I think this is a really interesting debate and I would like to learn more about it.
I think one of the problems that needs to be adressed is that in general NP's, OD's and other non-physician practitioners who have prescibing privellages are not prescibing the same type of drugs that psychologists want to.
What I mean by this is that psychotropic medications as a whole carry rather unfavorable side effect profiles. As opposed to the antibiotics and analgesics that are often prescibed by NP's and OD's.
For instance patients put on stimulants like methylphenidate need to have thier bp monitored, and thier cardiac function followed. The person prescibing the drugs should be to detect a bruit b4 prescibing or catch a murmur after treatment has begun.
Also, if the patient above does experience adverse side effects the presciber should be in the position to prescibe other classes of drugs to deal with these side effects.
A good example that comes to mind is beta-blocking, or diuresing a child who is mildly hypertensive after a regimen of a stimulant for ADHD. Other drugs like clozapine need frewuent blood draws, and someone who can order and interpert a differential blood count to make sure that there is no deraingment of hematopoeisis.
I think that if psychologists are to have prescribing privellages they will need to integrate more basic science into thier education process, as well as clinical rotations in other medical disciplines. Ideally a few months of internal medicine, neurology, psychiatry, and surgery would be great. I like the idea of psychopharm MA degrees, but I think they need to be more multidsciplinary, integrating various medical subspecialties.
Courses in basic physical diagnosis teaching how to use a stethescope and BP cuff, how to interpert a CBC, Chem-7, liver enzymes, etc.... should also be included.
My question is really though, why? As it stands now, I think the field of psychiatry is moving rapidly towards a totally organic view of mental illness. My inpatient psych rotation was all psychopharm. I saw no individual therapy, no psychodynamic testing, no analysis, no group therapy..... There is a huge void that I believe will evolve over the next few years as a result of psychiatry moving away from its traditional roots.
For instance, every week we had a session with a group of older psychiatrists who were no longer practiting. All of them were in thier mid 70's and some in thier 80's. These guys were awesome, but totally a diffrent breed than the residents and attendings that I was working with. These doctors all beleived in diffrent forms of psychoanalysis, thought that the residents over-prescibed and were not really treating the patients effectivley.
I think Psychologists are in an excellent position to really carve out a specialized niche. Why expand your scope of practice to pharmacological managment when as it stands now your traditional competition is (for all intents and purposes) leaving the field?
Just some thoughts
I would love to hear what people think.