Oregon House Bill 2702 coming out of State Senate Committee for a full vote

[whopper]

Does anyone know ...
... what percentage of prescription-trained psychologists have had prescription-based malpractice claims issued against them?
... what percentage of psychiatrists have had prescription-based malpractice claims issued against them?

I doubt anyone knows it other than the insurer group covering existing psychologist prescribers, and since there seems to be an agenda there, as CGOpsych mentioned, I doubt they'd release it.

As mentioned before, the oft-cited GAO study is not a valid correlation to the situation today even though the psychologist prescriber uses it as its pseudo-bible to advance the cause. Again-it only allowed for SSRIs, it only allowed psychologists to prescribe to those already screened to not have an existing nonpsychiatric medical disorder, nor allow prescriptions to the Geri or pediatric population, and psychologists readily referred to psychiatrists when they couldn't handle the case. The study even recommended it shouldn't be used as a correlation outside the military because several things in the civilian world differed, and even on top of that--the GAO study showed the use of psychologist prescribers cost the system more & did not help get more psychotropics to those in need.

Yet the GAO is so often cited as the evidence to back the psychologist prescriber movement.

If the percentages are relatively equal, then it may suggest that the training for prescription rights for psychologists may be adequate.

As for the rest--psychologist prescriber vs psychiatrist-who has the more malpractice suits, I don't think such would be a good gauge & here's why.

I doubt several of the psychologist prescribers are handing out much more than SSRIs due to the complications I mentioned above. I bet several of them don't want to risk the liability of giving out a mood stabilizer or antipsychotic. So if psychologists prescribers for example were to have outcomes that were not as bad, it might be explainable by not taking on cases that are as psychopharmacologically &/or medicall difficult.

Again--another problem I have with the Oregon law. It gives psychologist prescribers the power to prescribe all psychotropic meds & interpret labs.

You could gauge 100 psychiatrists vs 100 Ob-Gyn doctors and find that none of the patients with the psychaitrists had cervical cancer, and 15 with the Ob-Gyn docs had cervical cancer--and conclude that psychiatrists were better in treating & preventing cervical cancer for that reason based on doctor vs doctor model. As I'm sure you know, its really more complicated than that.

On a more specific comparison, I have never been sued nor do I anticipate being sued over the use of administering & interpreting an MMPI--because I am not trained to do so, nor will administer or interpret one unless I got the right training. You can't conclude that I'm superior in giving an MMPI because I've had no problems with it, but a psychological colleague of mine did.

A study like you suggested would only be valid if the complexity of the patients treated by both were equal.

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Members don't see this ad.

 

[scottresident]

in addition to the psychologists who are being sued, i wonder if the patient and family members can sue the lawmakers. those that allow the prescriptions to happen?

 

[CGOPsych]

I think that these concerns about malpractice are critically important. Thank you for raising them.

If any prescribing group is party to an inordinately high number of prescription-based malpractice claims, this would definitely call into question the legitimacy of that group's prescription rights.

Does anyone know ...
... what percentage of prescription-trained psychologists have had prescription-based malpractice claims issued against them?
... what percentage of psychiatrists have had prescription-based malpractice claims issued against them?

If the percentage of prescription-based malpractice claims against RxP psychologists is significantly in excess of the percentage of prescription-based malpractice claims against psychiatrists, then it would point to inadequacy in the training for prescription rights for psychologists.

If the percentages are relatively equal, then it may suggest that the training for prescription rights for psychologists may be adequate.

On the other hand, if the percentage of prescription-based malpractice claims against psychiatrists is significantly in excess of the percentage of prescription-based malpractice claims against RxP psychologists, it may be interesting to ask why this may be so and what might be done to bring these percentages more in line.

I'm 99 percent certain there have been no malpractice lawsuits filed against any of the 65 civilian prescribing psychologists for their prescription practices. In fact, 13 or 20 percent don't even live in NM or LA.

In New Mexico they're only allowed to prescribe medications with FDA indications for psychiatric disorders, which obviously limits what they do bigtime. They tried to broaden that authority, but lost.

But comparing them with psychiatrists would be tricky. You'd have to compare their rate with the rate of malpractice suits against psychiatrists just for medication management. I'd bet that base rate is pretty low. Psychiatrists do more things that have consequences than just prescribe, e.g. inpatient case management, ECT, manage severely mentally ill outpatient more often, etc.

 

[whopper]

i wonder if the patient and family members can sue the lawmakers

Yes--they can sue for any reason they'd like. I don't like someone's hair color--I can sue them. However will it win in court? I highly doubt it. It can though be challenged through several means such as through the courts through a process called Judicial Review.

This is exactly a reason why IMHO psychologist prescribers would very much limit what they'd prescribe. They know they're on the knife's edge. An interesting study would be to see just exactly what they are prescribing, and when they would be willing to not handle a case & let an M.D. or D.O. take over. All my psychologist colleagues told me that even if they did pursue prescribing power (and the overwhelming majority said they would not--more than 10 to 1) they would only prescribe in the most limited of circumstances. E.g. only SSRIs and would still rather have a physician review the case from time to time.

But comparing them with psychiatrists would be tricky. You'd have to compare their rate with the rate of malpractice suits against psychiatrists just for medication management.

Exactly. Psychologist prescriber who is probably is not taking anybody with any apparent non-psychiatric medical problems is not going to compare to a psychiatrist who has patients on clozaril and have medical side effects due to the clozaril, but the need for the clozaril outweighs the side effects.

 

[Sneezing]

I find it hard to believe Oregon has such a deficiency of rural psychiatrists when a simple google search can pull up one like this psychiatrist.

 

[CGOPsych]

I find it hard to believe Oregon has such a deficiency of rural psychiatrists when a simple google search can pull up one like this psychiatrist.

