for related services. This can lead to increased competition, lower costs, and greater efficiency in providing services.

The benefits of the scope of practice expansion laws can be seen through the lens of dental hygienists. In many states, dental hygienists are not allowed to perform certain procedures, such as administering anesthesia or filling cavities. This limits their ability to provide comprehensive care to patients and creates unnecessary barriers to entry for dental hygienists seeking to expand their practice. By passing legislation that expands dental hygienists’ scope of practice to include these procedures, patients can receive more comprehensive care, and dental hygienists can expand their practice, creating more competition and lower costs for consumers.

In the world of occupational licensing, turf wars can seem like a never-ending battle between established professionals and emerging players. The consequences of these battles can be far-reaching, impacting individuals seeking to enter the workforce and the overall economy. But there is hope for reform. Clearly, it’s time to put an end to the battle and work toward a system that benefits both consumers and professionals alike.