The Globalization of Professional Practice
A Discussion of Global Licensure
by David J. Knauer
Advances in the electronic transfer of data in recent years have greatly influenced the international practice of professions throughout the world. Although the professional who practices in a foreign country must still recognize local laws, codes and business customs, national borders do not appear to be an impediment to electronic practice generated from a home jurisdiction. In fact, one could argue that borders are non-existent electronically, and language really isnt a barrier at all in cyberspace.
Telecommunication through such entities as the Internet has opened up a wide array of economic opportunities. The availability of electronic "oversight" (when one professional reviews the work product of another as part of a business association) encourages international professional practice, and presents new challenges to regulatory authorities. Should this activity be regulated and, if so, how are regulators to go about it?
The purpose of this paper is to encourage a discussion of professional practice through telecommunication and the feasibility of global licensure to regulate it.
Regulation Versus Laissez-Faire
Telecommunication has created a world market for professional services. Consumer to professional access is instant and constant. This greatly expanded economic opportunity exists in an untested arena. Such a development naturally generates a great deal of excitement, controversy, and rapid movement, as commerce attempts to fill the vacuum. This is the current condition in todays world of professional practice through telecommunication, or telepractice, as it is now sometimes called.
At this time there are many international organizations investigating the ways and means to encourage, and control, the globalization of the world economy. The World Trade Organization (WTO) is examining the impact of regulatory measures and how they effect the exchange of professional services1. The Organization for Economic Co-operation Development (OECD) has published the "OECD Report on Regulatory Reform"2 and continues to study and advise on ways to reduce regulatory burdens to trade. It would appear that almost every major profession has either developed regional and international conferences to address this subject, or is in the process of doing so.
The debate on the issue of professional practice through telecommunication is centered around what, if anything, is to be regulated, and which entity is responsible for establishing and enforcing the regulation. As a national issue this topic generates much discussion and ascertaining of individual jurisdictional rights. As an international issue it engenders the consideration of such weighty issues as international law, mutual recognition of professional standards, and acceptance of various governmental authorities.
Some professions have taken a more hands-off approach to international practice. Foreign practice through association with a locally registered professional is a widely accepted format for providing services. This places the responsibility for the work product with the local registrant, who also bears all liability for the project.
Practice by association in this manner across local and international jurisdictions has been in place for some time, and, in most cases, appears to work. However, individual practice via telecommunication is an area which lawmakers and regulators are still coming to terms with. It appears that where issues of public health and safety are more obvious, for instance in the health professions, we are more likely to see national certification initially attempted. Other professions will closely monitor the effectiveness of programs of this nature and look to model their national certification on the success stories. As national certification takes hold there will be more possibility for international certification.
The Prospect of Global Licensure
In considering the possibility of some form of global licensure it is far easier to number all the reasons why it would not be possible than it is to enumerate the positive aspects of doing it.
One of the biggest constraints standing in the way of any kind of global license or certificate is assessing competency. The very nature of some professions lends itself to ascertaining competency through testing. However, judging from the amount of debate this topic generates, there is often a wide discrepancy internationally between those who feel the emphasis to judge competency should be placed on testing and those who feel experience and education should be the main qualifying factor. Reaching global accord on a basic formula for establishing professional integrity, profession by profession, could take a tremendous amount of time and energy.
How would such a license be administered? Would it be necessary to establish an international entity to determine policy issues and authenticate credentials? How would such a license be regulated to ensure fair practice? Would disciplinary matters be under the jurisdiction of such a separate entity, and, if so, how would a disciplinary action be enforced? Is establishing another bureaucratic entity in the publics best interest?
These questions only begin to address the many concerns associated with the idea of global licensure. And we are only in the infancy stage of world-wide development of telecommunication. The rapid technical advances in this area portend possibilities in the near future we can barely imagine now. This includes random electronic access to communication networks, which will make tracking of telepractice difficult, at best.
Given the wide array of unknowns concerning technological possibilities, one approach to the issue of regulating global telepractice may be to encourage "local " regulation. Local meaning state, or district, jurisdictions initially, followed by a national application of regulation. If regulators take the position to act as educators for jurisdictional and national legislative bodies they can contribute to the development of realistic and enforceable regulations in the area of professional practice through telecommunication. As promulgation of these regulations increases, there may be more likelihood of international agreement for standards of practice. The idea being that what has proven effective in the microcosm may be applicable to the macrocosm.
Another alternative to developing global licensure may be certification through international professional associations. However, the general public often cries "foul" when professional bodies take on regulating their members, citing the fox guarding the hen house metaphor. In order to assuage these concerns the professional association would not only have to develop sound criteria for validation, but would also have to demonstrate some ways and means to enforce infractions.