You are referring to The Myth of the Rural Prescribing Psychologist. This is one of several dishonest arguments made by APA's RxP political campaign. First, in Illinois a survey of psycholoigsts, published in an APA journal (it was mostly pro-RxP so it passed the censors) clearly stated that there aren't any rural psychologists, at least not in Illinois:

"The issue of there not being enough qualified physicians in
underserved areas, including rural areas, has been an often quoted
reason that psychologists are pursuing prescription privileges. This
study examined the rural argument in particular and did not find
data that supported this argument in Illinois. Evidence against the
rural argument includes the fact that almost no psychologists
practice in the true Illinois rural counties."
See Baird, K. (2007). A survey of clinical psychologists in Illinois regarding prescription privileges. Professional Psychology: Research and Practice, 38, 196-202.

So what about the 65 civilian psychologisists with prescriptive authority? Have they gone to the boondocks to serve the unfortunate rural patients who have been abandoned by those greedy psychiatrists?

Here's the breakdown of what size cities they practice in according to their state licenses. As is obvious, zero practice in "rural" areas. 20% don't even have an address in the state.

(I had to edit this fix the chart, which looked great before it was posted)

Population: LA NM TOT %
100K+ 29 2 31 48%
50-100K 2 5 7 11%
25-50K 2 3 5 8%
2.5-5K 8 1 9 14%
<2.5K ("Rural") 0 0 0 0%
Out of State 10 3 13 20%
TOTAL 51 14 65
* US Census Dept defines "rural" as unincorporated areas or towns of less than 2,500 residents
** "out of state" means that these psychologists can not prescribe in their place of residence.

But once this sham argument is demolished, they just drop it and move on to another one. After all, this is politics and not professionalism.

 

[hereandnow]

But comparing them with psychiatrists would be tricky. You'd have to compare their rate with the rate of malpractice suits against psychiatrists just for medication management.

Yes, I absolutely agree. It is important to compare apples to apples. Thank you (and Whopper) for noting this.

So, with respect to medication management only, does anybody know what the prescription-based malpractice incidence rate for psychiatrists is?

I expect it is fairly low, but just do not have this information on hand.

A direct apples to apples comparison of non-comorbid prescription-based malpractice incidence rates would seem to be a fair way of determining statistically if and when psychologist prescribers might be subjecting their patients to undue and irresponsible risk beyond industry practices and standards of care.

I doubt several of the psychologist prescribers are handing out much more than SSRIs due to the complications I mentioned above. I bet several of them don't want to risk the liability of giving out a mood stabilizer or antipsychotic. So if psychologists prescribers for example were to have outcomes that were not as bad, it might be explainable by not taking on cases that are as psychopharmacologically &/or medicall difficult.

Hopefully, your assessment is correct and psychologist prescribers are exercising prudence in their prescriptions and referring out appropriately. (Perhaps their prudence may be motivated by fear of litigation, as you suggest, or perhaps it may be motivated by responsibility to patient and knowledge of their own limitations -- it is hard to know exactly, and I suspect it may be a bit of each-- just as I suspect it is also for almost every other healthcare professional when faced with a case at the borders of their competence. But hopefully the outcome may be the same -- namely that those individuals who have been vested with the responsibility of their patient's care not place that patient in circumstances of undue risk.)

 

[whopper]

I agree with CGOpsych. I haven't seen too many psychologists in rural practice. It like psychiatry, or other more specialized fields (professional athletes, opera singers, news anchormen) are pretty much only found (with exceptions) in more urban areas.

If one really wanted to get psychotropics out to the rural areas--telepsychiatry, scholarships--where doctors commit to practice in rural areas among other incentives, increased partnerships among specialist mental health care providers & the true #1 provider of mental health services- Primary Care Physicians need to encouraged.

 

[CGOPsych]

I agree with CGOpsych. I haven't seen too many psychologists in rural practice. It like psychiatry, or other more specialized fields (professional athletes, opera singers, news anchormen) are pretty much only found (with exceptions) in more urban areas.

If one really wanted to get psychotropics out to the rural areas--telepsychiatry, scholarships--where doctors commit to practice in rural areas among other incentives, increased partnerships among specialist mental health care providers & the true #1 provider of mental health services- Primary Care Physicians need to encouraged.

I certainly agree. If psychologists want to enhance the treatment of patients needing psychotropics they can learn enough to collaborate with physicians of all types. APA's model actually calls for three levels of training for prescriptive meds. The third is for independent practice, but the second level is intended to prepare the psychologist to be an informed collaborator with a physician.

Ah, but although collaboration models would serve our patients well without new legislation and without a threat to psychology, doing so would not advance the political and financial interests of APA and its "corporate partners".

And so I repeat: The APA RxP campaign is not about helping patients. It's about money and political power.

 

[ronin12]

I certainly agree. If psychologists want to enhance the treatment of patients needing psychotropics they can learn enough to collaborate with physicians of all types. APA's model actually calls for three levels of training for prescriptive meds. The third is for independent practice, but the second level is intended to prepare the psychologist to be an informed collaborator with a physician.

Ah, but although collaboration models would serve our patients well without new legislation and without a threat to psychology, doing so would not advance the political and financial interests of APA and its "corporate partners".

And so I repeat: The APA RxP campaign is not about helping patients. It's about money and political power.

thank you for your honesty and standing out for truth. Unfortunately most posters in this forum who are in favor of this prescription privilege fraud are willing to compromise their honesty and integrity by blindly favoring this quackery.

 

[CGOPsych]

thank you for your honesty and standing out for truth. Unfortunately most posters in this forum who are in favor of this prescription privilege fraud are willing to compromise their honesty and integrity by blindly favoring this quackery.

I think many psychologists have been utterly duped by the propaganda campaign conducted against them ruthlessly by these political Machiavellis.

