Arnold Kling  

Notes for the Credentialism File

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A New York Times Story:


Doctorates are popping up all over the health professions, and the result is a quiet battle over not only the title "doctor," but also the money, power and prestige that often comes with it.

...For decades, a bachelor's degree was all that was required to become a pharmacist. That changed in 2004 when a doctorate replaced the bachelor's degree as the minimum needed to practice. Physical therapists once needed only bachelor's degrees, too, but the profession will require doctorates of all students by 2015 -- the same year that nursing leaders intend to require doctorates of all those becoming nurse practitioners.


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COMMENTS (9 to date)
J Oxman writes:

Surely not all those who intend to be pharmacists or nurses need research degrees? Are these doctorates more along the lines of the MD?

I get the feeling this type of credentialism is going to have results along the same lines as requiring all teachers to have M.Ed. degrees. Basically a wealth transfer to institutions offering watered-down M.Ed. degrees just to get the credential, with no increase in the value of the signal or in knowledge.

Ray writes:

I suppose this should come as no surprise. If you can't disrupt them, join them. But it's exactly the opposite of what I'd like to see. The education requirements and restrictions on MDs are already too high. They should be coming down, rather than nurses and physical therapists taking on more education.

Shangwen writes:

A question for Dr. Kling (and perhaps Nick Schulz):

In health care, 'twas ever thus. Accordingly, wages go up, productivity goes down, and more and more people in the HC system have a bias for costlier treatments, a bias they then pass on to patients.

How does your claim about a New Commanding Heights in health care stand up to this? I can't see that happening unless governments/voters decide to give the AMA the finger and deregulate professionals, amongst many other unlikely things.

kiwi dave writes:

One thing that astonishes me about the health care debate in America is how rarely anyone mentions the out-of-control credentialism as a significant driver of health costs – and, conversely – judicious pruning back of credentialism as a possible source of savings.

One example: the US is just about the only country in the world that (in all but a few cases) requires students to obtain a general undergraduate degree before starting medical school. In most other developed countries, a medical degree is a six year program that you can get into straight out of high school. Straight off the bat – six years vs. eight years of expensive post-secondary training, tuition plus the opportunity cost of being out of the workforce. I have family experience with medical education in both systems, and I sincerely doubt the possession of a BA is necessary to be a competent doctor. Yes, when I say this in real life I am subject to the usual bromides, but I really don’t think a BA or BS should be a pre-req for med school.

There are many other examples: such as the ludicrous requirements in some states of PhDs for physical therapists, pharmacists and others.

Chris writes:

Arnold,
I think this relates to your later post, "Two Interesting Questions." Here is one place the technocrats are winning, and winning big. Credentialism has run amok. This delights the technocrats, who

Another for your file: In Illinois, a group successfully battled the requirement that hair braiders obtain a cosmetology licence by lobbying for (and getting) "a new law creating a special category of licenses for the state's professional hair braiders."

Everywhere you turn, you have to have some credential to "enter the profession."

Les writes:

The trend towards doctorates for all has long been in vogue. Once upon a time, lawyers got LL.B's, now they get LL.D's. Today physicians get M.D.'s, and dentists get D.D's whereas, in earlier years they did not.

The doctorate used to be a research degree, but today few, if any, M.D's or D.D's (dentists) or LL.D's are capable of (or interested in) research.

I suppose that when garbage collectors are called sanitary engineers, credentialism has become as common as dirt.

Lori writes:

Reminiscent of Kurt Vonnegut's little dystopia Player Piano. Part of it, I'm sure, is credentialism in service to cartel, but a larger part of it, I suspect, is a sort of education arms race triggered by a hypercompetitive labor market.

joshua writes:

File under Blame Unemployment on Increased Licensing...

GinSlinger writes:

A quiet battle over the term "doctor," eh?

Serves the MDs right, as they stole it from the real doctors long ago.

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