Psychologists should NOT be given prescribing powers

[JattMed]

It would be dangerous to allow psychologists prescribing powers.
Firstly they dont have the training to understand how drugs work and how they affect the body
Secondly they dont even know how the body functions and how it presents when it 'dysfunctions'.
Thirdly, they will destroy psychiatry.


Allow psychologists to prescribe meds:
1. No
2. Yes
3. No opinion
4. I am ugly (i.e., you the voter)

See poll

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[50960]

Is this realy happening???

 

[JattMed]

Is this realy happening???

No but the lobbying for it is growing every year.

Take a look at how homeopaths have somehow gotten their hooks into medicine. --->I think some are now even on the FDA boards and similar bodies.
Talk about sellin' snakeoil!

 

[50960]

Actually I meant, Is someone really bringing this up AGAIN after the thorough discussions that have already occured on the matter here?? Do you research before you post imflammatory info....

 

[JattMed]

Actually I meant, Is someone really bringing this up AGAIN after the thorough discussions that have already occured on the matter here?? Do you research before you post imflammatory info....

Well it sure looks like it! Do you see, read and understand before posting?

 

[edieb]

It has already happened in Louisiana and New Mexico. NM starts prescribing in October.

 

[leorl]

To the OP: When you start a discussion in these forums, please keep it constructive, otherwise it could be viewed as trolling.

I think those of us pursuing roles as physicians need to ask questions like how can other fields be used in conjunction with our treatment to help the patient get maximum quality of life. So instead of focusing what they (psychologists, PAs, nurses, etc.) can't do, we should be focusing on what they Can do.

Having said that, I don't agree with psychologists being given prescribing privileges. But instead of harboring on it, we should focus on why other professions are gaining more autonomy while we are losing ours. I won't go on the whole social side of why other professions are starting to "encroach" on doctors' roles here. But they give big clues as to what's wrong with the medical profession. And we should focus on how we can incorporate people like psychologists in our multidisciplinary team (whether they have prescribing rights or not), not alienating them.

 

[PublicHealth]

But instead of harboring on it, we should focus on why other professions are gaining more autonomy while we are losing ours. I won't go on the whole social side of why other professions are starting to "encroach" on doctors' roles here. But they give big clues as to what's wrong with the medical profession. And we should focus on how we can incorporate people like psychologists in our multidisciplinary team (whether they have prescribing rights or not), not alienating them.

I'm all ears.

 

[50960]

I certainly agree with all that, but this person posted this in the psychology forum. I have to reiterate for purpose of a fair fight...psychologists as they are will never be prescribing, only those that choose to pursue a post doctoral, post-license masters level psychpharm/medical training. Some will, most won't.

 

[PublicHealth]

I certainly agree with all that, but this person posted this in the psychology forum. I have to reiterate for purpose of a fair fight...psychologists as they are will never be prescribing, only those that choose to pursue a post doctoral, post-license masters level psychpharm/medical training. Some will, most won't.

Good point. Unfortunately, most people tend not to read the relevant literature before voicing their opinion. To those interested in learning more about psychologist RxP, please refer to the 20+ page thread in the psychiatry forum.

 

[Skip Intro]

It would be dangerous to allow psychologists prescribing powers.
Firstly they dont have the training to understand how drugs work and how they affect the body
Secondly they dont even know how the body functions and how it presents when it 'dysfunctions'.
Thirdly, they will destroy psychiatry.


Allow psychologists to prescribe meds:
1. No
2. Yes
3. No opinion
4. I am ugly (i.e., you the voter)

See poll

Dude, you asked this question in the Clinical Psychology [ PhD / PsyD ] forum. You're results will be, therefore, biased: unrepresentative sample.

IOW, I wouldn't take the results too seriously... or, go ask it in the Psychiatry forum and see what kind of answer you get.

-Skip

 

[edieb]

You're dead wrong. I am a clinical student at LSU and the school has made the training pre-doctoral. 99 perecent of the 20 clinical students are taking the course work.

I certainly agree with all that, but this person posted this in the psychology forum. I have to reiterate for purpose of a fair fight...psychologists as they are will never be prescribing, only those that choose to pursue a post doctoral, post-license masters level psychpharm/medical training. Some will, most won't.