- They control almost all the information psychologists get about their profession and they have slanted it shamelessly. There are almost no sources of information outside of journals that are not controlled by APA. Other organizations, like APS, don't want to get involved in these politics. Most journals don't want to deal with the subject because it's politics and not science. APA professional practice journals shameless shill for RxP. Of course, the negative consequences of RxP to psychology are not discussed.
- They forbid dissent. It is forbidden in APA for any organizational subunit or any official of APA to oppose RxP publicly. I know many persons who have elected and appointed positions in APA who oppose RxP and they refused to publicly talk about it because it would be politically dangerous.
- They suppress information flow in open forums. I have literally been admonished in an APA-sponsored public list-serve that I should get all my information about RxP bills from the RxP committee and not spread "rumors" such as the death of an RxP bill. Of course that information was accurate.
- They do not reveal how many times RxP bills have failed, but any success anywhere is met with fireworks. Many psychologists who oppose RxP have told me they thought RxP was inevitable, based on all the rosy cheerleading conducted by APA.
- They hide vital information, such as the budget for RxP. APA spends the money of clinicians but they do not release how many millions have been spent on this, as it might lead to questions.

RxP is just one aspect of a campaign of political insiders which began in the 1980s. These individuals successfully took over the reins of power at APA and pushed hard to downgrade the role of science, accreditation standards, and professional standards. They replaced this with pure commercialization and power politics. One of them ran an HMO and made a fortune off it. Another was an aide to a powerful US Senator, and arranged for the DOD PDP project. They generally agree that psychology is destined to be the "pre-eminent mental health profession".

As a result, many scientists left APA and formed the Association for Psychological Science, which has about 11,000 members as I last heard. APA's membership is declining and it has been running budget deficits. In 2008 the deficit was $3.4 million. Also, a new organization is forming to accredit training in psychology because APA's standards represent a shameless sell-out to the commercial interests of the professional schools, which now dominate APA. They have lowered standards to create more psychologists and develop "corporate partnerships" with the for-profit professional schools. Many of these people who have commercialized APA into the ditch have strong ties to professional schools. The former executive director of the Practice Directorate quit and now works for them.

So while appreciate your words about my honesty, I truly believe my outspokenness is only the result of learning more than what APA has fed its membership in a tasteless, dishonest and shameless campaign conducted against psychologists themselves.

 

[worriedwell]

Don't forget about they MCAT...which they should take as well...that is the predominant weeding out tool for people getting into medical school. They should need at least a 24 (or 8 on each section) which wouldn't get you into most med schools...then they should take USMLE STEP 1, 2, 3 and have to pass. Then the Written and Oral Boards for Psychiatry. Plus show a certificate of "internship" of a certain number of hours supervised.

Maybe the solution is just have them prescribe the way NP's prescribe...under the supervision of an MD who assumes the risk and who assures things are kosher. Perhaps, then the MD could serve more people by overseeing more midlevels.

 

[edieb]

I think many psychologists have been utterly duped by the propaganda campaign conducted against them ruthlessly by these political Machiavellis.

- They control almost all the information psychologists get about their profession and they have slanted it shamelessly. There are almost no sources of information outside of journals that are not controlled by APA. Other organizations, like APS, don't want to get involved in these politics. Most journals don't want to deal with the subject because it's politics and not science. APA professional practice journals shameless shill for RxP. Of course, the negative consequences of RxP to psychology are not discussed.
- They forbid dissent. It is forbidden in APA for any organizational subunit or any official of APA to oppose RxP publicly. I know many persons who have elected and appointed positions in APA who oppose RxP and they refused to publicly talk about it because it would be politically dangerous.
- They suppress information flow in open forums. I have literally been admonished in an APA-sponsored public list-serve that I should get all my information about RxP bills from the RxP committee and not spread "rumors" such as the death of an RxP bill. Of course that information was accurate.
- They do not reveal how many times RxP bills have failed, but any success anywhere is met with fireworks. Many psychologists who oppose RxP have told me they thought RxP was inevitable, based on all the rosy cheerleading conducted by APA.
- They hide vital information, such as the budget for RxP. APA spends the money of clinicians but they do not release how many millions have been spent on this, as it might lead to questions.

RxP is just one aspect of a campaign of political insiders which began in the 1980s. These individuals successfully took over the reins of power at APA and pushed hard to downgrade the role of science, accreditation standards, and professional standards. They replaced this with pure commercialization and power politics. One of them ran an HMO and made a fortune off it. Another was an aide to a powerful US Senator, and arranged for the DOD PDP project. They generally agree that psychology is destined to be the "pre-eminent mental health profession".

As a result, many scientists left APA and formed the Association for Psychological Science, which has about 11,000 members as I last heard. APA's membership is declining and it has been running budget deficits. In 2008 the deficit was $3.4 million. Also, a new organization is forming to accredit training in psychology because APA's standards represent a shameless sell-out to the commercial interests of the professional schools, which now dominate APA. They have lowered standards to create more psychologists and develop "corporate partnerships" with the for-profit professional schools. Many of these people who have commercialized APA into the ditch have strong ties to professional schools. The former executive director of the Practice Directorate quit and now works for them.

So while appreciate your words about my honesty, I truly believe my outspokenness is only the result of learning more than what APA has fed its membership in a tasteless, dishonest and shameless campaign conducted against psychologists themselves.

Before you spread mis(dis)information, please get your facts right. Look at the following link http://www.apa.org/monitor/2008/04/torture.html and look at the APA budget which forecasts a surplus, not a deficit

 

[whopper]

Before you spread mis(dis)information, please get your facts right. Look at the following link http://www.apa.org/monitor/2008/04/torture.html and look at the APA budget which forecasts a surplus, not a deficit

If there's a surplus, great. Budgets change with time.

Since you're back on this thread (you mentioned before you were leaving it), care to explain how you know so much about psychology without being a psychologist? You mentioned how psychologists have more training in seeing mental illness-which I countered. I mentioned before that the bulk of the psychology curriculum contains several classes that do not directly deal with mental illness such as sensation & perception, social psychology, industrial psychology, statistics, comparitive psychology, evolutionry psychology etc., and that psychiatrists are required to do 4 years of residency--about 3.5 of which is seeing mentally ill patients.

