California has just filed an RxP bill

[doctorpsych]

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Members do not see this ad.

Either way there are several questions need to be answered.

This bill will cause a decrease in the amount of medical students going into psych residents. WHY would a student spend 4 years of pre med( gen chem, org chem, physics, cell and molecular bio etc.) the Medical College Admissions Test, 4 years of medical school and then 4 years of residency when someone can go to grad school and then post doc and for less time tuition too. There is a medical doctor shortage anyway, is it worth loosing more medical doctors? I am upset because it caused me to change my ERAS applicaltion already.

When I was in grad school, there was a major reaction against the medical model and the client centered approch was promoted and it appears to be that way today. WHY do you want to prescribe medications as that really embraces the medical model. I would think you would look to alternative forms of treatment. Also, as one of your writers informed "We are doctors." , I would think you would want to be called therapist it's less medical. When you prescribe medication and want to be called doctor this seems to be contradictory to the client centered philosophy. What's up with that?

If want you say is true about psychiatrists not doing their job, H&P's checking labs (which I have not seen. If fact the residency programs where I interviewed stressed the importance of skillfull internal medicine skills as we are responsible for not only managing the psychiatric conditions but the patient's medical problems as well. It was stressed in my interviews that there is a comming trend for psych patients to be medically managed by psychiatrists as increasingly more PCP's don't want to manage psych patients.
Also , at many of the programs there is a major research forcus for genetic causes for the biological cause for mental illness, so both medical and research skills were being recruited. So if there are problems with psychiatrists not doing there job then the psychiatrists need a kick in the pants, but not to cause the decrese of badly needed medical doctors by licensing non medical people.

Why shouldn't social workers have prescribtion rights? They do similar work, there are some great MSW's doing couseling that I'm sure would love to use some Haldol on a few of their patients?

I agree, I think that rxp for psychologists will deter some medical students from going into psychiatry, but mainly those who are not genuinely motivated to go into psychiatry in the first place. Those who really wanted to be well trained psychiatrists who are committed to mental health services then rxp for psychologists should not deter their decision. It's just like in business, during the internet bubble, everyone and their mothers started dot coms, regardless of whether their businesses provided good services... after it crashed and the field became more competitive, only the good ones remained.

Not all psychologist strictly followed the Rogerian client-centered approach, sure there tends to be a cohort effect, but the biomedical approach has been present in clinical psychology for a while now. The field of psychology, just like any other field is constantly evolving. With the advent of rxp, clinical psychology has been moving more and more toward truly incoorporating the psycho-bio-social model. This is much more comprehensive then any previous movement.

Lastly, I was the one who stated that psychologist are already doctors. You identified yourself as a psychologist, didn't you considered yourself a doctor after your passed your dissertation?

 

[positivepsych]

For Immediate Release
February 27, 2007

CPA Supports Legislation Authorizing Prescriptive Authority for Psychologists in California


The California Psychological Association (CPA) is pleased to announce that two bills have been introduced in the California Legislature that would authorize prescriptive authority for appropriately-trained psychologists.

The American Federation of State, County, and Municipal Employees (AFSCME), a union that represents nearly 1,000 California State-employed psychologists and with whom CPA has a long-standing and positive working relationship, has introduced SB 822, a spot bill that will be amended in mid-March to provide for prescriptive authority for California psychologists. CPA has been invited by AFSCME to partner in writing the bill and to coordinate its lobbying strategy. CPA has accepted this invitation and will be a co-sponsor for the bill. The AFSCME /CPA bill will be carried by oral surgeon and 2006 CPA Legislator of the Year, Senator Sam Aanestad (R-Grass Valley). Sen. Aanestad is the Vice Chair of both the Senate Business and Professions Committee and the Senate Health Committee.

A separate bill, SB 993, co-sponsored by the Service Employees International Union (SEIU) and the recently organized National Association of Professional Psychology Providers (NAPPP), has also been introduced and will be carried by Senator Ron Calderon (D-Montebello). CPA looks forward to working very actively with Senator Calderon’s office on his bill.

We are gratified to see this unprecedented interest in this important issue. The debate surrounding health care reform in California, the lack of access to affordable psychiatric services in the community, and the deterioration of services in California’s state hospitals and prison system are strong arguments for a positive reception by the State Legislature as it considers these two bills.

