Will Future Doctors Need a Medical License?

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Licensing Doctors – Do Economists Agree?

By Dr. David Edward Marcinko MBA CMP™


Dr. MarcinkoChallenging conventional wisdom is something I like to think … that I do.

After all, I am considered a healthcare ‘thought-leader”, and to the extent possible, we publish outside traditional box thinking on this Medical Executive-Post.

It’s all Relative

But, I am a piker compared to Shirley Svorny PhD.

Who is she?

Dr. Shirley Svorny is chair of the economics department at California State University, Northridge, and she holds a PhD in economics from UCLA

Medical Licensure Issues

Now, remember the old saying, “if everyone is thinking alike, then nobody is thinking”.

Well, a while back, Dr. Svorny wondered if a medical degree is a barrier – rather than enabler – of affordable healthcare. Enter the PP-ACA of 2010.

As an expert on the regulation of health care professionals, including medical professional licensing, she has participated in health policy summits organized by Cato and the Texas Public Policy Foundation. She argued that licensure not only fails to protect consumers from incompetent physicians, but, by raising barriers to entry, makes health care more expensive and less accessible.

Institutional oversight and a sophisticated network of private accrediting and certification organizations, all motivated by the need to protect reputations and avoid legal liability, offer whatever consumer protections exist today. Malpractice attorneys, and monetary gain motives, too!

Her Published Abstract

“Despite the wide reach of medical licensing in health care production through its impact on the nature and cost of care, it has been all but ignored in debates over health care reform.

This paper pulls together statements made by economists whose expertise is in the area of health economics or, more specifically, medical licensure and discipline. Economists who have examined the market for physician services in the United States generally view state licensing as a means by which to enforce cartel-like restrictions on entry that benefit physicians at the expense of consumers. Medical licensing is seen as a constraint on the efficient combination of inputs, a drag on innovations in health care and medical education, and a significant barrier to effective, cost efficient health care.”

Full paper link:  2004-08-svorny-reach_concl


Am I Thought-Leader?

Am I a thought leader? Well, I don’t rightly know; that’s for others to decide. But, I do know that this essay was published a decade ago; in 2004, and at a time before the ME-P’s existence.

And so, based on this essay, Dr. Svorny is surely a “thought-leader” in my opinion

More about Dr. Svorny

In 1986-87, Dr. Svorny managed an industry risk group at Security Pacific Bank. She was a Milken Institute Affiliated Scholar and served as director of the San Fernando Valley Economic Research Center at Cal State Northridge. She has published articles in Economics of Education Review, Contemporary Economic Policy, Urban Affairs Review, Public Choice, Regional Science and Urban Economics, Cato Journal, Applied Economics, The Journal of Medical Licensure and Discipline, The Energy Journal, Economic Inquiry, and the Journal of Labor Research. Her opinion articles have appeared in the Los Angeles Times and the Los Angeles Daily News. Her research interests are in the areas of urban, labor, and health economics.


Do traditionalists or collective healthcare reform advocates and health economists react rationally; or irrationally on this issue? What do you think?


Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com


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15 Responses

  1. Dr. Marcinko,

    Interesting idea. But, the need for a medical license will not be obviated in your lifetime.



  2. The Decline of the Credential

    Aaron – While the academic-industrial complex will continue to churn out superbly trained physicians, massive on-line education will enable persons to gain a surprising level of lay-expertise.


    At least according to Jaan Sidorov.



  3. Unlicensed Practitioners?

    I received much flack for my ME-P above. Now, I feel a bit vindicated with this breaking information. So, what do readers think, now?



    MO Bill Would Create Assistant Doctors to Boost Rural Care

    Missouri may soon allow licensed medical school graduates to practice medicine and prescribe drugs without having completed a residency. The proposal, which has passed the state legislature and awaits the governor’s signature, aims to address the issue of providing adequate healthcare in rural and other underserved areas of the state.

    Under the bill, graduates of accredited medical schools could become “assistant physicians” and provide primary-care services in rural or medically underserved areas if they haven’t completed residency training.

    However, they must have completed the first two steps of their medical licensing exam. A collaborating physician would be responsible for all services rendered by the assistant physician.

    Source: Bob Herman, Modern Healthcare [6/24/14]


  4. On the rise of the non-physician expert

    ME-P; you are ahead-of-the curve on this subject. Here’s more:




  5. Physician Licensure and Telemedicine

    To begin, it’s important to understand that the regulation of telemedicine services depends on the state where the patient is physically located, not where the healthcare provider is originally licensed.

    According to Dr. First for example, if the world’s leading kidney transplant surgeon is licensed to practice medicine in Utah, and wants to perform a video consultation for a patient who lives in California, the surgeon would be unable to do so without first obtaining a California medical license. Although telemedicine regulations are created to protect patients, they often have the opposite effect by creating barriers to the delivery of high-quality care.

    Here’s a look at a few state variances in licensure requirements:

    • California and Florida—require a physician to hold a full-unrestricted license to provide telemedicine services to patients within their state
    • Minnesota, Texas, and Alabama—created unique, shorter, and less expensive telemedicine licensing processes

    In an effort to promote communication and unity among states, the Federation of State Medical Boards (FSMB), published their Interstate Medical Licensure Compact on May 5, 2014.

    The proposal envisions an interstate compact for telemedicine, which would establish an abbreviated licensing process for physicians in participating states who have held a full-unrestricted license for at least five years, without any disciplinary or legal action on their record. Such a compact would be immensely helpful in removing the hurdles that providers face in delivering their services outside of their home state.





    “Let us allow physicians, hospitals and schools to spring up where they’re needed, abolish the restrictive licensure laws, and simply invoke the laws against fraud to insure honesty among all providers of health care …That will make health care affordable for everyone”

    Ron Paul MD

    [Former Texas Congressman]
    Paul, R: “Health Care”
    Health Freedom News
    Monrovia, CA, February 1989, P18-19

    via Ann Miller RN MHA


  7. North Carolina May Eliminate Licensing for Podiatrists

    Lawmakers are considering a proposal to eliminate state licensing requirements for a dozen occupations ranging from podiatrists to public librarians. The bill will be considered Tuesday by a joint legislative committee, which could recommend that it be taken up by the Legislature during its session starting in late April.

    Sen. Andy Wells, R-Catawba, said that too much licensing hurts the economy and argued that consumers already do a good job of weeding out bad professionals through online reviews and other means.

    Asked specifically about eliminating the licensing requirement for podiatry, a medical specialty, he said: “The question is whether they should have their own board. We don’t have a separate board for every medical specialty there is.”

    Source: Associate Press [4/2/16] via PMNews #5,634


  8. The International Landscape of Medical Licensing Examinations


  9. AI Passes U.S. Medical Licensing Exam

    Two papers show that large language models, including ChatGPT, can pass the USMLE. The papers highlighted different approaches to using large language models to take the USMLE, which is comprised of three exams: Step 1, Step 2 CK, and Step 3. ChatGPT is an artificial intelligence (AI) search tool that mimics long-form writing based on prompts from human users. It was developed by OpenAI, and became popular after several social media posts showed potential uses for the tool in clinical practice, often with mixed results.

    According to Victor Tseng, MD, of Ansible Health in Mountain View, California, and colleagues, the results showed “new and surprising evidence” that this AI tool was up to the challenge. Tseng and team noted that ChatGPT was able to perform at >50% accuracy across all of the exams, and even achieved 60% in most of their analyses. While the USMLE passing threshold does vary between years, the authors said that passing is approximately 60% most years.

    Source: Michael DePeau-Wilson,
    Medpage Today [1/19/23]


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