Psychology mind you is the study of the human mind--in general--in all aspects, not just mental illness. One could be a psychologist & use that training to help advertisers, increase productivity in a corporation, help in an election campaign, design dashboards, study gorrilla tribes etc.

As you stated in post #90

1. ) No, I am not a psychologist.

Why so gung ho for psychologist prescribers and lauding psychological training? What is your evidence that psychologists have more training in seeing mental illness & diagnosing it?

 

[edieb]

My coursework was pretty representative of accredited, university-based PhD clinical programs and I never took an industrial psychology class, an evolutionary psychology class, etc. I did take some courses that could be considered tangentially related to mental illness (e.g., many statistics classes (6 of them), research methods classes (4 of them), cognitive bases of behvior and social bases of behavior). However, they were taught in ways that were relevant to the understanding of mental illness. For example, in cognitive bases of bx, we spent months on Kelley's Covariate Theory of Attribution and how that led to Beck's Cognitive Model of psychopathology and then delved into research showing the best methods of showing how to change these cognitive biases in patients. Thus, these courses, although not directly related to psycopathology, were taught in ways that made them very germane to the topic.


I am not a psychologist, but an intern. I still have a couple years ago before I can become licensed as a psychologist.

By the way, the APA has had budget surpluses for many, many years. You can Google the APA budget for the last 10 years and find out. The previous poster was talking about things he was clueless about and did not care to do a 10 second Google search to learn more about

 

[CGOPsych]

Before you spread mis(dis)information, please get your facts right. Look at the following link http://www.apa.org/monitor/2008/04/torture.html and look at the APA budget which forecasts a surplus, not a deficit

My facts are straight. Please read what I wrote.
You are referring to a forecast (talk is cheap). I wrote of the 2008 budget.

 

[CGOPsych]

Don't forget about they MCAT...which they should take as well...that is the predominant weeding out tool for people getting into medical school. They should need at least a 24 (or 8 on each section) which wouldn't get you into most med schools...then they should take USMLE STEP 1, 2, 3 and have to pass. Then the Written and Oral Boards for Psychiatry. Plus show a certificate of "internship" of a certain number of hours supervised.

Maybe the solution is just have them prescribe the way NP's prescribe...under the supervision of an MD who assumes the risk and who assures things are kosher. Perhaps, then the MD could serve more people by overseeing more midlevels.

You make a very good point. If the RxP training (online in many if not most cases) is equivalent to medical school as far as prescribing psychiatric medications is concerned, then the applicants should be able to pass the MCAT and the psychiatric boards.

The proposals are pathetic not only because they purport to train MD Wannabes on the computer, but they want absolutely no entrance requirements except having a psychology license (which requires exactly 1 biologically based course) and a check, since the RxP certification at CSPP cost $10,000. After that, the "national exam" was written by, who else? a group of psychologists who are fervently invested in this campaign.

As always, any close scrutiny of the deails of these proposals reveals what a sad scam it is. It's all about power and money, not about quality of care.

 

[whopper]

Medical school is approximately 60-100 hrs of work/week for 4 years.

Psychiatry Residency is approximately 60-80 hrs a week for 4 years (not including the studying for the USMLE Step 3 that you have to do on your own, if you factor that in, that's about an added 10-20 hrs/week).

This Oregon program appears to be about 40 hrs a week for 2 years.

 

[Therapist4Chnge]

How does it compare to NP training, as they prescribe independently in some states (which would be a much more fair comparison)?

 

[CGOPsych]

Medical school is approximately 60-100 hrs of work/week for 4 years.

Psychiatry Residency is approximately 60-80 hrs a week for 4 years (not including the studying for the USMLE Step 3 that you have to do on your own, if you factor that in, that's about an added 10-20 hrs/week).

This Oregon program appears to be about 40 hrs a week for 2 years.

APA's model, which all its state franchises use, calls for 400 contact hours of training. Thus, a three-hour course over a 15-week semester would be about 45 hours. This works out to the equivalent of 9 semester courses. This is sometimes referred to in the RxP propaganda as a "two year master's degree."

Now, how much do we trust them to actually observe these limits given that many of these courses are taken in home-study, and monitored by people who are devoted to making as many prescribers as possible? Also, since these courses are big money-makers, do you think they're going to fail anyone?

Thus, psychologists who may have gotten their "doctorate of psychology" in weekend or online courses (this is not unusual) from high-tuition schools that pass anyone, and with a single biologically related course under their belt, then go into online home-study courses to prescribe medication.

What is actually being proposed as medical training is pathetic. The last thing they would ever agree to is oversight from the outside, or meeting objective standards, such as the MCAT, or training in medical facilities. That's why they want to control all training, certification, oversight, etc.

 

[DrFraud]

How does it compare to NP training, as they prescribe independently in some states (which would be a much more fair comparison)?

While I'm not a big fan of NP prescribing either, their scientific/medical training - both academic and clinical is much more extensive than the APA model for RxP training. NPs usually have much more medical experience than psychologists, so in my opinion, the two are incomparable. Even though I find the medical training of NPs to be quite good, I believe in most cases it is best to have a doctor sign off on NP prescriptions.

 

[whopper]

Pretty much what I was going to write. NPs are a different thing. However in terms of clinical & medical training, they require an RN & a masters, so that's about 6 years of medical training. In addition, NPs are viewed by the layman as lower level practitioners vs M.D.s, & are not viewed as being experts in mental health while I do not think the same would apply to psychologist prescribers because they still have the title of being a doctor.

My point though with the hour comparison was that there isn't going to be enough training IMHO in the current psychologist prescription laws.

My wife is an opera singer (in addition to being in a counseling program), and part of her curriculum is memorizing the anatomy of the throat, and having an intimite knowledge of how it works in performance. With 2 more years of training of a specialized traing, would that in no way make someone of her training appropriate to do ENT procedures or prescribe ENT medications.