CPA, which has a long history and keen interest in advancing prescriptive authority for psychologists, will keep all interested parties informed of developments in this legislative battle that will most certainly require significant commitment and resources. Your help now is critical in order to achieve this important step for the patients we serve!

For more information, please contact Amanda Levy at [email protected] or (916) 286-7979, ext. 106.

 

[deleted6669]

I apologize, I meant in regards to psych only. If I wanted to know all that other stuff I wouldn't do what I do.

fair enough. in that light I will concede that you guys know a lot more psychiatry than the typical pa/np and are more appropriate prescribers to this pt population.

 

[50960]

Thanks for your support, and sorry for the misunderstanding. FWIW midlevels usually do as good of a job with psychopharm as docs.

 

[einey]

positivepsych-The "doctor "name was used lightly it was more like Dr Bill or Dr Phil and generally not pushed because of the intense back lash against anything that smelled like the medical model.




I'm going to close with the argument that there are many well supported reasons why it would be unwise and dangerous for psychologists to prescribe drugs but I think you and your fellow writers have sumed it up best by your own comments about questionable training at non acredited schools like CGI (which I am very familiar with) and questionable knowelege and skills. Your comments " Just looking at Ca (probably home to the most questionable PsyD programs."


I ask you- are these the people you want prescribing and managing drugs and working with some of the sickest people in the jails, rural areas and prision?


As far as using the argument that psychologist will treat patients in areas that MD/DO's won't go- one of the writers admits that not many psychologists will or have gone to these areas. And this is also supported by the state legislative statistics.

It is too big a cost to the public with little reward.



Quote:
positivepsych: 4) If the APA wants to help mental illness, quality control will make the biggest difference. I'm sick of seeing questionable PhD's practice under MFT licenses and questionably-trained social workers take psychologist jobs because they're willing to work for pennies on the dollar.
Once again, I blame the professional schools for churning out too many candidates. Just looking at CA (probably home to the most questionable PsyD programs):

Alliant, Agrosy, Calif. Institute of Integral Studies (what is that?), California Graduate Institute and all the CSPP schools, have a whopping rate of:
39-63% (and that's not including Saybrook's magnificent 0% in its history).

The quality schools have match rates at 80%+. More evidence that the APA needs to learn to be like the AMA and not accredit questionable schools.





Second, "regional accreditation" means nothing nowadays. Accreditation is a joke, and some places have no right to be accredited (e.g. online programs). If your complaint is about psychology's public image, I can tell you that I've been told by members of the public that a clinical psychology degree is a joke nowadays because you can get the degree online. How's that for public image? Online degree programs degrades the value of a Ph.D. degree. I don't know a single pharmacist, dentist, or any other clinical doctorate get their degree online, and everybody still respects those professionals.



Of the say, hundreds of psychologists, that graduate from professional schools, how many are willing to relocate to North and South Dakota? Not very many. Since a lot of prof. schools are in major cities, they want to stay there, and continue to contribute to the oversupply.



Neuro[sychstudent writes:
Dragonstyle, you are right. There are many training sites that view the PsyD as better training for that reason. I know of clinical PhDs who are reaching their final year of school and they have yet to have real clinical experiences. Some do not even know what they want to do clinically, and their understanding of clients/patients, diagnosis, and clinical work is based largely on class discussions/descriptions, not actual experience. I know this may not be the norm, but it is also not unusual. For all the ranting against the PsyD on this site (which is actually one of the only places where it seems tolerated), I've noted that each year the very best PsyD students achieve excellent internships and postdocs. There are some sites that will not consider PsyDs, but you can note from the APPIC match stats that many of the most interesting sites do. You may also notice an increase in training directors at some prestigious sites who hold PsyD degrees.






Psychwhy writes:
Want an example of psychology's status? Columnist Kathleen Parker, commenting on the recently released report on the oversexualization of girls: "When it comes to figuring out what's gone wrong with our culture, we can usually rely on the American Psychological Association to catch on last."