 

[JRB]

<snip>....we should focus on why other professions are gaining more autonomy while we are losing ours. I won't go on the whole social side of why other professions are starting to "encroach" on doctors' roles here. But they give big clues as to what's wrong with the medical profession. And we should focus on how we can incorporate people like psychologists in our multidisciplinary team (whether they have prescribing rights or not), not alienating them.

This is exactly the heart of the issue, and has much more relevance than whether or not a certain group should have x,y, or z priviledges.

The 'real' debate should be about how the practice of medicine is defined, and what is in the best interest of our patients.

What does it mean to practice medicine? What is the definition of medicine? What definition of medicine is in the best interest of the patient? These are things that we have not decided. And who gets to decide anyway?

JRB

 

[JRB]

You're dead wrong. I am a clinical student at LSU and the school has made the training pre-doctoral. 99 perecent of the 20 clinical students are taking the course work.

I would like to better understand the reasons that a student, knowing at the start of their academic training that they want to practice from a medical model, wouldn't have pursued medical school with a psychiatry specialization.

Thanks in advance,
JRB

 

[JattMed]

To the OP: When you start a discussion in these forums, please keep it constructive, otherwise it could be viewed as trolling.

Considering that medicine is going to be MY livelihood I think it is VERY constructive that this thread is started.
Is it not within my 'rights' to protect my livelihood?
I have already considered the patient well-being aspect and I really dont see a significant improvement in help when boundaries are fuzzied and care is duplicated.
The roles as they are now should stay that way wherein each 'profession' has a specific role and no encroachment upon another.
However when it comes to keeping the economic viability of medicine (for the practitioner) at the state it is or was or could be, I will stand up to protect its autonomy, authority and privilege and not let 'others' usurp any aspect of being a medical doctor.
As someone had posted above, if you wanted to prescribe meds then perhaps you should have entered medicine and gone into psychiatry.

 

[Sanman]

Well, in the case of LSU, where psychologists can already prescribe, why not get a fully funded education that allows a greater number of job opportunities in the mental health field and saves you 150-200k than got to med school?

 

[JRB]

Well, in the case of LSU, where psychologists can already prescribe, why not get a fully funded education that allows a greater number of job opportunities in the mental health field and saves you 150-200k than got to med school?

Economic comfort and opportunity in lieu of quality education and concern for patient well-being?

Please correct me if I misconstrued your response.

JRB

 

[Sanman]

well economic comfort and opportunity are a part of reality, otherwise people wouldn't go to med. school. As for the quality of education, that is every person's individual opinion. You may not feel that it is adequate and others may, it is simply a matter of opinion. Whether psychologist or psychiatrist, the competence in prescribing drugs is in the hands of the individual, not the degree conferred. If a psychiatrist is against it because of the ecnomic problems it may cause, well that is valid, but then you can't blame the psychologists for being for it for the same reason.

 

[edieb]

That's dichotomous thinking, sir. You don't just practice from the medical model or the psychological model; LSU is combinin the cognitive behavioral model with the medical model (aka "biopsychosocial.).

I would like to better understand the reasons that a student, knowing at the start of their academic training that they want to practice from a medical model, wouldn't have pursued medical school with a psychiatry specialization.

Thanks in advance,
JRB

 

[edieb]

It seems that you make a lot of judgement before you have any data ("Economic comfort in lieu...").

Economic comfort and opportunity in lieu of quality education and concern for patient well-being?

Please correct me if I misconstrued your response.

JRB

 

[PublicHealth]

I would like to better understand the reasons that a student, knowing at the start of their academic training that they want to practice from a medical model, wouldn't have pursued medical school with a psychiatry specialization.

Thanks in advance,
JRB

Most of the people in LSU's doctoral program in clinical psychology probably weren't even aware of the fact that they could "train from a medical model" until they were already enrolled! To my knowledge, most people in clinical psychology doctoral programs want to become scientist-practitioners. Medical school does not offer students much of an opportunity to pursue research to any significant degree, and residencies and psychiatric practice tend to overemphasize pharmacotherapy. People are drawn toward clinical psychology as opposed to psychiatry because of it's emphasis on the psychosocial conceptualizations of mental illness and concomitant psychosocial therapies. In theory, adding psychopharmacotherapeutic skills to this training would foster the development of comprehensively training behavioral healthcare providers.