 

[edieb]

Online schools in psychology are very, very rare. In fact, there is only ONE school that offers this option. Furthermore, because its students cannot obtain internships, fewer than half of its students ever obtain licensure.

Although there are less-competitve professional/non-unversity based schools (which I did not attend), this is no different than tuition-driven medical schools based in the Caribbean...

APA's model, which all its state franchises use, calls for 400 contact hours of training. Thus, a three-hour course over a 15-week semester would be about 45 hours. This works out to the equivalent of 9 semester courses. This is sometimes referred to in the RxP propaganda as a "two year master's degree."

Now, how much do we trust them to actually observe these limits given that many of these courses are taken in home-study, and monitored by people who are devoted to making as many prescribers as possible? Also, since these courses are big money-makers, do you think they're going to fail anyone?

Thus, psychologists who may have gotten their "doctorate of psychology" in weekend or online courses (this is not unusual) from high-tuition schools that pass anyone, and with a single biologically related course under their belt, then go into online home-study courses to prescribe medication.

What is actually being proposed as medical training is pathetic. The last thing they would ever agree to is oversight from the outside, or meeting objective standards, such as the MCAT, or training in medical facilities. That's why they want to control all training, certification, oversight, etc.

 

[Therapist4Chnge]

Pretty much what I was going to write. NPs are a different thing. However in terms of clinical & medical training, they require an RN & a masters, so that's about 6 years of medical training.

That is very much of a stretch, as they have bridge programs that bring an AA to an NP in far less than 6 years.

 

[DrFraud]

Online schools in psychology are very, very rare. In fact, there is only ONE school that offers this option. Furthermore, because its students cannot obtain internships, fewer than half of its students ever obtain licensure.

Although there are less-competitve professional/non-unversity based schools (which I did not attend), this is no different than tuition-driven medical schools based in the Caribbean...

Actually, there is a significant difference between the training that a psychologist receives, even at the best programs, and that which a medical student receives, even at in your words 'tuition-driven medical school based in the Caribbean' or for that matter the training at any international medical programs that are acredited and accepted by the state licensing boards and the U.S. department of education.

The most important difference being medical training, something that you seem to be trying to obfuscate. Your attempts to try and equate the two insofar as training is almost alarming in terms of your disregard to patient safty and your dishonesty to patients.

 

[DrFraud]

That is very much of a stretch, as they have bridge programs that bring an AA to an NP in far less than 6 years.

Can you please provide a link to a program or state reg that allows nurses to bypass so that they can prescribe will less education & experience than 6 years.

 

[CGOPsych]

Online schools in psychology are very, very rare. In fact, there is only ONE school that offers this option. Furthermore, because its students cannot obtain internships, fewer than half of its students ever obtain licensure.


Although there are less-competitve professional/non-unversity based schools (which I did not attend), this is no different than tuition-driven medical schools based in the Caribbean...

No, they're not that rare. I can think of three off the top of my head and I don't make it my business to keep track of diploma mills.

As for the Caribbean schools: The difference is that these for-profit and expensive private psychology schools have become the rule, not the exception, in psychology. This is thanks to APA's sliding-scale accreditation it has pursued for years. (And that's why there is a new body forming to accredited psychology training, because APA sold out to the corporate schools).

Example: In Illinois there are many, many professional schools, and the largest one cranks out more psychologists than all the state's university programs combined. And these schools are famous for cutting corners. I know one that offers required core curriculum in three-day cram courses, Friday through Sunday. Now that's a quality education.

I also know that another professional school lets people become psychologists solely through weekend courses. And some of those students are Canadians who fly in for to become weekend psychologists. Do you know of any medical school that trains MD's on the weekends?

Now the same wrecking crew that has proudly degraded psychology training standards, sold out to the corporate professional schools, and pushed scientists out of the organization, is trying to do the same thing to medical education through RxP. Amazing.

It's all for a buck and political power.

 

[Therapist4Chnge]

Can you please provide a link to a program or state reg that allows nurses to bypass so that they can prescribe will less education & experience than 6 years.

Certificate/Associates to MS in 2 years
http://www.jefferson.edu/jchp/nursing/rnbsnmsn.cfm

Here are the courses:
http://www.jefferson.edu/jchp/nursing/rnbsnmsncurrft.cfm

I'm not sure how they quantify rotations, but even adding 2 years for that (which are usually done part-time in conjunction with regular nursing responsibilities), they are in and out in 4 years or less.

2.5 year RN to MS program @ TWU:
http://www.twu.edu/nursing/rn-ms.asp

While I disagree with online learning, here are a host of online NP programs where you can cram in courses an get out quickly:
http://www.allnursingschools.com/nursing-degree/nurse-practitioner

Taking an accelerated program + online NP would take ~3-4 years, if that.

PA programs are 18-24 months, add in 1 years to get the pre-reqs....you have 2.5 to 3 years.

 

[CAPBonanza]

You have to have an RN first for all those programs you just listed. The RN programs themselves take 2 years to complete, and require prereqs before that. You're still looking at around 6 years total. Columbia Nursing has an accelerated program 0-MSN for people with a previous non-nursing degree that takes 2.5 years. Still 6 years.

 

[Therapist4Chnge]

You have to have an RN first for all those programs you just listed. The RN programs themselves take 2 years to complete, and require prereqs before that. You're still looking at around 6 years total. Columbia Nursing has an accelerated program 0-MSN for people with a previous non-nursing degree that takes 2.5 years. Still 6 years.

The question involved being an RN, which requires an Associates degree (at the least). Starting with an RN--> NP is 4 or less, which was my original point.

 

[Ollie123]

No, they're not that rare. I can think of three off the top of my head and I don't make it my business to keep track of diploma mills.

Which ones? I'm fairly certain there's only one that is actually accredited.

 

[futureapppsy2]

Which ones? I'm fairly certain there's only one that is actually accredited.

My guess is that he's referring to Capella, Saybrook, and Fielding (the accredited one).

