Information on the Request for Exclusion of Psychology from the “Pilot Project” on Mandatory

LETTER TO THE EDITOR

Continuing Competency Requirements

To the Editor:

I thought my fellow MSPP members would be interested to read the letter that the Ad Hoc Committee on Mandatory Continuing Education sent to Governor Granholm in September. No reply has yet been received.

Marvin Hyman, Ph.D., West Bloomfield

____________________________

September 6, 2005

Governor Jennifer Granholm

P.O. Box 30013

Lansing, Michigan 48909

Dear Governor Granholm:

In our previous communications with your office and with the Michigan Department of Community Health, we presented petitions protesting the possible inclusion of mandatory continuing education (MCE) requirements for renewal of psychologists’ licenses. Along with the petitions, we presented evidence based on the existing scientific literature that mandatory continuing education requirements are without merit as a means of protecting the public from incompetent or unscrupulous practitioners. It was our impression that your administration—like many others across the country--came to share that point of view and, as a result, chose not to impose mandatory continuing education requirements.

According to Melanie Brim, Director of the Bureau of Health Professions, Michigan Department of Community Health, your office subsequently requested that her Department investigate the issue of “continuing competency.” The Department developed a “pilot project” to carry out this request. As we have been given to understand, what began as a multi-year pilot project intended to design regulations and then assess their effectiveness has, due to political pressures, been reduced to a rapid “review” project. Its purpose is only to gather and report the existing literature on forms of mandatory “competency” requirements in use by other states with the assumption that these requirements “should” improve professional competency. It is also our understanding that it has been decided ahead of time that—no matter what Ms. Brim’s review project might find--some number of these requirements will necessarily be imposed on all members of the health care professions that are included in the competency review project (which is often still erroneously referred to as the “pilot project”) because of a priori agreements made between your office and various professional associations. In fact, what is being presented as a new category of “continuing competency” or “professional development” requirements for re-licensure is nothing more than the widely discredited policy of mandatory continuing education under a new name.

At a public meeting held by the Michigan Society for Psychoanalytic Psychology (May 1, 2005), Melanie Brim explained that the impetus for the move to change from MCE to “mandatory continuing competency” regulations arose from her contact with the Citizen’s Advocacy Center (CAC). The CAC has indeed published a series of recommendations regarding the development of professional competency regulations. None of these, however, is being followed in Michigan’s competency review project.

The CAC presents a two-phase process by which to establish the scientific validity and reliability of continuing competency requirements (Citizen Advocacy Center, April 2004. Maintaining and Improving Health Professional Competence: The Citizen Advocacy Center Road Map to Continuing Competency Assurance, http://www.cacenter.org/new.htm):

Phase 1 involves enabling legislation “necessary to direct licensing boards to (1) develop and implement a series of pilot projects to gather data comparing the validity, reliability, and affordability of various methodologies and techniques for competency assessment and assurance,” and (2) based on an analysis of the results of these pilot projects, “set standards for effective, valid, and reliable continuing competency assessment and assurance programs” (p. iv).

Phase 2 proceeds only when and if research analysis derived from Phase I has demonstrated that particular “assessment and assurance methods” are valid and reliable means of improving competency. The work of Phase 2 is to “develop and implement regulations setting standards for acceptable methodologies, including assessment methodologies” (p. vi).

Our understanding from Melanie Brim is that Michigan’s competency review project does not involve any actual research, nor are there any plans to conduct research for the purpose of establishing the validity or reliability of any of the methods that are, in the end, recommended by the Bureau for increasing “competency” among professionals. Once imposed, the regulations will simply remain, never evaluated as to their effectiveness in meeting the goals for which they are intended, while the public is given the State’s assurance that it is “ensuring continuing professional competency.” This once-over-lightly approach to the regulation of health professions is warned against in an article we would like to recommend to your legal staff: Klein, A. L. (1996, July/August). Validity and reliability for competency-based systems: Reducing litigation risks. Compensation & Benefits Review, 28(4), 31-37. Klein states that “to work, competency- based systems must be developed and administered with methodological rigor” and “improperly implemented competency-based programs become vulnerable to legal action under Title VII of the Civil Rights Act of 1964.”

Lastly, we wish to point out that Psychology was not originally included in the competency review project. It was inserted only after the fact at the urging of the Michigan Psychological Association (MPA), whose non-student membership represents less than 15 percent of the state’s licensed psychologists. The MPA lobbied for the inclusion of our profession without consulting even its own members, a large number of whom (including sponsors of this committee) oppose inclusion. It appears to us that many of the advocates of the project and of the concept of continuing competency are dedicated to it for the sole reason that it is currently fashionable. Others, including many in the professional associations, support “continuing competency,” just as they supported mandatory continuing education, as a means of raising their “non-dues income.”

Since the Ad Hoc Committee found no merit in the review project or the inclusion of Psychology therein, we wrote to all licensed Michigan psychologists inviting them to study the issues and, if they agreed with it, to sign a statement requesting that Psychology be excluded from any participation in the review project on competency and its sequelae.

Approximately 2,000 psychologists returned signatures requesting exclusion of Psychology from the competency review project.

This constitutes 30 percent of the licensed psychologists in Michigan, which is more than double the number that the MPA can claim to represent by virtue of its membership. Moreover, 234 of the Michigan Psychological Association’s own members (and at least 12 of its former presidents) signed the requests for Psychology’s exclusion. This attests to the very strong opposition of psychologists (who do understand the nature and importance of valid research) to the arbitrary institution of mandatory license renewal requirements based on insufficiently examined measures of an undefined and highly controversial construct

labeled “competency.”

On behalf of 30 percent of the licensed psychologists in this state, the Ad Hoc Committee on MCE is requesting the removal of the profession of Psychology from the Department’s competency review project, along with any requirements that might follow from this project.

We would like to meet with your staff at your earliest possible convenience to discuss our concerns regarding the current status of Psychology in the review project on continuing competency.

Please contact Dr. Walter Sobota at 25600 Woodward Avenue, Suite 107, Royal Oak, Michigan 48067.

Telephone: (248) 542-8421

Sincerely yours,

Marvin Hyman, Ph.D., ABPP

Walter Sobota, Ph.D., ABPP

For the Ad Hoc Committee on MCE