Nurses Can Practice Medicine — Only if They Work for Government

April 18, 2011
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Full post by Robin Hanson is worth reading:

[Licensing restrictions] prevent cheaper medicine via nurses directly managing patients, even though randomized trials suggest nurses are just as effective…..

Full post by Robin Hanson is worth reading:

[Licensing restrictions] prevent cheaper medicine via nurses directly managing patients, even though randomized trials suggest nurses are just as effective…..

Most states have special laws allowing school nurses to directly manage students as patients. True, school nurses can’t do everything docs can, but nurses who offered these same services to passersby at a shopping mall, without direct doc supervision, would violate medical licensing laws. Apparently, we like the comfort of knowing that medical help is onsite at school, but know that an onsite doctor would be very expensive, and so compromise with school nurses.

 For soldiers, we similarly like the comfort of having medics available near each soldier, yet know that requiring medics to be full doctors would be very expensive. So we also relax our usual medical rules to let medics to care for soldiers without being doctors, or under their direct supervision. But we refuse to relax such rules elsewhere in society. Why do we allow the exceptions of school nurses and military doctors, but no other exceptions?

One obvious common element here is that most medics and school nurses are government employees. This seems to be part of a more general pattern, whereby we often relax regulations for the government. For example, the military is also not subject to OSHA rules on workplace safety, and the worst asbestos and hazardous waste sites have been on government property. Congress has also exempted itself from rules against workplace discrimination and stock insider trading.

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So why are governments often held to lower standards?