Licensure Challenges

A new generation of practitioners will be at the forefront of the movement for patients' access to quality care performed by properly educated and trained professionals through the adoption of licensure.

Each state's journey toward licensure is unique and fraught with different challenges, players, and statutory hurdles. No one prescription can lead to the adoption of licensure in every state. States pursue licensure on an individual basis. Measures taken on a federal level typically pertain to reimbursement and offer little proactive regulatory guidance on who can provide care.

Sue Stout, president and CEO of the Amputee Coalition, explains, "States license professionals from physicians to plumbers, and each state takes a slightly different approach," Stout continues. "The only federal approach to this issue would be to require that certain professionals have certain credentials to be eligible for reimbursement from Medicare or other federal programs. However, this does not constitute licensure because it would not set up a structure for removing a license from someone who breaks the law, nor would it address the training requirements and mandatory adherence to specific practices spelled out in licensure laws."

"The Amputee Coalition supports licensure of prosthetists because the standards of training required to earn a license help guarantee quality care for amputees. In addition, licensure laws that include a mechanism for consumers to lodge official complaints against licensed providers who cause harm can lead to the revocation of a license from a practitioner who practices unsafely. This is a key consumer protection," Stout concludes.

The protection of consumers is the crucial component of a convincing argument in favor of licensure. It is the safety of the patient that is truly at stake in discussions about licensure. Movements undertaken solely by practitioner groups may seem self-serving, no matter how unified, and will ring hollow without the voices of those who need their services. Grassroots efforts are more effective when the testimonials of patients and the legitimate concerns of providers are balanced. Licensure's emphasis on professional qualifications satisfies the concerns of patients, payers, and licensing entities.

States with licensure have generally developed an energetic organization committed to attaining licensure over the long haul. Lobbyist assistance, while costly, is also effective. The August Academy Advantage Licensure Corner will feature perspectives on discussing licensure with state legislators, including using a professional lobbying group.