....instead of being the high-end therapists they are now, they are going to become the low-end psychiatrists of tomorrow.
Ideally a clinician can see their patients regularly, which can provide a greater level of care because they will be able to offer not only on-going therapuetic services, but also meds management, which eliminates the need to refer out.
Will psychologists work under an MD or a psychiatrist?
Neither. They practice completely independently
I worry that psychologists will assume too much without looking in to other areas. Do psychiatrists look for other problems related to behavioral issues like diabetes? I know of few psychologists who even suggest a physical for behavioral issues and hope their scope will broaden if they start dispensing medications.
A physical, blood work, etc should all be standard info that is required. Not having any of that and doling out meds is a problem. This is where consulting with the GP is key. Talk to GPs/FPs....and many WANT psychs to get RxP privledges, because they can keep in touch and keep the physician in the loop, who only sees the patient when they are sick. Psychiatrists don't do physicals or any of that, it is almost always outsourced....psychs can do the same.
A)Ritalin is NOT for anxiety. In fact, it often increases anxiety.
You can't have an N=1 and generalize across the board. (Not you Ollie, I'm just making a general statement)
The premise is not to just "Give RxP to psychologists. Its to give them 2 additional years of training FIRST, then give them RxP. Makes a big difference and while it doesn't put us on the same level as MDs in terms of our knowledge about prescriptions, I think that would put us roughly in line with PAs and NPs.
2 years of training, 1-2 more years in residency. It is MORE training than PAs and NPs, though definitely not at the same level as an MD. There are two different setups for RxP now...one that has consultation, one that is fully independant. I happen to prefer the consultation model...because no man should be an island, and it will help the pt.
I have few concerns with your post.
1) you say that the Rx privileges would put us at roughly the same level as PN's and AP's, but I thought that big argument in the other thread was that PN's and AP's were unqualified and not trained extensively? I may be wrong but why would it be a good thing for us to be "roughly" on their level when we don't think they are doing a good job? (please don't get mad, the last thing I want is for another all out war on this subject again)
NP's and PA's will see the person for how long? I think one of the STRONGEST arguments is that the clinician can see the person on a regular basis, and not just once a month for 10-15 minutes. The current model is broken, and forces current prescribers to limit their contact, and I think that is a disservice to the pts. This setup can allow the clinician to be in better touch with the pt, and keep a closer tab on them. I don't really agree with someone who JUST wants to do meds management, I think that really limits your clinical abilities.
2) you stated that psychology is becoming more "hard science" and "math and numbers", what exactly do you mean by that? do you mean hard science in terms of biology and chemistry (if so, I am @#$!ed) and by "math and number" do you mean the research component?
There is much more of an emphasis on the biological factors, neuro, etc. I think we need more of this because we are learning more and more about the biological basis of psychology. I think our training can really be enhanced by understanding this part, and then being able to apply our research-supported orientations.
I think the degree can really be what you make of it. It's very very versatile.
Definitely. Some people are afraid of diversification, but I think it strengthens our position, as long as we don't cede assessments to lesser trained providers. Therapy training is hard to 'prove', but I still think clinicians should be handling the more severe pathologies out there.
Work with the FM/IM docs to manage comorbid disorders, make sure you are checking for physical illness when psych symptoms present (although honestly, even MDs rarely do this).
Uh....yeah, I missed that you said this. I totally agree. A multi-disciplinary TEAM approach is the way to go.
If we get RxP, clinical psychologists will inevitably shift to being pseudo-psychiatrists.
This is where we disagree. I think this will allow us to better service our pts. There will be some who just do med consults, but for those who do meds management for their practice, I think this will substantially raise the level of care.
I just don't understand why people who are so interested in prescribing pills don't just become psychiatrists. Honestly, my psychopharm training has been basically nil, and I never took any chem or bio in college. I'd be hopeless at doing meds. I know that the plan is for psychologists to take a two year course to get RxP, but why would you want to go to school for 6 years to become a clin psych, and then go back for another 2? Why not just go to med school for 4 years? I'm starting my fourth year of grad school now, and nothing sounds less appealing than going back for more school once I'm finally done.
My reasoning is because I wanted the research background, combined with clinical training, and in the end I didn't want to be a physician. My career goals match much closer to the clinical path than medicine. Psychiatrists are physicians first....and it would have been a purely academic endeavor for me.
I have noticed that people from PsyD programs and professional schools tend to be the ones most strongly advocating for RxP.
Many of the people I've talked to at conferences who are looking at this are PhDs with PPs who want to manage their PP + RxP. I doubt more research oriented people would bother (why would professors bother, unless they wanted to do it with their PP?) Of course more clinically trained people would look at this route.
-t
My comp preparation knows no bounds....except sleep. I'll catch up with this tomorrow afternoon; it will give me time to ponder what has been written so far.