Sanman makes a good point about debt. Why should a student interested in assessing, diagnosing, and treating mental illness have to endure medical school and residency in psychiatry, and accumulate $150-200K in debt when they could complete a doctorate in clinical psychology free-of-charge, gain valuable research experience, and end up doing pretty much everything that a psychiatrist does?

 

[gzaky]

Psychiatrists can fight Psychologist prescription rights all they want but they can not stop the train that has left the station. TWO STATES HAVE PASSED THE BILL ALLOWING PSYCHOLOGISTS TO PRESCRIBE SUBSEQUENT TO A PSYCHOPHARMACOLOGY MASTERS AND OTHERS WILL FOLLOW, HOPEFULLY, FLORIDA IS NEXT.

PSYCHIATRISTS EXPRESS CONCERN REGARDING THE PATIENT WHILE RELUCTANCE TO MENTION THEIR GREATER CONCERN FOR THEIR ECONOMIC JEOPARDY. RESEARCH HAS SHOWN THAT PROPERLY TRAINED PSYCHOLOGISTS WITH THE DOD HAVE BEEN VERY SUCCESSFUL IN PRESCRIBING WITH OUT JEOPARDIZING THE PATIENTS SAFETY. SO I TRULY BELIEVE THAT PSYCHIATRISTS ARGUMENT IS TRULY AN ECONOMIC THREAT AND NOT ENTIRELY FOR JEOPARDIZING PATIENT SAFETY.

PSYCHIATRISTS SHOULD WORK JOINTLY WITH PSYCHOLOGISTS INTERESTED IN PURSUING RxP TO BETTER EQUIP THEM FOR BEST PATIENT CARE

 

[PsychMode]

Most of the people in LSU's doctoral program in clinical psychology probably weren't even aware of the fact that they could "train from a medical model" until they were already enrolled! To my knowledge, most people in clinical psychology doctoral programs want to become scientist-practitioners. Medical school does not offer students much of an opportunity to pursue research to any significant degree, and residencies and psychiatric practice tend to overemphasize pharmacotherapy. People are drawn toward clinical psychology as opposed to psychiatry because of it's emphasis on the psychosocial conceptualizations of mental illness and concomitant psychosocial therapies. In theory, adding psychopharmacotherapeutic skills to this training would foster the development of comprehensively training behavioral healthcare providers.

Sanman makes a good point about debt. Why should a student interested in assessing, diagnosing, and treating mental illness have to endure medical school and residency in psychiatry, and accumulate $150-200K in debt when they could complete a doctorate in clinical psychology free-of-charge, gain valuable research experience, and end up doing pretty much everything that a psychiatrist does?

What I foresee is that if the majority of psychologists in the U.S. get prescribe, what's to stop even lesser trained practitioners from pursuing privileges? Clinical psychology is extremely competitive. We are not talking about people who couldn't necessarily get into medical school. I know a med school student now who was originally pre-clinical psych and switched over due to managed care (and she is NOT going into psychiatry, even though she would have been a psychologist). Other programs, such as social work programs and other masters programs aren't as competitive (some of them are like walking in off the street with any undergrad degree) and some of these practitioners have already started talking about prescription privileges, believe it or not. They will probably say, "Why go through a really long phd program and have to do all that research on top of clinical training when you can get a masters degree and be able to prescribe?" They will also say, "Well, why can a clinical psychologist prescribe without going to medical school and we can't? We are competing with them now in the job market."

I'm not against clinical psychologists prescribing as long as their post doctoral training in RxP is rigorous and difficult. It should be. But keep in mind that people like social workers, many of whom are still confused about why clinical psychologists should be paid more than them after underbidding clinical psychologists, may end up attempting to get prescription privileges.

 

[50960]

Good points, and I agree! The training has to be top notch or it is doomed to failure. Undertrained prescribing psychologists will make a bad name in medicine for the whole lot.

 

[leorl]

What exactly is the difference between psychiatrists and clinical psychologists with prescribing rights?

 

[PublicHealth]

What exactly is the difference between psychiatrists and clinical psychologists with prescribing rights?

Clinical psychologists can only prescribe in New Mexico and Louisiana.

Psychiatrists can prescribe in every state.

For more information, check out this thread:

http://forums.studentdoctor.net/showthread.php?t=118082