How Can We Encourage High Quality Engineering? Two Comments

A recent article in the Wall Street Journal¹ demonstrated investigative journalism at its best. The article dealt with the National Practitioner Data Bank created by Congress in 1986. The data bank “was designed to make it easier for hospitals and state licensing boards to check on doctors’ qualifications before hiring them or licensing them.” The article described a method used by doctors to avoid being included in the data bank. If a doctor is dismissed from a malpractice claim, leaving only the hospital or other corporate entity as the responsible party, the doctor’s name need not be reported to the data bank. Of course, the doctor’s insurer has made a settlement, but removing the doctor as a defendant avoids the requirement to report the name of the doctor.

The Health Resources and Services Administration (HRSA), an agency of the federal Department of Health and Human Services, administers the data bank. The HRSA estimates that half of the medical malpractice payments are not reported. Obviously, this greatly reduces the list and diminishes the value of the data bank.

The information is not open to the general public. If you or I are considering a doctor to perform brain surgery, we cannot check the data bank to see if a doctor we are considering has been sued successfully for malpractice. If such a list is not used intelligently, it could be unfair to the doctor listed. Yet, the more complete the list, the more valuable. In the best of all possible worlds, a complete list of doctors sued successfully available to the public would help those who are selecting doctors by providing information vital to a market system, even one that involves professionals. But as we shall see, those who might appear on such a list hotly resist free availability of such information. We live in an imperfect world.

Still, hospitals must consult the list when they consider an applicant for a staff appointment or clinical privileges. Medical licensing boards can use the information when they decide whether to license a doctor. While this is not a real market mechanism, the data bank not being open to the public, it can still play a modest role in weeding out incompetent doctors.

Of course, many arguments can be made for and against such a system. The Journal article notes them and the contentions made by those in health care.

After I read the article, a simple question came to my mind: How does a consumer of professional services decide whether to engage a particular professional person, such as a doctor, lawyer, or engineer?

This made me think about Legal Aspects of Architecture, Engineering and the Construction Process, the 7th edition of which I and my coauthor, Marc M. Schneier, published in 2004. In our discussion of licensing laws, we noted the use of contractor licensing laws both as a forum for resolving construction disputes and an indirect method of providing consumers information.² If I was about to engage a contractor, or for that matter an engineer, I would want to know how many complaints have been lodged against the potential contractor or engineer. I might not need to know how these complaints were resolved, although that would help, but I would want to know how many times owners complained to the licensing officials about persons I was planning to hire. Of course, I would very likely discuss these complaints with the person I was thinking of engaging. Proper explanations might be found that would convince me that I still wanted to engage this person. But, the information would certainly help me. Any unfairness to the person with a number of black marks could be handled by obtaining explanations. I do not ignore the power to the owner to affect the license of the engineer, but in the rough and tumble of construction disputes, he often needs it.

In California, a member of the public can find out whether complaints have been made against a contractor.³ The detailed provisions and many qualifications, along with the many amendments to the statute, demonstrate that this apparently simple method of giving consumers helpful information is indeed complex in operation. But the fact remains that California thought that this information, although subject to abuse and needing refinement, provides modest consumer protection, something sadly lacking in construction.

Consumer protection of this sort can be looked at as a method of weeding out incompetent persons. This made me think about a chapter I wrote a number of years ago for an engineering text.⁴ That chapter was entitled “High-quality Engineering Design: An Elusive Goal.” In my chapter I sought to list and evaluate methods to encourage quality engineering. While engineers are involved in an astounding variety of projects, I thought of the skill of an engineer in doing the engineering work for which he is retained by a client or company. I discussed factors and techniques that can affect the quality of engineering.

What about engineering schools? Can they weed out the applicants and students most likely to do a poor job? Can they judge applicants and decide who receives their degrees as to the potential for quality engineering? One concern is the large number of schools that need students, particularly those that are “for profit”? Will they have the courage to reject potential customers?

How about registration laws as a filter? Can that process sift out the competent from the incompetent? Can education and experience requirements, along with the testing process, predict who will be a good engineer? As to ongoing policing through suspension and revocation powers, I have my doubts. Rarely do even incompetent engineers lose their licenses. They fight in court and often win. Even if they are thrown out they still practice illegally. It is all they know how to do.

Then, I moved to professional liability insurers. Can their decision whether to insure protect us from bad engineering? Underwriting decisions can take into account the many claims made. But we do not know whether it is the poor engineers who get sued. Underwriting decisions often take into account the need to have customers, like any other business. There is the insurance cycle. Insurers rush to insure when they can see the possibility of front-end premiums and high investment income and then retreat when the claims come in. In any event, we know that engineers often “go bare.” They continue to practice without professional liability insurance if the client will let them.

What about the tort system, the private law process under which someone who suffers a loss can recover it from the engineer whose negligence caused it? The tort system is very erratic. Good engineers lose and bad ones escape. Yet I am sure that the tort system does have some affect on the quality of engineering, although at best a modest one.

Finally, I looked at the market. Will the market weed out the incompetent? Will the really bad ones stop practicing because they have no work? But how does the market work? If consumers will not buy a product or service, the business goes under. Does that apply to engineers? To check this we need to know how engineers are chosen.

A skilled client or employer, particularly one with engineering skill or experience, can evaluate prior work, ask for references, check on the prospective engineer’s reputation, and gather any public information that could help, such as the California licensing method, or, if one existed, a data bank similar to the data bank of doctors against whom successful claims have been made. But, I suspect retention decisions are more likely to be based on appearances, forensic skills, and good old-fashioned salesmanship.

We can see that all these systems can contribute, but have their weaknesses. Each mechanism plays a role in the search for quality engineering. I hope that this editorial can generate discussion in the engineering profession, particularly in engineering schools, about methods to improve the quality of engineering. How can we produce good engineers? Perhaps research that can help us determine the best techniques or mixes of techniques that can upgrade the quality of engineering. We need to find the best methods for making the engineering profession something of which we can be proud.