 

[Ollie123]

ah, yeah I see now he didn't specify, I just assumed he was talking about accredited programs.

 

[CGOPsych]

Which ones? I'm fairly certain there's only one that is actually accredited.

The three I had in mind were fielding, walden, liberty. There may be more but I have no interest in keeping up with them or all the ways to degrade psychology education. My examples of three-day cram courses came from direct testimony from the students.

I also don't know if all the schools offering RxP certification do so online, but many do. CSPP says half their students are learning to practice medicine at home. Such shoddy standards is why they insist on controlling all the entrance requirements, education, supervision and practice oversight.

In Missouri some RxP proponents NOT affiliated with APA added amendments to the RxP bill that would increase the required training, making it closer to what physician assistants would get. And did the state psych association back this compromise for the sake of the people of Missouri so they can finally get badly needed prescriptions rather than wait decades from those lazy and greedy psychiatrists?

Not on your life. The Missouri Psych Association, which has carried water for APA's training model for 13 years didn't even show up for the committee hearing. That's how much they care about patient care over making it quick and easy for psychologists to get that prescription pad by paying the for-profit professional schools. And golly gee, one of the leaders of the Missour RxP movement is the president of a large professional school. What a coincidence!

As I said, pathetic. Such antics make many of us ashamed to be psychologists.

 

[CGOPsych]

Actually, there is a significant difference between the training that a psychologist receives, even at the best programs, and that which a medical student receives, even at in your words 'tuition-driven medical school based in the Caribbean' or for that matter the training at any international medical programs that are acredited and accepted by the state licensing boards and the U.S. department of education.

The most important difference being medical training, something that you seem to be trying to obfuscate. Your attempts to try and equate the two insofar as training is almost alarming in terms of your disregard to patient safety and your dishonesty to patients.

Exactly! To become a psychologist APA requires only one course related to biology, and that's usually some broad vague course called "biological bases of behavior." From there, APA says you can take the equivalent of 9 semester courses online and should be able to practice medicine. Incredible.

And don't forget that psychologists have always had the option of taking medical training. In my state, PA training is one full year of classwork and a year of practicum rotations in medical settings. They have FAR broader prescriptive authority than any prescribing psychologists currently have with very few, and reasonable, oversight provisions.

Any psychologist who took that training would be worth his/her weight in gold. That person's practice would be overflowing. And they wouldn't have to wait around years, maybe decades, if ever for RxP legislation.

Ah, but that would not incorporate medicine into psychology and bring in all those bucks and power. Follow the money ... follow the power.

 

[deleted6669]

PA programs are 18-24 months, add in 1 years to get the pre-reqs....you have 2.5 to 3 years.

TYPICAL PROGRESSION TO PA SCHOOL:
4 YR PREMED UNDERGRAD DEGREE WITH OCHEM/A+P/MICROBIO/BIOCHEM/ETC
MEDICAL TRAINING(6MO-2 YRS) EMT/LPN/RN/RT, ETC
INSERT YRS OF MEDICAL HEALTH CARE EXPERIENCE.
GRE
2 YR PA PROGRAM(most are ms level now so a bs is required for entry)
NATIONAL BOARD EXAM AT GRADUATION AND Q 6 YRS.

my path:
emt/er tech at 17
4 yrs at university of california for bs #1 , working as er tech straight through 24 hrs/week during the yr and 60 hrs/week during the summers
paramedic school 1 yr
5 yrs as a medic
3 yr pa program (bs #2)
1 yr postgrad masters program
1 yr postmasters training in em/fp(postmasters certificate)
so 10 yrs of education over 15 yrs with 5 yrs as a medic in between degrees.

the really slick way to do psych as a pa is this:
pa school followed by one of these pa psych residencies. this is probably the best one:
http://www.psychiatricpa.com/

 

[edieb]

No, they're not that rare. I can think of three off the top of my head and I don't make it my business to keep track of diploma mills.

As for the Caribbean schools: The difference is that these for-profit and expensive private psychology schools have become the rule, not the exception, in psychology. This is thanks to APA's sliding-scale accreditation it has pursued for years. (And that's why there is a new body forming to accredited psychology training, because APA sold out to the corporate schools).

Example: In Illinois there are many, many professional schools, and the largest one cranks out more psychologists than all the state's university programs combined. And these schools are famous for cutting corners. I know one that offers required core curriculum in three-day cram courses, Friday through Sunday. Now that's a quality education.

I also know that another professional school lets people become psychologists solely through weekend courses. And some of those students are Canadians who fly in for to become weekend psychologists. Do you know of any medical school that trains MD's on the weekends?

Now the same wrecking crew that has proudly degraded psychology training standards, sold out to the corporate professional schools, and pushed scientists out of the organization, is trying to do the same thing to medical education through RxP. Amazing.

It's all for a buck and political power.

While I agree that some professional schools have poor standards and are a a bane to the field of clinical psychology, many are very good. If all of them were bad, I doubt that Stanford University would have joined with Pacific Professional School to form a consortium.

Furthermore, as neither Walden nor Cappella are APA-accredited programs (and, hence most of their students do not obtain intenships and become licensed to practice psychology), your argument that online schools are prevalent in the field, and that tons of psychologists have degrees from them, is false.

Furthermore, just because something is offered online does not make it bad. If you have data to the contrary, I would love to see it.

Although I cannot personally speak for the quality of a medical education attained in a third-world country like Grenada, I can attest to the fact that in at least one state (I believe NY) graduates from these schools are banned from completing residencies in the state's hospitals. I think that fact alone speaks volumes....

 

[silas2642]

While I agree that some professional schools have poor standards and are a a bane to the field of clinical psychology, many are very good. If all of them were bad, I doubt that Stanford University would have joined with Pacific Professional School to form a consortium.

Furthermore, as neither Walden nor Cappella are APA-accredited programs (and, hence most of their students do not obtain intenships and become licensed to practice psychology), your argument that online schools are prevalent in the field, and that tons of psychologists have degrees from them, is false.

