How Can We Attain Licensure?

Last month we discussed the need for licensure for biomedical equipment technicians (BMETs) and clinical engineers (CEs). (See Soap Box: “Are You Licensed?” June 24x7.) Now let us consider how we can accomplish this goal.

First, almost all professional licenses are issued by the states, not the federal government. So we will have to lobby legislators in every state, asking them to pass legislation requiring licenses for all BMETs and CEs, much as what nurses, respiratory therapists, and other licensed allied health professionals did many years ago.

Next, we cannot justify our licensure simply because other healthcare professionals are licensed or some other countries are requiring licenses for their BMETs and CEs. We need to convince state legislatures that to ensure safety of patients it is absolutely essential to regulate those who manage and service medical equipment, train clinical users, and advise on highly complex and increasingly costly investments in technology. These professionals must have a minimum level of competency acquired through a combination of education and work experience, and they must adhere to a high standard of conduct and professional ethics.

The success of several state and regional biomed associations — in Colorado, Florida, Virginia, Pennsylvania, Minnesota and Texas, to name a few — in securing “appreciation week” proclamations from their respective state governments shows that we can get proper recognition. However, we will have to work much harder to get licensure than we did to get the proclamations, as the latter are often issued only by the governor, while licensure requires approval of both legislative and executive branches. For this reason, we must unite and work toward this common goal. Both BMETs and CEs must be included in this process; otherwise, we will not have enough political lobbying power to accomplish our goal. Furthermore, the cost of individual licenses may be substantial due to the need to match license revenue with the regulatory staffing costs.

We also must secure support from our licensed clinical colleagues as well as endorsement from our engineering brethren. In addition, we need to work with educational institutions and accreditation entities such as the Accreditation Board for Engineering and Technology (ABET of Baltimore, Md.) to create educational standards for future professionals. Obviously, an open and widely acceptable process has to be developed for the current practitioners to be licensed until the educational institutions can produce new graduates.

We have to prepare ourselves for possible opposition from some institutions and companies that are concerned about higher labor costs. And yet, leading organizations that want to offer quality services will probably support us, knowing that they cannot, and should not, compete solely on price. Some manufacturers may be reluctant to support and join us in the beginning (for the same reason), while the more visionary ones will realize that licensure will help reduce their exposure to risk and liability when service can be performed only by qualified professionals.

Some colleagues have advocated using the existing certification process to achieve licensure. While this could be a good approach, the fact that there currently is little enthusiasm for certification at both BMET and CE levels suggests that this is not likely to be achieved. It is also unfortunate that we do not have a national organization that can lead the process. However, as the majority of the work will have to be carried out at state level, it is possible to depend on individual state and regional biomed associations to take the initiative. Currently there are roughly 30 state, regional and metropolitan associations that can take up this challenge. Eventually a national organization may have to be created to coordinate the effort and establish liaison with academic institutions, healthcare organizations, government agencies and other healthcare professional associations.

I do realize that this proposal is much “easier said than done” and that a lot of “blood, sweat and tears” from many people will be required before national recognition can be achieved. Unless we are willing to sacrifice our “free time” and energy, I think we will continue to “get no respect” and we have nobody to blame but ourselves.

We may be tilting at a gigantic windmill; however, what other, more interesting tales will you have to tell your grandchildren about your professional life?

Binseng Wang, Sc.D., CCE, is vice president, Quality Assurance & Regulatory Affairs, for MEDIQ in Pennsauken, N.J. E-mail him at binseng.wang@mediq.net.