Originally Posted by Psyclops
I think that from a pragmatic point RxP for psychologists be the way things are going and it may be the thing to do to provide the appropriate care to patients. But l'd like to draw attention to your own arguments, you seem to think that the way things are going are not in everyones best interest. I'd also like to think that mental health is a little more complex than dental work and eye care. I don't mean to take away from thier professions by any means, but its like comparing apples and oranges from my point of view. Specifically, those tend to be very practice oriented, specific professions I think that clinical psychology requires the ability to deal with a broader scope of problems, many of which are chronic. It's not like "take two of these and call me never". It requires management and should be part of a multidisciplinary plan. Mental health or the lack of it is a far cry from many of the problems that are dealt with on a routine basis by many of those in the general health care profession. Ideally I would see for practice specialized prescribing psycholgiatrist, who had more braodly informed mental health training than a psychiatrist and more biology/chemistry than a psycholgist. But, I still think that the profession, unless it is extreemly careful, will fall into the same place that psychiatry has. Which isn't something that I would like to be a part of. Call it whatever you want.
Not really. The problem with RxPs and psychologists is no different than it was for other health care professions. The issue is whether a properly trained psychologist (either during his/her doctoral program or after his/her doctoral program) can safely and effectively prescribe the appropriate psychotropic medication to the appropriate patient for the appropriate reason.
I used dentistry and optometry as an example to illustrate how this issue played out in other areas. Forget the "complexity" of the practice area; that is not relevant. Dentists Rx a wide range of meds for a wide range of conditions, including powerful narcotics for pain relief after root canals and oral surgery. Optometrists Rx a very limited range of diagnostic and therapeutic meds to treat a very limited range of ocular conditions. Nevertheless, both professions do so regularly, in all states, without any harm done to their patients. Why is this example helpful? It is because it shows that other professionals, who have not attended medical school, can effectively, competently, and safely prescribe appropriate meds to their patients.
Historically, if your dentist performed a root canal, you had to see your MD to get pain meds for post op pain. After dentists lobbied for and obtained fairly unlimited RxPs, they could Rx the meds themselves w/o MD/DO consultation. Dental schools began to incorporate pharmacology into their curricula. The same is true of optometrists who also began to study pharmacology in opt school.
Now, rather than earn a post doc MS in psychopharm, I think medical psychologists should earn a professional PsyD (not a PhD) degree which includes physical assessment, biochem, neuroanatomy, pharmacology, etc., classes like those taught in comparable health programs such as dentistry, optometry, pharmacy, and podiatry. I think the PhD (a research degree with a clinical component to it) is inappropriate for clinical medical practice. Who cares about stats, MANOVAs, ANOVAS, dissertations, etc., when your primary educational goal is to render clinical services to patients?
I really believe there needs to be reform to the training program of clinical psychologists in order for the profession to stay alive and compete with mid-levels and psychiatry. I also think a post PhD masters degree in psychopharm is overkill. IF (and only if) psychologists want RxPs, then push the APA to reform its curriculum and move from a scientist-practitioner-researcher emphasis (PhD) to a professional practitioner (PsyD) emphasis. Swap 2-3 stats classes, dissertation classes and requirements, and other "irrelevant" to clinical practice classes for pharmacology, neurobiology, biochem, physical assessment, etc. For those who want to research, get a PhD in experimental or developmental psych. For those who just want to do counseling, get a PhD/EdD in counseling psych. For those who want to do clinical psychology and have RxPs, get a professional degree and not a researcher's degree.