Furthermore, just because something is offered online does not make it bad. If you have data to the contrary, I would love to see it.

Although I cannot personally speak for the quality of a medical education attained in a third-world country like Grenada, I can attest to the fact that in at least one state (I believe NY) graduates from these schools are banned from completing residencies in the state's hospitals. I think that fact alone speaks volumes....

I think that you're talking about SGU or Ross. Both schools are pretty good and tend to produce competent physicians. I'm pretty sure that these two schools are accredited in all 50 states.

Physicians are people, too and you have to take them one by one. The fact of the matter is you're going to find some terrible physicians that graduated from Caribbean schools but you're also going to find excellent physicians that graduated from places like Ross and SGU. You're going to find the same from places like Harvard, Stanford, and every other medical school.

 

[Faebinder]

While I agree that some professional schools have poor standards and are a a bane to the field of clinical psychology, many are very good. If all of them were bad, I doubt that Stanford University would have joined with Pacific Professional School to form a consortium.

Furthermore, as neither Walden nor Cappella are APA-accredited programs (and, hence most of their students do not obtain intenships and become licensed to practice psychology), your argument that online schools are prevalent in the field, and that tons of psychologists have degrees from them, is false.

Furthermore, just because something is offered online does not make it bad. If you have data to the contrary, I would love to see it.

Although I cannot personally speak for the quality of a medical education attained in a third-world country like Grenada, I can attest to the fact that in at least one state (I believe NY) graduates from these schools are banned from completing residencies in the state's hospitals. I think that fact alone speaks volumes....

Your inflammatory response towards international/foreign medical graduates is very obviously baiting and clearly ignores the fact that these graduates fight to their teeth with all other american graduates to achieve their positions including excelling in US medical licenses exams all 3 (3.5 if you count the CS which btw does include psychiatric cases). But hey, lets just be selectively blind to this fact and continue to spout things about international graduates deviating from the main topic of ... are the psychologists qualified to prescribe safely. Of course you continue to ignore the fact that these graduates go through residencies just like all other american graduates (ALL WITH NO EXCEPTIONS, unlike what was cited for psychology weekend/online courses... we dont have any weekend or online only residencies here). The bottom line, they are in the end ten times more qualified to prescribe while a psychologist with little to no medical training is not.

But feel free to convince yourself otherwise and do me a favor... when you get hospitalized, make sure you tell your doctor that your dont want any international grads on your case.

 

[whopper]

Taking an accelerated program + online NP would take ~3-4 years, if that.

Hmm, wasn't aware of those. Thanks for the information.

Although I cannot personally speak for the quality of a medical education attained in a third-world country like Grenada, I can attest to the fact that in at least one state (I believe NY) graduates from these schools are banned from completing residencies in the state's hospitals. I think that fact alone speaks volumes....

Sure, something that you can attest to, but cannot confirm which state banned SGU grads, so that speaks volumes?

Furthermore, just because something is offered online does not make it bad. If you have data to the contrary, I would love to see it.

Just as you asked for info to prove the contrary about online degrees--where's the data to support your last statement? Especially considering that I know dozens of SGU grads currently doing residency in NY that are on track to graduate, and graduated this year, and that SGU is recognized by the NY State Dept of Education.

http://www.op.nysed.gov/medforms.htm

Form 2CC is not needed for graduates of the following medical schools, which have been approved by the New York State Education Department to allow students to complete more than 12 weeks of clinical clerkships in New York State

Scroll down the list...
SGU is on it. In fact it is recognized by several other states such as California.

Is SGU banned from a specific state? I'd be surprised. ECFMG never stated as far as I'm aware that graduates from a specific school cannot graduate from an ACGME approved residency in a specific state. I'd like to hear more about it if you're willing to back this statement up with some evidence. If you can, then fine, and that'd be great.

I think that fact alone speaks volumes...

Well, that type of logic can justify quite a bit. For example in the 80s, when several of the first people being identified with AIDS were homosexuals, well of course several in the extreme right just loved to use that fact alone to speak volumes.

Since you've already claimed that psychologists are the "pre-eminent" providers of healthcare (they aren't according to studies-I already cited a major one), why don't you pick up a book on Social Psychology and look up the chapters on prejudicial cognitive approaches when judging other groups of people. Several things you've written here directly fall in the group-think problems cited by social psychologists, and if you taken a look at this thread and the past Oregan law thread, I've criticized pro-psychiatrists as well when I've detected them doing the same. This is one of the reasons why I was not surprised when you admitted you are not a psychologist--because most psychologists I do know (& highly respect) would not have used this form of thinking.

You could've judged SGU grads by more objective standards such as average USMLE scores, average number of graduates who became chief residents, research being done by the institution, etc.

I can attest to the fact that in at least one state (I believe NY) graduates from these schools are banned from completing residencies in the state's hospitals. I think that fact alone speaks volumes....

Hmm, you know what? The majority of states where psychologist prescription laws were attempted have failed. Using your logic--one state banning SGU grads speaks volumes. Using that same (faulty) logic, what does that speak of the several states that refused to allow psychologist prescribers?

http://www.nami.org/Template.cfm?Se...tManagement/ContentDisplay.cfm&ContentID=8375

Since 1990, 12 states have rejected legislation to grant psychologists prescription privileges. These states (some of which have rejected prescribing legislation on multiple occasions) include Alaska, California, Connecticut, Florida, Georgia, Hawaii, Illinois, Louisiana, Missouri, Montana, Tennessee, and Texas.

 

[CGOPsych]

Since you've already claimed that psychologists are the "pre-eminent" providers of healthcare (they aren't according to studies-I already cited a major one), why don't you pick up a book on Social Psychology and look up the chapters on prejudicial cognitive approaches when judging other groups of people. Several things you've written here directly fall in the group-think problems cited by social psychologists, and if you taken a look at this thread and the past Oregan law thread, I've criticized pro-psychiatrists as well when I've detected them doing the same. This is one of the reasons why I was not surprised when you admitted you are not a psychologist--because most psychologists I do know (& highly respect) would not have used this form of thinking.

