License to Shrink Heads
[Lucy Wightman] was liked in part because she was more laid-back than your typical psychologist. She didn’t wear makeup, and dressed in flowing skirts and turtleneck sweaters during her meetings with patients. Often her dog, Perry, was by her side. "My daughter, says one Braintree mother, fell in love with her at first sight."...
Wightman was indicted on 26 counts of felony larceny, six counts of filing false health-care claims, six counts of insurance fraud, and one count of practicing psychology without a license. Michael Goldberg, the president of the Massachusetts Psychological Association and a psychologist in Norwood, compares it to a surgeon operating without a medical license.
… When Al Deluca, 38, began seeing Wightman in the summer of 2003 to talk about his marital problems, he says Wightman told him not to file an insurance claim because she was not licensed. Many patients, however, believed that she was. The word psychology was in her business name, and that, according to Eric Harris, a lawyer for the Massachusetts Psychological Association, is enough to put an unlicensed practitioner in violation of the law. Her e-mail address is "Dr. Wightman." Her billing statements are printed with "Lucy Wightman, Ph.D."
… While a person can legally practice psychotherapy without a license in Massachusetts, state law requires that psychologists have a degree in psychology from a state-recognized doctoral program and that they be licensed with the state Division of Professional Licensure. Licensed psychologists must also have two years of supervised training. They must take specific courses, pass an exam, and meet continuing-education standards long after they have tacked their degrees to the wall.
… “I HAVE A FULL CASE LOAD RIGHT NOW,” WIGHTMAN E-MAILED IN mid-November. She was talking about her practice, still running and apparently still prospering. The name has changed. It’s now called South Shore Psychotherapy, a notable distinction legally. The people who come to see her don’t care what she calls herself.
In the medical field, likewise, the state's licensing cartel sets a minimum level of expertise and training that you're allowed to hire. Even for a medical problem that doesn't require that level of training, you've got to buy the whole package. I discussed the issue in an earlier post, "The Right to Self-Treatment." While many medical tasks require the full expertise acquired in the full course of med school and internship, many do not: what about setting an ordinary fracture, say, or listening to someone's lungs and doing a sputum culture to prescribe a round of antibiotics for pneumonia?
A paralegal has all the expertise needed to help someone, say, file the papers for a Chapter Seven, and talk him through the process. But only a licensed attorney who has absorbed the full law school curriculum of torts, contracts, property, criminal law, etc., can perform this basic task.
Same thing goes for practicing skilled trades. If you teach yourself to do specific rewiring or plumbing tasks satisfactorally, and then do them for your neighbor in return for some consideration (only those tasks that you've learned to do well, mind you), then you fall afoul of the licensing cartels. Their effect is to set hurdles for translating skill into service, and for transmitting skill from one person to another, and thus to create artificially higher prices for basic services.