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lower rates of untreated dental disease,
more recent studies that control for potentially
confounding factors find no evidence that tighter dentistry licensing requirements lead to better
dental health, though they do lead to higher prices.
Studying quality in a newly-licensed area,
floral design, Carpenter (2012) recruited a randomly selected sample of florist-judges to compare
floral arrangements produced by licensed retail florists from Louisiana and unlicensed florists
from Texas. He found that licensing appears not to result in a statistically significant difference in
the quality of floral arrangements.
Other research finds that imposing licensing requirements
or stricter regulations (such as performance examinations or education requirements) did not
significantly affect the severity of injuries suffered among electricians.
Other research suggests that licensing is not always adequate to address quality concerns, but
may be complementary with other forms of regulation. For example, Phelan (1974) distributed
televisions with known defects in areas with and without licensing requirements for television
repair workers. He found that fraud was not lower in areas with licensing alone, but was lower
when licensing was coupled with a State agency that investigated fraud allegations.
Much research on the impact of licensing restrictions on quality and public safety focuses on the
impact of scope of practice restrictions (laws limiting the range of services that some
practitioners can legally provide). There is evidence that Advanced Practice Registered Nurses
can provide a range of primary care services to patients at least as effectively as physicians,
including wellness and prevention services, diagnosis and management of uncomplicated acute
conditions, and management of chronic diseases.
A systematic review of the literature found
that outcomes for nurse practitioners (NPs) compared to physicians (or teams without NPs) are
comparable or better for all 11 outcomes reviewed, including blood glucose, blood pressure,
mortality, patient satisfaction with care, and number of emergency department visits.
One important channel through which licensing might affect quality is through increasing the
training of licensed practitioners. Data on accountants, attorneys, cosmetologists, and teachers
suggests that while stricter licensing requirements are not associated with higher rates of
vocational class enrollment, such restrictions are associated with additional training since
workers began their most recent job.
One possible explanation for the latter finding is that
Holen, Arlene. 1978. “The Economics of Dental Licensing.” Department of Health, Education and Welfare.
Kleiner, Morris M. and Robert T. Kudrle. 2000. “Does Regulation Affect Economic Outcomes? The Case of
Dentistry.” Journal of Law and Economics 43, no. 2: 547-582. The University of Chicago Press.
Carpenter II, Dick M. 2012. “Testing the Utility of Licensing: Evidence from a Field Experiment on Occupational
Regulation.” Journal of Applied Business and Economics 13, no. 2: 28-41.
Kleiner, Morris M. and Kyong Won Park. 2014. “Life, Limbs and Licensing: Occupational Regulation, Wages, and
Workplace Safety of Electricians, 1992-2007.” Monthly Labor Review. U.S. Bureau of Labor Statistics.
Phelan, John J. 1974. “Economic Report [on the] Regulation of the Television Repair Industry in Louisiana and
California: A Case Study: Staff Report to the Federal Trade Commission.” 23. U.S. Government Printing Office.
Fairman et al. (2011); Institute of Medicine (2010); Cassidy (2012).
Stanik-Hutt et al. (2013).
Klee, Mark A. 2013. “How Do Professional Licensing Regulations Affect Practitioners? New Evidence.” U.S. Bureau
of Labor Statistics, SEHSD Working Paper 2013-30.