APA-endorsed midlevel practitioners

[bigpsychguy]

Just read this article in the APA Monitor on Psychology Psychologists are seeking to modernize the profession.

The APA is working to create a uniform model for masters-educated midlevel practitioners within the discipline of professional psychology to stand alongside masters-level clinicians in other disciplines (counseling, social work, MFT).

Do you all think this will help or hurt psychologists and job prospects? Will this promote scope creep and push psychologists out of work? Some argue that the APA historically has not done well defending Psychologists and their scope, ex. allowing LPCs a lot of expansion and leeway. Is this more of that trend or will this effort actually help?

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[smalltownpsych]

Just read this article in the APA Monitor on Psychology Psychologists are seeking to modernize the profession.

The APA is working to create a uniform model for masters-educated midlevel practitioners within the discipline of professional psychology to stand alongside masters-level clinicians in other disciplines (counseling, social work, MFT).

Do you all think this will help or hurt psychologists and job prospects? Will this promote scope creep and push psychologists out of work? Some argue that the APA historically has not done well defending Psychologists and their scope, ex. allowing LPCs a lot of expansion and leeway. Is this more of that trend or will this effort actually help?

I think this would have been a great idea to do with counselors 30 years ago. I have no idea how it will work now. I already have a business model that involves close collaboration and oversight of midlevels and it seems to work well for all involved. I suspect that the APA won’t do a very good job of implementing this though.

 

[PsyDr]

It might make everyone sound a bit more professional if they used the proper terms.

Psychologists are federally classified as midlevel providers. It's why we are required to identify the referring physician on Medicare claims.

 

[smalltownpsych]

It might make everyone sound a bit more professional if they used the proper terms.

Psychologists are federally classified as midlevel providers. It's why we are required to identify the referring physician on Medicare claims.

Is there really a federal designation of what is a midlevel or not? Or is that really just referring to who is a physician and requiring a physician to make that referral?

 

[WisNeuro]

Is there really a federal designation of what is a midlevel or not? Or is that really just referring to who is a physician and requiring a physician to make that referral?

Theoretically, yes. Mostly due to lack of specificity. CMS essentially considers any advanced practice provider who is not a physician, a midlevel provider.

 

[bcliff]

https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/ge101c05.pdf

 

[PsyDr]

Is there really a federal designation of what is a midlevel or not? Or is that really just referring to who is a physician and requiring a physician to make that referral?

AFAIK it's CMS/SSA and DEA. CMS' definition is created via the Social Security Act's §1861(r)(1). Don't know how RxPers got the middle level designation by DEA, but know that they do.

 

[R. Matey]

The APA is working to create a uniform model for masters-educated midlevel practitioners within the discipline of professional psychology to stand alongside masters-level clinicians in other disciplines (counseling, social work, MFT).

Cynically, it's shrewd business move. Master's level clinicians make up the bulk of psychotherapy providers in this country. Selling accreditation to programs could ice out smaller orgs like the ACA/AAMFT, allowing APA to position itself as the top accreditors of psychotherapy providers in this country.

Do you all think this will help or hurt psychologists and job prospects? Will this promote scope creep and push psychologists out of work? Some argue that the APA historically has not done well defending Psychologists and their scope, ex. allowing LPCs a lot of expansion and leeway. Is this more of that trend or will this effort actually help?

Potential Pros:
-One way to do it would be for their clinical work to be supervised by us doctoral-level psychologists. That would be great for jobs.
-It might ensure better training to EBPs. Counseling and social work have humanistic bends to their training philosophies, which leads many to eschew EBPs, at the expense of patient care (IMHO).
-Making a psych undergrad mandatory for admission would also be a positive step. This could ensure somewhat of a research background (varies--I went to an R1 for undergrad so I got this in spades) prior to entry. My first year of my master's program was essentially a repeat of what I learned in undergrad and I know I'm not the only one.
-Leverage existing training sites in APPIC to build out post-degree supervision structures for master's level trainees rather than the largely unregulated structure that exists for counselors and social workers.
-Potentially more faculty jobs for psychologists as master's level trainers

Potential Cons:
-Making the training structure not materially different than what already exists (current proposal) will lead to the same problems in variability. Calling them psychologist practitioners or whatever doesn't magically fix that.
-Public confusion as to actual difference between as master's level-psychologist and doctoral level psychologist.
-People practicing out of scope, especially as it relates to psychological testing, which should stay a doctoral level competence.
-Calling master's level training "updating the profession" is a horrible narrative. If were going to do it, the selling point is higher quality at the same cost as a master's level practitioner, regulated by the premier accrediting body for psychotherapeutic care in the country.

 

[RxPsych]

View attachment 398527

https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/ge101c05.pdf

Chiropractors have done an incredible job at weaseling their way through the system.

 

[EnPsychlopedia]

Chiropractors have done an incredible job at weaseling their way through the system.

Grifters tend to be good at that. (Not saying all chiropractors are knowingly grifting people, but the establishment certainly is.)

 

[WisNeuro]

Grifters tend to be good at that. (Not saying all chiropractors are knowingly grifting people, but the establishment certainly is.)

Well, when your entire field is founded on the visions from a dead physician received by an ativaxx faith healer....

 

[PsyDr]

Well, when your entire field is founded on the visions from a dead physician received by an ativaxx faith healer....

DD Palmer didn't say that the ghost of Dr. James Atkinson, of Iowa, only talked to him during that séance in Missouri (Palmer, 1914). Dr. James Atkinson's ghost also revealed the workings of chiropractor-y to Palmer's 4th wife, while she was in an opiate induced coma (Foley, 2016).

Then chiropracty tried to say it was REALLY Dr. JOHN Atkinson, a British "bonesetter" (Bovine, 2020).