 

[50960]

Good post for the most part. I am a PsyD, and never expected respect because of my title, that just breeds mediocrity. I get respect from medical providers because I am good at what i do, simple as that. APA and accreditation are worthless...correct. This field needs a good swift kick in the ass for sure, but part of the problem is the party-line, PC training, mixed with naive students who believe it all to be true. Psychology is a health science in this day, not a philosophy, not an academic, not a liberal study. Until the old-timers get out, and students are trained in the new reality, nothing will change. I have just been asked to teach psychopharm for a PhD program at a major university that gives their students not 1 course in meds, let alone neuroanatomy etc.... It is sad. They will learn biochem, neuroanat/phys, and pharmacology in as much as I can fit. Things need to change and we need to change them now.........

 

[positivepsych]

I just want to point out that there are currently TWO bills in the CA legislature:

1) For psychologist prescription privileges.
2) For graduate programs to provide the psychopharm training in-house (e.g. getting the training at UCs and their top-notch med centers and hospitals instead of having to rely on Alliant). In the future, graduate programs in psychology will mandate coursework in anatomy and physiology, biochemistry, neurosciences, pharmacology, psychopharmacology, pathophysiology, health assessment (including physical and laboratory assessment), and clinical pharmacotherapeutics.

We can rant and rave all we want, but RxP will happen eventually. It's just a matter of where and when.

 

[Therapist4Chnge]

In the future, graduate programs in psychology will mandate coursework in anatomy and physiology, biochemistry, neurosciences, pharmacology, psychopharmacology, pathophysiology, health assessment (including physical and laboratory assessment), and clinical pharmacotherapeutics.

This is what we need to happen! Academics may recoil at the thought (turning into a med-school look-alike)....but psychology and medicine are converging. I think we need to embrace a more biological approach, and use what we do know about science the best way we know how. I chose to get further training because I thought it necessary. I'd like to see everyone get the training (or at least some additional training), because I believe it really can help clinically.

-t

 

[positivepsych]

From: http://www.nappp.org/calrxp.php

SB 993 Prescriptive Authority Legislation

We need your support!! Psychologists have an unprecedented chance to reform the delivery of and increase access to mental health services in California. We need support letters to be sent no later than April 16th to be counted.

As you know, earlier this year, two bills were introduced in the State Senate that would authorize prescriptive authority for appropriately-trained psychologists.

The proponents of SB 822 (Aanestad) and SB 993 (Calderon), both wanting the bill to have the strongest chance of passage, have joined forces to offer one prescriptive authority bill-SB 993 (Aanestad and Calderon).

SB 993 (Aanestad and Calderon) is now jointly sponsored by the National Alliance of Professional Psychology Providers, the Service Employees International Union, the California Psychological Association, an the American Federation of State, County, and Municipal Employees Local 2620.

Please send a letter of support of SB 993 (Aanestad and Calderon) to the Chair and Members of the Senate Business, Professions, and Economic Development Committee. SB 993 (Aanestad and Calderon) will grant prescriptive authority to appropriately-trained psychologists.

SB 993 (Aanestad and Calderon) has a very strong chance of passing its first committee-but ONLY if legislators hear from their constituents-YOU!!!

Please take a couple of minutes to send a letter and make a phone call voicing your STRONG SUPPORT of SB 993 (Aanestad and Calderon). Please fax your letters to Sen. Leland Yee, a fellow psychologist, at 916-327-2186. You can also call the other committee members as well. This needs to be done before April 16th. Please do it now. Example letters for psychologists can be downloaded at HERE Letters from consumers and patients At this location

Thanks,
The NAPPP RxP Committee
John Caccavale, Ph.D.
Steve Berger, Ph.D.
Howard Rubin, Ph.D.

