From: MEG04@ALBNYDH2.BITNET
Newsgroups: misc.emerg-services
Subject: Certification vs. Licensure
Date: 1 Oct 92 14:25:02 GMT
Comments: Gated by NETNEWS@AUVM.AMERICAN.EDU


 .                           Mike Gilbertson
 .                           (meg04@albnydh2.bitnet)
 *** Forwarding note from MAILER  --ALBNYDH2 09/30/92 18:41 ***
 In a previous posting,
 PJ Geraghty <JX655C@GWUVM.BITNET>  says

 "I have just gotten home from a class callem "EMS and the health care system."
 The intent of this class (as I see it) was to see how EMS relates to the
 rest of the health care system, what the rest of the HCS think of EMS, and
 ideas about the future relationships between the two.

 Sadly, several people (out of the ten or so in the class) have turned it into
 almost a single-issue gathering each time: the "utter unfairness" of paramedics
 being (in most states) certified rather than licensed.  It boils down to a
 question of respect, according to the other people in my class.  They think
 that the other people in the HCS look down on paramedics because we are the
 only group to be certified by people at higher levels of care (e.g., MD's are
 licensed by MD's, RN's and other nurses by RN's, but EMT-P's are *certified*
 by MD's).

 Obviously, I have a different opinion.  I honestly don't care whether I'm
 certified, licensed, blessed, or whatever.  I was trained as a paramedic and
 I do what I'm trained to do, ignoring (for the most part) the interference
 and/or superiority (what little I see) from other members of the HCS.  I'm
 getting a little tired of the whole argument, but it is a thread which pervades
 the entire degree program here, I fear.

 My question to the vast community of EMT-P's reading this on your computer
 screens:  what are your thoughts?  Do you want to be licensed?  Why?  Are you
 content with being certified?  Why?

 I'll try to keep a running tally on the votes either way and post a summary
 at some point, along with any interesting points I come across.

 -----------------------------------------------------------------------
 Well, here's some food for thought:
 According to Benjamin Shimberg, in his classic book "Occupational
 Licensing, a Public Perspective":
     Licensing is "the process by which an agency of government grants
     permission to an individual to engage in a given occupation upon
     finding that the applicanht has attainted the minimal degree of
     competency necessary to ensure that the public health, safety,
     and welfare will be reasonably well protected" (DHEW, 1977).
     Since the law establishing a licensed occupation usually sets forth
     the "scope of practice" covered by the act, licensing laws are
     often referred to as "practice acts."

     Before a license is granted, the applicant must meet certain
     requirements as set forth in the law.  These usually include
     training and experience, minimum age, years of formal education or
     academic degrees, a period of residence within the state, and
     evidence of good moral character.  As a rule, only those applicants
     who satisfy the stated prerequisites are allowed to take the
     licensing examination.

      Licensing is the most restrictive form of occupational regulation
      because it prohibits anyone from engaging in the activities
      covered by the "scope of practice" without permission from a
      governmental agency.
      <A list of typical licensed occupations follows.>

      Certification is the process by which a governmental agency or
      nongovernmental agency or association grants authority to use a
      specified title to an individual who has met predetermined
      qualifications.

      Unlike licensure, the law does not prohibit individuals from
      engaging in the regulated occupation.  However, it prohibits
      some from using a given title or from holding themselves out to
      the public as being "certified" or "registered."  For example,
      in most states anyone may practice accounting, but only those
      who have met state standards may call themselves Certified
      Public Accountants (CPAs).

 Just to be provocative, let me pose a couple of questions:
 What is the exclusive scope of practice of paramedics?  (i.e., what
 can paramedics do that no one else is allowed to do?)  Is there any
 state in which the scope of practice is spelled out in the statute
 (law) rather than in regulations or worse yet in the curriculum?
 Notice that Shimberg does not discuss setting (i.e., prehospital),
 only activities.

     EGW02   --ALBNYDH2 Ed Wronski         TJD01   --ALBNYDH2 Thomas Dean
     LSB02   --ALBNYDH2 Lee Burns          JJC02   --ALBNYDH2 John Clair
     RXE01   --ALBNYDH2 Robert Elling      JDL02   --ALBNYDH2 John Lewis
     JMJ03   --ALBNYDH2 Jean M. Johnson    DLJ01   --ALBNYDH2 Dana Jonas
     EAL04   --ALBNYDH2 Liz Lister         KRM02   --ALBNYDH2 Karen Meggenhoefen
     JLM05   --ALBNYDH2 Larry Mottley, M.D FXO03   --ALBNYDH2 Frank Oberkoetter
     AMS08   --ALBNYDH2 Amy Schrom         JSS02   --ALBNYDH2 James Soto
Newsgroups: misc.emerg-services