Hmm, you know what? The majority of states where psychologist prescription laws were attempted have failed. Using your logic--one state banning SGU grads speaks volumes. Using that same (faulty) logic, what does that speak of the several states that refused to allow psychologist prescribers?

Excellent points, as always.
First, this talk of psychology being the "pre-eminent" providers of health care is the classic example of arrogance from the wrecking crew that has worked to destroy psychology. No serious scientist or professional has made statements like that. But the greedy and power-lustful politicians and corporate pitchmen who are eager to wage a turf war at any cost to psychology are full of such bloviations.

Also, just for the record, RxP bills have failed in the following 20 states:
Alaska, Arizona, California, Connecticut, Florida, Georgia, Hawaii, Illinois, Maine, Missouri, Mississippi, Montana, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, Tennessee, Texas, and Wyoming. They have failed approximately 87 times and passed twice, in New Mexico and Louisiana.

APA's politicians in the all-powerful Practice Directorate love putting RxP to a vote in state legislatures. However, they have refused to give psychologists a vote on whether they want to pursue this turf war. This is just one of many examples of the arrogance of power that is causing APA to shrink and to embroil the organization in international controversy over its handling of the torture issue. APA's governance has been taken over by arrogant and ruthless politicians who have driven away or marginalized many of the best in our profession. This takeover is proudly detailed in a book written by one of them called "The Practice of Psychology: The Battle for Professionalism". A review of the book by a scientist can be found at: http://www.srmhp.org/0201/review-02.html

Therefore, I continue to ask my medical colleagues to NOT regard this shameful campaign as representative of the science and profession of psychology.

 

[whopper]

One of the top forensic psychologists in the country-Victor Bressler, and an expert in false confessions will be training me in my fellowship which I just started yesterday.

The Beck Institute in Philadelphia has several psychologists working with them that are in Aaron Beck's own opinion his equals.

When I ran my forensic unit, my psychologist was a neuropsychologist, and I needed her big time (in fact the entire institution did) to do neuropsychological testing on my brain damaged patients.

I could go on.

This entire psychologist vs psychiatrist thing is silly. There are several great psychologists we psychiatrists should be gladly working with.

 

[Therapist4Chnge]

One of the top forensic psychologists in the country-Victor Bressler, and an expert in false confessions will be training me in my fellowship which I just started yesterday.

The Beck Institute in Philadelphia has several psychologists working with them that are in Aaron Beck's own opinion his equals.

When I ran my forensic unit, my psychologist was a neuropsychologist, and I needed her big time (in fact the entire institution did) to do neuropsychological testing on my brain damaged patients.

I could go on.

This entire psychologist vs psychiatrist thing is silly. There are several great psychologists we psychiatrists should be gladly working with.

Several.

 

[sunlioness]

Indeed.

 

[billypilgrim37]

Several.

At least five or six of them, ya know.

 

[OldPsychDoc]

At least five or six of them, ya know.

How many DOES it take to screw in a light bulb?

 

[kugel]

How many DOES it take to screw in a light bulb?

Just two. The trick is getting them to....

 

[CGOPsych]

Just two. The trick is getting them to....

Wait. Is this an HMO bulb? Is this screwing-in procedure really necessary?
Are these psychologists in-network? There are no out-of-network benefits. A referral from the primary care physician is required. They'll have to speak to a care manager who has a 5th grade education. They'll have to have a copy of the bulb's insurance card ready before they see the bulb for the first time. There are forms to be completed and faxed. These will be ignored until they are faxed a second time.
There will be a coordination of benefits letter issued and responded to before this procedure is approved. A pre-existing condition clause may apply. If this bulb is on COBRA then benefits may not be available. The bulb will have to attest by mail that this procedure is not required due to an on-the-job injury or auto accident. This should take another two weeks.
Following the initial screwing-in session they will be asked for their records before payment is considered.
Any quote of benefits is not a guarantee that the psychologists will be paid for screwing in the bulb. The quote of benefits will be incorrect and fail to mention the high deductible which will not be satisfied for three more years. Any benefits will be subject to limits and restrictions required by the HMO contract. Any payment for services will be mistakenly sent to the light bulb, which will keep the payment and fail to return calls to the psychologists.
For further information press 3. For a mailing address press 4. To stay on hold interminably until you become furious, press 5.

 

[Faebinder]

Wait. Is this an HMO bulb? Is this screwing-in procedure really necessary?
Are these psychologists in-network? There are no out-of-network benefits. A referral from the primary care physician is required. They'll have to speak to a care manager who has a 5th grade education. They'll have to have a copy of the bulb's insurance card ready before they see the bulb for the first time. There are forms to be completed and faxed. These will be ignored until they are faxed a second time.
There will be a coordination of benefits letter issued and responded to before this procedure is approved. A pre-existing condition clause may apply. If this bulb is on COBRA then benefits may not be available. The bulb will have to attest by mail that this procedure is not required due to an on-the-job injury or auto accident. This should take another two weeks.
Following the initial screwing-in session they will be asked for their records before payment is considered.
Any quote of benefits is not a guarantee that the psychologists will be paid for screwing in the bulb. The quote of benefits will be incorrect and fail to mention the high deductible which will not be satisfied for three more years. Any benefits will be subject to limits and restrictions required by the HMO contract. Any payment for services will be mistakenly sent to the light bulb, which will keep the payment and fail to return calls to the psychologists.
For further information press 3. For a mailing address press 4. To stay on hold interminably until you become furious, press 5.

How many sessions does the bulb get to be screwed?

 

[ronin12]

How many sessions does the bulb get to be screwed?

depends upon the endurance of bulb and persistence/ignorance/greed of "screwrer"