Relying on student subservience in the degree escalation competition game.

I was wondering today how many students were paying attention to the early presidential primary activities.  During Joe Biden's kickoff presidential rally in Pittsburgh yesterday he discussed the problems with over-credentialing and how it can serve to restrict competition in the marketplace.

He framed his basic presentation in context of lower wage earners and Union jobs, but does his argument apply to health care other middle income licensed occupations?

"They do the same thing with occupational licenses. Why should someone who braids hair have to get 600 hours of training? It makes no sense. It's designed to keep the competition down.

Look, folks, you can't just transfer your licenses across one state to another. They're making it harder and harder in a whole range of professions all to keep competition down."

He also talked about reclassification into exempt categories in order to prevent paying overtime.  That made me think of all my colleagues working in long term care facilities and their productivity requirements.

Twelve years ago, the occupational therapy profession was featured in the Chronicle of Higher Education in an article entitled 'Credential Creep.'  The concern at the time was that credentialism, or the gradual increasing of requirements to enter a profession, was driven by professional associations and often served to cheapen doctoral education in what was referred to as a 'race to the bottom.'

Have these issues ever really been addressed?  It does not seem that they have.

In our recent professional discussions it seems that there has been a majority opinion that there is not enough evidence to support credentialism in occupational therapy.  There are still those who disagree and would like to see increasing degree requirements.


Who benefits from credentialism?  Small liberal arts based teaching focused schools are not equipped for doctoral education - at least at a level that would avoid criticism about the relative value of the degrees.  Credentialism means that elite schools that can churn out doctoral degrees are better positioned to feed the hungry higher education industry - a system bloated on college debt that now exceeds $1.5 trillion.


On the flip side of the coin, occupational licensing theoretically helps workers in the field  from competition by raising barriers to entry into a profession.  In most market economies, such barriers provide what are called 'rents' to the protected classes - often in the form of higher wages.  This is the missing piece in the economics of credentialism in the occupational therapy profession: there has been no corresponding increase in the 'rents' associated with all the inflation that has been promoted by the educational institutions.  This is something that occupational therapy students know all too well - the only pathways that many have toward higher pay is to take horrendous travel positions with low mentoring and high productivity requirements.  They learn quickly that many jobs in their local environments can't offer the salaries they require to pay down debt and begin their adult lives.


So the clear 'winners' are only the educational institutions who restrict their competition and continue to feed from the student debt trough.  Not enough occupational therapists are fluent in economics of the health care workforce to really engage the issue.  Instead, too many people simply deferred to the professional association - a group primarily populated by educators and their students.  And the students are left all searching for jobs that pay the highest possible wage to mitigate their student debt.  That causes many young health care professionals to burn out on their careers too early - a problem so severe that policy analysts are now discussing how to model for burnout prevention in their overall health care reform schemes.

This is a dangerous configuration - and the higher education industry will only be able to continue with this model until the day comes when the students come to understand who put their nose rings in and what purpose they are primarily serving.


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