PHONE NUMBERS OF BUSINESS AND PROFESSIONS
COMMITTEE MEMBERS

SENATOR MARK-RIDLEY THOMAS (D-LOS ANGELES)
916-651-4026

SENATOR SAM AANESTAD (SB 993 AUTHOR)
(R-GRASS VALLEY) 916-651-4004
SENATOR ELLEN CORBETT (D-SAN LEANDRO)
916-651-4010

SENATOR JEFF DENHAM (R-MERCED/SALINAS)
916-651-4012

SENATOR DEAN FLOREZ (D-FRESNO)
916-651-4016

SENATOR TOM HARMAN (R-COSTA MESA)
916-651-4035

SENATOR JOE SIMITIAN (D-PALO ALTO)
916-651-4011

SENATOR LELAND YEE, PH.D. (D-DALY CITY)
916-651-4008

NAPPP supports RxP for appropriately trained psychologists because this is the one proficiency that can separate doctoral level psychologists from masters-level practitioners. Moreover, RxP allows psychologists to control the whole treatment process through an integrated process. The split-treatment model that now requires physicians to provide medications, when necessary, simply does not work in the best interest of patients. There are too many medications being prescribed to patients as a "short cut" and "cheap cut" that has led to a significant drop in psychotherapy. When psychologists control treatment, we make the decision and, if experience is any indication, prescribing psychologists prescribe less than any other prescribing practitioners. We know that psychotherapy works but we need to decide with our patients when and how medications can be helpful. We cannot leave that decision to managed care or others who are not able to follow patients or provide psychotherapeutic interventions. Please support your California colleagues.

 

[positivepsych]

An editorial opposing prescriptive authority for psychologists ran in the Sacramento Bee (see below).

It is VITAL that we send as many letters to the editor as we can TODAY and get them printed in tomorrow’s issue.

The editorial is short on accurate facts and research, and is basically a re-do of their 1997 editorial on the issue.



PLEASE send a letter to the Editor TODAY supporting prescriptive authority.

The more letters they get, the more likely they will be to publish one.

Please also forward this e-mail to your colleagues to have them weigh in as well.



To send a letter, click on the following link:

http://www.sacbee.com/326/story/19629.html#letter





Sample Letter



As a licensed California psychologist, I was disappointed to see the editorial “Pushing Pills (again)” in Tuesday’s Sacramento Bee. The editorial failed to mention the stellar prescribing record of prescribing psychologists in the military and other states-over 200,000 prescriptions have been written without any adverse outcomes. In many cases, psychologists used their superior mental health training and behavioral skills to “unprescribe” and take people off of unnecessary medication. Shortages of psychiatrists have persisted in California and have increased greatly since 1997. 28 counties in California currently have five or less psychiatrists. These shortages have resulted in over 80% of psychotropic medication being prescribed by non-psychiatrists. These shortages have also resulted in a Federal Court Receiver offering salaries of $300,000 to recruit psychiatrists to California’s prisons. The State must explore new alternatives or face continued budget pressure. There is a mental health crisis in California and SB 993 allows psychologists, who are experts in mental health care, to receive additional, intense medical training to independently prescribe medications for the treatment of mental illness. Psychologists are ready and willing to go to work to solve the mental health crisis in California by providing safe and effective mental health treatment.





http://www.sacbee.com/110/story/155933.html

Editorial: Pushing pills (again)

Psychologists shouldn't give prescriptions

Published 12:00 am PDT Tuesday, April 17, 2007
Story appeared in EDITORIALS section, Page B6

Print | E-Mail | Comments (1)

An economic turf battle between psychologists and doctors is heating up once again in the Capitol. Four times, lobbyists representing the psychologists have tried to pass legislation that would give them the ability to prescribe psychotropic drugs. Four times, they have failed. They are back a fifth time.

They likely will fail again if the political power of the doctors' lobby has anything to do with the outcome. But failure would be good policy as well. The traditional roles of the psychologist and the doctor serve patients better than blurring the lines between the expert in the mind or the body. Worse, there is inadequate assurance that a psychologist with a prescription pad would have the medical training necessary to make an appropriate decision.

The latest effort is by state Sen. Ron Calderon, D-Montebello, who is author of Senate Bill 993. It would create a new category of "prescription psychologists" who could authorize a wide array of medications. These psychologists would have to undergo additional training. The State Board of Psychology, which is not a bastion of scientific or medical expertise, would decide which training programs are adequate and which psychologists have passed the not-yet-crafted tests.

As this editorial board said in 1997 when a similar bill was making its way through the Legislature, "The real motive behind the psychologists' push for prescription pads looks to be economic. ... (P)sychologists aren't adequately trained to prescribe some of the most powerful and dangerous drugs available."

The rationale against this idea still holds true today. Since 1997, the psychology lobby has succeeded in two states -- Louisiana and New Mexico -- in giving certain psychologists authority to prescribe drugs. But neither this track record nor that of military psychologists is enough to unleash the California Board of Psychology to administer a poorly defined licensing program for thousands of psychologists with nonmedical backgrounds.

