actual day-to-day of RxP

[bcliff]

I'm curious to hear from psychologists who have pursued RxP licensure about the types of jobs and positions that prescribing psychologists fill. I was going to post this in the RxP sticky, but that thread seems more focused on RxP debate and the merits/limitations of prescribing psychologists rather than the actual day-to-day work of an RxP psychologist.

Do RxP psychologists apply for positions advertised for psychiatrists, or are they limited to mid level positions (psychiatric NP/PA, etc.) Which CPT codes are used to bill for med management - I've been doing some research, and it looks like there are "add on" codes for med management, which are added to a base CPT code for psychotherapy? What is the difference in compensation for salaried positions? How is private practice different as an RxP psychologist? Are there limits on where you can prescribe even in RxP states (e.g. the VA, specific hospitals, etc.)?

I'm not 100% sure that RxP is something I'll pursue in the future, but as I get ready to start a (balanced) clinical PhD program this fall, I'd like to keep my options open. I understand that RxP in NM & LA doesn't become much of an issue until post-doc, but RxP in IL seems to be much more involved throughout graduate school (specific undergrad & grad courses, a specific dissertation topic, etc.) - Any advice on pursuing eligibility for IL RxP as a student getting ready to start a clinical PhD (outside of IL)? I haven't found much information on an actual RxP curriculum for Illinois, and what I'm trying to find is a concise timeline from 1st year grad student to actual prescribing psychologist.

^^ I've always used the term prescribing psychologist, but I see medical psychologist used more often. Is there a consensus in what RxP psychologists are called? Does it vary by state?

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[xXIDaShizIXx]

I'm curious to hear from psychologists who have pursued RxP licensure about the types of jobs and positions that prescribing psychologists fill. I was going to post this in the RxP sticky, but that thread seems more focused on RxP debate and the merits/limitations of prescribing psychologists rather than the actual day-to-day work of an RxP psychologist.

Do RxP psychologists apply for positions advertised for psychiatrists, or are they limited to mid level positions (psychiatric NP/PA, etc.) Which CPT codes are used to bill for med management - I've been doing some research, and it looks like there are "add on" codes for med management, which are added to a base CPT code for psychotherapy? What is the difference in compensation for salaried positions? How is private practice different as an RxP psychologist? Are there limits on where you can prescribe even in RxP states (e.g. the VA, specific hospitals, etc.)?

I'm not 100% sure that RxP is something that I would consider pursuing in the future, but as I get ready to start a (balanced) clinical PhD program this fall, I'd like to keep my options open. I understand that RxP in NM & LA doesn't become much of an issue until post-doc, but RxP in IL seems to be much more involved throughout graduate school (specific undergrad & grad courses, a specific dissertation topic, etc.) - Any advice on pursuing eligibility for IL RxP as a student getting ready to start a clinical PhD (outside of IL)? I haven't found much information on an actual RxP curriculum for Illinois, and I'm really trying to find a concise timeline of 1st year grad student to actual prescribing psychologist.

^^ I've always used the term prescribing psychologist, but I see medical psychologist used more often. Is there a consensus in what RxP psychologists are called? Does it vary by state?

Bump. You pretty much asked every question I have ever wanted to know.

 

[PsyDr]

Not an active prescriber, but follow it closely.

1) The billing now goes under E/M codes with a psychotherapy "add on". The practice seems to vary by provider. Some just do med management. Some do psychotherapy with medication as a possibility.

2) Compensation difference is somewhat substantial from traditional general practice psychology. It is approximately 25% higher than neuropsychology based on location. EdieB has remarked on his/her income before.

3) There are many places that just will not accept RxPers. VA has prohibited them. Several hospitals will not grant privileges for RxPers, regardless of state. It would best serve you to learn about the process of getting on staff at hospitals.

4) The term of art is somewhat contentious. Federal level = "medical psychologist", NM= "prescribing psychologist", LA= "medical psychologist". Although NM passed the law first, LA was the first to "get" a real prescribing psychologist. In order for the law to be enacted, the DEA had to provide a term. DEA used "medical psychologist". So NM rxpers' state license is "prescribing psychologist", but are licensed to rx controlled substances by the DEA under the term medical psychologist.

 

[AcronymAllergy]

Just a quick, general note re: practice in the VA, as PSYDR did an excellent job of addressing pretty much everything asked in the OP. By and large, VA providers adhere to federal rather than state guidelines, as while you're on VA (i.e., federal) property, you're bound by federal (not state) laws. This is how/why VA providers can be licensed in any of the 50 states regardless of their physical location.

I've heard speak of folks pushing for VA to allow prescribing psychologists to practice, but have no idea how far along that might be.

 

[HomeworkHelper]

You might check out a previous issue of the Behavior Therapist, which has a piece from a prescribing psychologist on page 153. www.abct.org/docs/pastissue/37n6.pdf

 

[DynamicDidactic]

RxP in IL seems to be much more involved throughout graduate school (specific undergrad & grad courses, a specific dissertation topic, etc.) - Any advice on pursuing eligibility for IL RxP as a student getting ready to start a clinical PhD (outside of IL)? I haven't found much information on an actual RxP curriculum for Illinois, and what I'm trying to find is a concise timeline from 1st year grad student to actual prescribing psychologist.

It seems others have not addressed this questions. I think in the main thread CGOPsych outlined the requisite education necessary for RxP in IL. The bottom line is that it is currently almost impossible to meet those requirements in any psychology program. The biggest impediment is the internship that varies significantly from the pre-doctoral internships required for psychology programs. If you are very committed you could meet all the other requirements and spend the next few years trying to find/create the necessary internship experience.

 

[DynamicDidactic]

Although NM passed the law first, LA was the first to "get" a real prescribing psychologist.

Everyone forgets Guam, the first place to pass RxP for psychologists and (I am pretty sure) has never had a prescriber.

 

[Therapist4Chnge]

I still need to sit for the PEP…it's on the To Do list.

*packs up bags to move to Guam*

 

[PsyDr]

DD,


The first state to pass any RxP law was....

Indiana= 1993 (the forgotten RxP state)

If you want to include non-state entities:

IHS = 1980s.
DoD =1991.
Guam = 1998.

 

[DynamicDidactic]

DD,
Indiana= 1993 (the forgotten RxP state)

????
was it banned later on?

 

[PsyDr]

It's not full on rxp. The law specifically allows psychologists to prescribe in federally sponsored government training or treatment programs.

It was geared towards the 6 PDP officers who were based out of Grissom AFB after they held a DEA number.

Still on the books. Never enacted.

 

[DocRankin]

any updates since this post? i am newly graduted in ILL.