House Bill 57, “Enact Physical Therapy Licensure Compact,” was signed by Gov. Roy Cooper and became law on June 8. As a law aimed at reducing fees and bureaucratic red tape for those licensed in another state to practice physical therapy, it can be viewed as favorable. On the other hand, in some ways it broadens bureaucracy and runs contrary to the ideal of unfettered entrepreneurial opportunity.
The bill makes North Carolina a member of the Physical Therapy Licensure Compact. According to an overview of the bill provided by the General Assembly Research Division, “Membership in the compact would allow physical therapists who hold licenses in good standing in any other Compact state to practice physical therapy in North Carolina. Likewise, physical therapists holding a valid license in North Carolina would be able to practice physical therapy in any of other the Compact member states.” Currently as of May 17 there are 10 states in the Compact, with similar bills having been introduced in another seven states.
Recognizing the licenses of other states in the compact is a favorable part of the law, as is discarding the current burdensome procedures of getting an endorsement from North Carolina for a license from another state to be recognized. Prior to HB 57 becoming law, a person licensed in another state and wanting a North Carolina endorsement had to submit an application and application fee, verify that he or she has a license in another state, and verify that he or she scored at least 600 or higher on the National Physical Therapy Exam.
The new law also is favorable to those in the armed forces. It prohibits the requirement of any fees as a prerequisite to issuing a license to a military-trained applicant or spouse of a military member. Also, it makes available temporary practice permits granted to military-trained applicants or spouses, which are valid for either one year or until the required renewal date for the occupation for which the permit was issued, whichever is later.
For free-market adherents, not charging fees and recognizing licenses from other states, as well as giving the military and their spouses a break on fees, is all favorable. However, the existence of fees and licenses and the concomitant regulations that surround the practice of physical therapy and other occupations is not favorable.
The Left’s embrace of bureaucracy, fees and regulations has lulled the public into believing that having a license is commensurate with safety and expertise. Who would think of going to an unlicensed physical therapist after knee or back surgery? The notion has been tattooed onto the mind of the public that if not for the government licensing and regulating most professions, there would be grave risk of harm to people and society.
The Licensure Compact that the law created by House Bill 57 is replete with regulations and stipulations. But what if there were no licensing requirements and no boards and no fees for licenses in any state?
Under the vision of market-based regulation, the market itself would regulate the profession. If given a choice to go to school and obtain to physical therapy education and training, most aspiring to that practice would likely do so. But the key word is choice.
If someone hung a shingle offering physical therapy services, but had no idea what he or she was doing, the market would shut that practitioner down. Word of mouth would spread and people desiring the benefits of physical therapy would seek out those who could better provide that service.
The market would regulate itself and competition would reflect the supply and demand for physical therapy services.
But what of the unlucky person who selected the untrained physical therapist and sustained a debilitating injury as a result? The phrase “buyer beware” comes to mind.
What we have instead is a system where government controls the physical therapy profession and hundreds more occupations in North Carolina and other states. Application fees, renewal fees, licenses, education and continuing education requirements all serve to create a sense of safety in the mind of the public.
This sense of safety is coming at the expense of would-be entrepreneurs, who find entry into many occupations and professions difficult if not impossible because of fees, etc. Big government would argue that the solution is to create more tax-funded programs wherein the would-be entrepreneur could obtain an education and a license at the taxpayers’ expense.
But, lowering or doing away with fees, and recognizing licenses from all 50 states instead of just those who join another bureaucratic creation like a compact, might be even better.