Regulating health professionals: a review of the empirical literature.

Abstract

to health care cost-containment, existing systems for regulating health professionals are being scrutinized. The federalized system of control mechanisms for credentialing, together with the procedures of accreditation, institutional rationing of practice privileges, peer review, malpractice actions, and the like, supplies a complex and often redundant array of regulations. These devices are manipulated by several federal agencies, each of the 50 states, professional groups, and several private organizations. These regulations are perceived by many to be a significant barrier to ongoing efforts to encourage costcontainment through more widespread use of competitive incentives in the health care industry. Health manpower regulations govern the locations and settings within which professionals can work and the activities of professionals in the course of their practice. The justification for these controls is the belief that the public interest will best be served if poorly trained, incompetent, and unethical people are kept from practicing. If these regulations are effective, they will ensure the patients' safe treatment by prohibiting some people from pursuing careers and will appropriately modify the behavior of practicing professionals. An unfortunate by-