President's Column

By LINDA VACLAVIK

The annual conference in Alaska was a great meeting with wonderful attendance. It provided a solid stepping stone into this year's activities, which are already in full swing. I appreciate that so many of you have expressed a willingness to provide continued support to CLEAR through committee and other project service.

After listening to and discussing the various "hot" regulatory topics at the annual conference and at CLEAR's recent health care regulatory issues symposium in Austin, I began to ponder the concept of freedom. Freedom is a basic right assured United States citizens, but a right that, it seems to me at least, is becoming less and less obtainable from both health and nonhealth professions. To focus on health professions for a moment, with the increasing hegemony of health maintenance organizations, preferred provider organizations and corporate healthcare institutions, we perhaps have become narrower in our scope of regulation than may be desirable for consumer freedom of choice. For example, we seek to regulate the providers of health care while those who pay for these services mandate who provides the service and how much service the consumer will get. Is this freedom to choose a qualified (regulated) provider, or is it financial gain at the expense of the consumer? As other external influences, i.e., the federal government, are increasingly playing a role in the regulation of the health care industry, the consumer advocacy role must be looked at more closely by the regulatory community. Telehealthcare, for example, may be good for consumers, but may end up stymied because of other issues surrounding who and where someone is qualified to practice. Why? Long distance practice is not a change--we have been consulting by telephone and through the mail for decades--it simply represents a new look at a technological twist to an old practice. We should concentrate our energies instead on issues such as whether a procedure that is performed via telehealthcare is completed by someone who is qualified. Also, the definitions of "qualified" and "competent" need to be examined. Continued competency is not always synonymous with initially qualified.

As regulators, we should be ready to intercede with the external forces affecting, not only the healthcare delivery system, but all services rendered by regulated providers, on behalf of the consumer. We must advocate for the consumer about what constitutes good service delivery. As licensing agencies, we can get caught up with the processing of applications and with disciplining licensees. However, part of our job must also be educating the consumer to know good service and how to access the regulatory system to remedy bad service. By educating the consumer, we, as regulatory entities, will have done our part in ensuring not only consumer protection, but also consumer freedom of choice.