Delay in approving licenses keeps psychologists sidelined
When Ethan L. Seidman hired a psychologist to join his practice last spring, he expected her to start Sept 1. But by late fall, she was still weeks away from working, because of delays in processing her license application.
The newly minted psychologist, who asked Seidman not to identify her, moved to the Boston area but still can’t earn a living or start helping the patients waiting for her services, he said.
“We have a long waitlist of clients who need to be seen and an excellent, highly trained psychologist ready to see them, but she can’t get started. It’s extremely frustrating,” said Seidman, whose Cambridge practice, Kendall Psychological Associates, includes six psychologists and a psychiatrist.
Other psychologists also say they are troubled by slowness at the Board of Registration of Psychologists, the state agency that vets applicants for licenses. The bottleneck reached an extreme last summer when some psychologists said they had trouble even getting through on the phone.
Psychologists assert that the delays involve more than an inconvenience, leaving licenses in limbo, holding up income, and potentially threatening public safety if misconduct investigations proceed too slowly.
The state division that oversees psychologist licenses said in a statement that two consecutive vacancies over the summer left it shorthanded amid the annual influx of license applications from recent graduates. But the board is now fully staffed and since the summer a staff member has been working full-time to process applications, the statement said.
The Board of Registration of Psychologists is made up of seven psychologists and two representatives of the public, appointed by the governor. Board members are volunteers who meet once a month and rely on staff to process applications and investigate complaints.
Andrea Piatt, principal and founder of a large Boston psychological practice, Commonwealth Psychology, said that the pace of license processing fluctuates “but it always takes longer than we wish it would.”
“I hope the state will re-evaluate whether they’re providing the board with sufficient resources,” she said.
Noting that the psychology board also handles misconduct complaints, Piatt said understaffing can be “a public safety issue.”
Recently, it took the board more than two years to resolve a credible accusation that a psychologist had sex with a patient, one of the most severe forms of misconduct. In June, four days after the Globe reported on the case, the psychologist, Melvin Rabin, turned in his license.
Public documents in the Rabin case show that a complaint received in early 2016 saw little action until May 2017, when the board issued misconduct allegations against Rabin that echoed the patient’s complaint. After that, the staff made efforts to reach an agreement with Rabin’s lawyer, but also continually granted the postponements requested.
Specialists in therapist-patient sexual abuse say that many clinicians who engage in sexual misconduct do so with more than one patient. But there was no evidence in the file that the board or its staff had weighed whether Rabin might have been a danger to other patients or considered exercising its power to immediately remove him from practice.
The Division of Professional Licensure, which oversees the psychology board, said in an e-mail to the Globe that there had been no other sexual misconduct complaints against Rabin throughout his long career. The statement noted that the board has an obligation to provide an accused person with fair and impartial due process.
Priority is given to complaints alleging sexual misconduct, physical abuse, substance abuse, and other potential threats to public health or safety, the e-mail stated.
The psychology board is among 39 licensing boards that are part of the Division of Professional Licensure. The boards regulate such health care professions as chiropractic, optometry, social work, and podiatry, as well as engineers, home inspectors, gas fitters, landscape architects, and a slew of other professions.
The division declined requests for an interview with Erin M. LeBel, the psychology board’s executive director, or with any other person associated with the board’s work. Instead, the division e-mailed responses without identifying who wrote them.
The e-mails stated that the average time to process an application for a psychologist’s license is 80 days and has remained steady for the last five to seven years, with occasional slowdowns during peak months.
In contrast, the Board of Registration in Medicine issues licenses to physicians an average of 56 days after receiving the application, provided the application is complete and does not require legal review, according to Gerard F. Dolan, assistant general counsel.
The psychology board, responsible for about 6,600 psychologists, shares its four staffers with two other boards, those regulating mental health counselors and social workers.
By way of comparison, the boards regulating nurses, dentists, and pharmacists have dedicated staff. But those boards are responsible for a larger group of professionals. For example, the Board of Registration in Dentistry licenses 25,000 dentists, dental hygienists, and dental assistants.
Jennifer B. Warkentin, director of professional affairs for the Massachusetts Psychological Association, said of the psychology board: “My sense has always been they’re trying to do the best they can. When there’s not enough personnel, the job becomes more difficult.”
The Cambridge psychologist who is president of the psychological association, Margaret Lanca, said the association heard complaints from some members about delays, and learned from the state that a staffing shortage was contributing to the problem.
Janna Koretz, a psychologist and founder of Azimuth Psychological, a practice in Boston and Cambridge, said that one of her employees recently waited months just to have her name changed on her license after she got married, delaying insurance reimbursements.
Such a delay, Koretz said, “has really serious implications for a delicate ecosystem. In a group of 10 people, if one person’s income isn’t coming, it’s a huge problem.”