Is global licensure something that should be administered by the United Nations? As an existing international body it contains the forum necessary for discussion and decision-making. Or, should this matter be left in the hands of professional organizations? Some professional associations, such as the International Union of Architects (UIA), are in the process of developing minimum standards of professionalism as they relate to international practice3. An accord addressing this issue was presented to, and approved, by the UIA Assembly in Barcelona, Spain, in July of 1996. Accords of this nature may be the precursors to reaching agreement on global certification.
Of course, there is always the option of creating a new entity to administer the license, whether it be born out of a international professional association or through international governmental agreement.
The Council on Licensure, Enforcement, and Regulation (CLEAR) has addressed educating legislative entities. During 1997 CLEAR developed "Telepractice and Professional Licensing: A Guide for Legislators"4. This guide is intended to help legislators make informed decisions regarding the regulation of telepractice. It is not meant to be the definitive answer as to whether telepractice is right or wrong, but to help legislators ask the right questions to determine if regulations are needed in their jurisdictions for particular professions.
There are serious problems inherent with the above-mentioned approaches to global licensure. Title, practice and liability issues vary from jurisdiction to jurisdiction. Mutual recognition and accord must be reached. The question of determining who is the prime contractor when various international professionals are participating in a project must be considered. A method referring infractions of local practice acts back to home jurisdictions must be developed and standardized. And, of course, the question of how such a license would be financed must be considered.
From a global perspective, most professions have large numbers of practitioners. A large volume of professionals could hold the cost of certification down to an acceptable amount. The option of creating "umbrella" global certification agencies also exists, and this too could keep costs and infrastructure at reasonable levels.
Global Licensure - A Viable Option?
The first questions concerning creating a global license to be asked are: is it a necessity? Or, would it be wiser to wait and see what kinds of solutions are arrived at by the various entities addressing the problem at this time? In order to determine this, each profession must look at telecommunication and consider the impact of this medium on their profession. This kind of consensus building, nation by nation, profession by profession, is an important ingredient in the first step to answering the above questions. Because, at the very least, each profession will need to develop a policy on telepractice. By determining a policy the profession will have a better idea of whether or not further action is required.
Instruments for policy-making currently exist in almost every profession. Besides national and international professional organizations and regulatory bodies, there are entities such as the WTO. Conferences such as this one given by The Center of Quality Assurance in International Education are excellent forums for discussion and the sharing of knowledge so important for global agreement.
When considering any kind of global licensure there are practical considerations that need to be addressed. Could such a license be implemented and enforced at a reasonable cost? And to whom would the cost be assessed, to the provider of the service or the recipient of it?
Financing a global license to practice through telecommunication may be the biggest impediment to creating this kind of certification. Whatever manner or method one might choose to initiate such a program there will always be a cost. The factors of cost will be driven by the expense of creating the process, and the demand for the certification. Demand for the certificate will be driven by how useful it is perceived to be by the practicing professional. Demonstrate to a professional that a possible financial gain will result from an additional license and the success of distributing that license is more likely to be assured. In any case, the key is global acceptance of the certificate by the profession.
And, finally, one must consider if there is any other way to ensure competent professional practice through telecommunication besides creating another regulatory entity. It is a valid argument against global licensure to state that such a license would be an impediment to global commerce.
Nevertheless, it would seem premature to rule out the possibility of a global license for telepractice at this time. At the very least, the consideration of this issue may act as a catalyst for moving professions towards reaching international accord on title and practice questions. Without this kind of basic international agreement the matter of a global license is a theoretical concept.
The ultimate factor for regulators in considering the imposition of additional regulatory conditions must be: are we doing all we can to protect the public? If a global license for telepractice is seen as a necessary benefit for the public, then a way for the administration of such a license will be found.
References:The "World Trade Organization Annual Report, 1996", plus a list of WTO publications may be found on the WTO web site located at: http://www.wto.org
For more information on the Organization for Economic Co-operation Development see their web site located at, www.oecd.org (under "Activities" choose "Trade").
The "Sixth International Conference on Architectural Registration", published by the National Council of Architectural Registration Boards (NCARB), may be obtained by writing to:
1735 New York Avenue NW
Washington, DC 20006
"Telepractice and Professional Licensing: A Guide for Legislators" may be obtained from the Council on Licensure, Enforcement, and Regulation (CLEAR).
403 Marquis Avenue, Suite 100
Lexington, KY 40502
COPYRIGHT 2000. Rights to copy and distribute this publication are hereby granted to members of the Council on Licensure, Enforcement and Regulation (CLEAR), providing credit is given to CLEAR and copies are not distributed for profit.