In an effort to redress the perceived imbalance between practitioner and consumer interests on occupational licensing boards, two structural reforms have been widely implemented: the addition of public members to the boards, and the consolidation of the licensing function into a single administrative entity within each state. The extent to which these reforms have improved the consumer oriented performance of licensing boards is evaluated, using the rate of disciplinary actions as the performance measure. Estimation of a multivariate model using physician and nursing board data reveals evidence in support of the effectiveness of public board members, but not administrative centralization, as a consumer reform. Increased proportions of public members are associated with more serious disciplinary actions. Administrative centralization is associated with fewer disciplinary actions.
Get full access to this article
View all access options for this article.
References
1.
American Nurses' Association.1986. Facts about nursing 1984-85.Kansas City, MO: American Nurses' Association.
2.
Berry, William D.1984. An alternative to the capture theory of regulation: The case of state public utility commissionsAmerican Journal of Political Science28:524-58
3.
. Carlsen, Amy.1988. Group says states are too lenient with quack doctorsHealth Week, 28 March, p. 16
4.
. Checkoway, Barry.1982. Public participation in health planning agencies: Promise and practiceJournal of Health Politics, Policy and Law7(3): 723-33
5.
. Chesney, James D.1982. Strategies for building representative HSAs: The impact of legal structureJournal of Health Politics, Policy and Law7(1): 96-110
6.
. Cohen, Harris S.1980. On professional power and conflict of interest: State licensing boards on trialJournal of Health Politics, Policy and Law5(2): 291-308
7.
. Council of State Governments.1982. The book of the states.Lexington, KY: Council of State Governments.
8.
Daniels, Mark R., and James L. Regens .1980. Physicians' assistants as a health care delivery mechanism: Incidence and correlates of state authorizationPolicy Studies Journal9:242-50
9.
. Denhardt, Robert B.1984. Theories of public organization.Monterey, CA: Brooks/Cole.
10.
Elliott, Ruth L., and Margaret J. Heins.1987. Disciplinary data bank: A longitudinal study.Chicago: National Council of State Boards of Nursing.
11.
Federation of State Medical Boards.1987. Physician licensing boards and physician discipline, Section 3 In Exchange.Fort Worth, TX: Federation of State Medical Boards of the United States.
12.
Gormley, William T., Jr.1983. Policy, politics, and public utility regulationAmerican Journal of Political Science27(1): 86-105
13.
. Graddy, Elizabeth.1989. Toward a general theory of occupational regulation Working paper, University of Southern California.1989.
14.
Graddy, Elizabeth, and Michael Nichol.1989. Public members on occupational licensing boards: Effects on legislative regulatory reformsSouthern Economic Journal55(3): 610-25
15.
. Joskow, Paul L., and Roger G. Noll.1981. Regulation in theory and practice: An overview In Studies in public regulation, edited by Gary Fromm. Cambridge: MIT Press.
16.
Leland, Hayne E.1979. Quacks, lemons, and licensing: A theory of minimum quality standardsJournal of Political Economy87(6): 1328-46.
17.
Mashaw, Jerry L.1985. Prodelegation: Why administrators should make political decisions.Journal of Law, Economics, & Organization1(1): 81-100
18.
. McCubbins, Matthew D., Roger G. Noll, and Barry R. Weingast.1987. Administrative procedures and political controlJournal of Law, Economics, & Organization3(2): 243-77
19.
. Meier, Kenneth J.1980. Executive reorganization of government: Impact on employment and expendituresAmerican Journal of Political Science24:396-412
20.
. -. 1985. Regulation: Politics, bureaucracy, and economics.New York: St. Martin's. Mick, Stephen S., and John D. Thompson
21.
. 1984. Public attitudes toward health planning under the health systems agenciesJournal of Health Politics, Policy and Law8(4): 782-800
22.
. Mitnick, Barry M.1980. The political economy of regulation: Creating, designing, and removing regulatory forms.New York: Columbia University Press.
23.
National Clearinghouse on Licensure, Enforcement and Regulation.1986. State credentialing of the health occupations and professions.Lexington, KY: Council of State Governments.
24.
Niskanen, William A.1975. Bureaucrats and politiciansJournal of Law & Economics18:617-43
25.
. Noll, Roger G.1985. Government regulatory behavior: A multidisciplinary survey and synthesis. In Regulatory policy and the social sciences , edited by Roger G. Noll. Berkeley: University of California Press.
26.
Olson, Mancur.1971. The logic of collective action: Public goods and the theory of groups.Cambridge, MA: Harvard University Press.
27.
Parachini, Allan.1985. Study questions emphasis in medical malpracticeLos Angeles Times, 20 September, p. 1
28.
. Rourke, Francis E.1984. Bureaucracy, politics and public policy.3rd ed. Boston: Little, Brown.
29.
Schneider, Saundra K.1987. Influences on state professional licensure policyPublic Administration Review47(6): 479-84
30.
. Schutz, Howard G.1983. Effect of increased citizen membership on occupational licensing boards in CaliforniaPolicy Studies Journal11(3): 504-16
31.
. Shimberg, Benjamin.1982. Occupational licensing: A public perspective.Princeton, NJ: Center for Occupational and Professional Assessment, Educational Testing Service.
32.
Simon, Herbert A.1946. The proverbs of public administrationPublic Administration Review6(4): 53-67
33.
. Stigler, George J.1971. The theory of economic regulationBell Journal of Economics2(1): 3-21
34.
. U.S. Bureau of the Census.1980. 1980 census of population: Detailed population characteristicsWashington, DC: U.S. Department of Commerce.
35.
-. 1989. Statistical abstract of the United States, 1989.Washington, DC: U.S. Department of Commerce.
36.
Weingast, Barry R., and Mark J. Moran.1983. Bureaucratic discretion or congressional control? Regulatory policymaking by the Federal Trade CommissionJournal of Political Economy91(5): 765-800
37.
. Wildavsky, Aaron.1984. The politics of the budgetary process.4th ed. Boston: Little, Brown.
38.
Wilson, Woodrow.1887. The study of administrationPolitical Science Quarterly2(2): 197-220.
39.
Wolfe, Sidney M., Henry Bergman, and George Silver.1985. Medical malpractice: The need for disciplinary reform, not tort reform. Health Research Group Report August 27. Washington, DC: Public Citizen.
