- educational preparation of the professional,
- the credentialing (or licensing) of the professional,
- the service delivery by the professional, and
- the continued competence of the professional.

These in turn encompass all the other issues of currency, including scopes of practice, cross-jurisdictional and professional discipline matters.

Using Technology for the World
For several decades now we have heard and read that we all live (or will soon live) in a global village. We don't yet, of course, but the concept of the world-as-village is being helped along by two developments from the late 1990s that will be responsible for significant and rapid world change:

- new, more affordable communications technologies, and
- a commitment by the world's countries to build an information exchange network that is useful to all the world's inhabitants.

One of the areas within this telecommunications structure that will likely touch the lives of every country's citizens is telepractice. Just emerging from its infancy, telepractice¹ holds promise to help ensure quality in both health and non-health professions by providing ongoing education and global access to services such as those provided by accountancy, architecture, and engineering, as well as the health professions and their various specialties. Certainly, professional cross-jurisdictional consultation using the telephone, fax machines and mail has gone on always. But it is the use of more interactive technologies such as the Internet that are part of the growing global infrastructure and a continuing source of concern to state lawmakers and policymakers.

In the United States, it is the military's technological advances that are also intended to change civilian practice that may serve as a great impetus for lowering state barriers to professional practice. There are undoubtedly many complex reasons that the military is taking the lead on this, but among them is the need to optimize personnel in battle and in remote locations. And, they enjoy lack of cultural and legal barriers such as practitioner resistance and state licensure laws that present their own barriers to telepractice.

History Revisited
In 1952, The Council of State Governments (CSG) published an extensive report on professional regulation.

The report said that the problem of licensing occupations is directly related to basic economic, societal and governmental trends. There is no surprise there--the same situation obtains today. Some of the post-World War II trends CSG identified as affecting licensing included:

- a shift from a predominantly rural to a predominantly urban/suburban population,
- a change from an economy of small manufacturers and merchants to one of large-scale enterprise,
- a movement away from the individual craftsperson with control over the entire productive process to widespread specialization and interdependence,
- a movement from individual assumption of risk to a larger economic security, and
- a shifting of local patterns to big institutions in which decisions are removed from the individual citizen.

Today we find ourselves in a partial reversal of these trends.

Urban/suburban back to rural
There is a shift from the predominantly urban/suburban population back to non-urban areas because it no longer matters where many members of our workforce reside.

Large scale enterprise/specialization to small  manufacturers/ merchants/ craftspeople
There is a renaissance of the small-scale entrepreneur who controls the entire production of goods and services as a balance to the large-scale enterprises with economic interdependence

Decision-Making/Risk-Taking from Institutions to Individuals
In part because of the enormous amount of information available to consumers through the Internet, more decisions may be shifted back from big institutions to the individual. At the very least, we have a growing collaborative effort between individuals and those who provide professional services to them.

But It's Not Really the Same
Of course, we are not experiencing a real return to the social model of sixty years ago: today's craftsperson and rural resident and small-scale entrepreneur are all better-informed and presented with more choices than ever before. At the same time, there is a trend toward a growing environmental awareness on the part of regulatory agencies. As a result of more sophisticated consumer demands, and as more readily shareable information grows, agencies have become much less insular.

These changes may begin to combine with other domestic changes, including (for example) P.L. 106-50, known as "The Veterans Small Business and Entrepreneurship Act" which opens a serious discussion on how former military personnel can receive appropriate state-issued credentials for their military training, and also combine with international changes (including the current trade agreement negotiations) in ways that will ultimately affect the way we handle the business of professional regulation.

The Council of State Governments' 1952 report also remarked on the resulting rapid speed with which regulation of the professions had proliferated, saying that "over the span of the last two generations, there has been an extraordinary increase in state legislation requiring governmental examination and licensure….[such]….that today (1952) there are at least seventy-five different professions, skills, trades or other occupations for which varying combinations of qualifications, examinations and licenses are required in order to practice." Of those 75 professions, only 14 were regulated by all of the then 48 states.

For purposes of comparison, it is interesting to note that the total number of professions and occupations regulated today by one or more of the provinces or states is more than 700. Fewer than 50 of these are regulated by all 50 these jurisdictions.

Just as our predecessors believed fifty years ago, we feel that the rate of change is so rapid right now that it is difficult to see too far down the road. The immediate challenge then is to use what we know from the past and what we can see of the present to expand our vision of the future, sharing it with others as we make the journey. CLEAR's new members-only forum is a tool for doing just that.

1. "Telepractice: Using Technology for the World," Brinegar and McGinley in The foundations of globalization of higher education and the professions, The Center for Quality Assurance in International Education," 1999.

2. Occupational Licensing Legislation in the States, The Council of State Government, Chicago, 1952.

© 2000, Council on Licensure, Enforcement and Regulation