Physicians and pharmacists are best trained to keep track of prescriptions and potential drug interactions. Leaving the doctor out of the loop may be in the financial self-interest of the psychologist, but not that of the patient. The Legislature should say No to SB 993 and Yes to the traditional role of physicians and psychologists.

 

[sicologia]

I've read this thread closely and have been curious about the future of psychology and meds for over 20 years. I have to admit that I'm still not clearly sure other than every program is different and every doctor is, as well. The APA may need a swift kick in the pants to tighten up it's standards. I've known Psychiatrists who knew very little about patient interaction and Psychologists who had very little desire to prescribe meds.

Thanks Guest for representing the field and telling the truth from the inside. Come back around and stay awile. 👍

 

[Therapist4Chnge]

I have to admit that I'm still not clearly sure other than every program is different and every doctor is, as well. The APA may need a swift kick in the pants to tighten up it's standards.

That's my biggest hang up about RxP becoming wide-spread. I am a big supporter of properly trained clinicians prescribing, but I'd like standardized (and strict) guidelines across the board, which will further legitimize the training and provide better medical psychologists.

-t

 

[halflife]

I am a psychiatrist from NZ, and I am in favour of psychologists with the proper training being able to prescribe. I have read a lot of posts since I joined SDN, and find it sad that there seems to be such a disconnect between psychology and psychiatry on this forum. Any idea why that is the case?

 

[Therapist4Chnge]

I am a psychiatrist from NZ, and I am in favour of psychologists with the proper training being able to prescribe. I have read a lot of posts since I joined SDN, and find it sad that there seems to be such a disconnect between psychology and psychiatry on this forum. Any idea why that is the case?

I can't speak for psychiatry, but I think these are the major issues:

1. Diff. training models. I think at the core they are two separate fields that both deal with the mental ill. There is more of a convergence now both in model and in practice, but they still are far from the same. I think both have a great deal to offer, but much like car loyalists or brand people.....THEIR brand is the superior one.
2. Turf battle....for the areas that cross over. Everything from RxP to private practice.

It was nice to see in the Panetti (sp?) court case that the AMA, APA, and A(Psychiatric)A all came together for support.

-t

 

[PGY2Psych]

I am a psychiatrist from NZ, and I am in favour of psychologists with the proper training being able to prescribe. I have read a lot of posts since I joined SDN, and find it sad that there seems to be such a disconnect between psychology and psychiatry on this forum. Any idea why that is the case?

Welcome. I'm a psychiatric resident who also supports psychologists with proper training getting prescriptive authority. Psychologists' focus on behavioral interventions comes first, with meds coming second. This is entirely in contrast with how mental health currently works, which is meds first, adjunctive therapy, or therapy second/no therapy at all. Many psychiatric problems are behavioral in nature and should be treated with such interventions or at least assessed for the potential utility of such interventions prior to pharmacologic intervention. Unfortunately, it's an ugly political battle to get prescriptive authority.

Which other states have active legislative agendas for "RxP?"

 

[PGY2Psych]

I am a psychiatrist from NZ, and I am in favour of psychologists with the proper training being able to prescribe. I have read a lot of posts since I joined SDN, and find it sad that there seems to be such a disconnect between psychology and psychiatry on this forum. Any idea why that is the case?

Welcome. I'm a psychiatric resident who also supports psychologists with proper training getting prescriptive authority. Psychologists' focus on behavioral interventions comes first, with meds coming second. This is entirely in contrast with how mental health currently works, which is meds first, adjunctive therapy, or therapy second/no therapy at all. Many psychiatric problems are behavioral in nature and should be treated with such interventions or at least assessed for the potential utility of such interventions prior to pharmacologic intervention. Unfortunately, it's an ugly political battle to get prescriptive authority.

Which other states have active legislative agendas for "RxP?"

 

[PGY2Psych]

sorry for the double post...i'm new here!

 

[Therapist4Chnge]

Which other states have active legislative agendas for "RxP?"

CA, MO, IL, HI, (mississippi maybe? I think there is 1 or 2 others). The RxP thread that is stickied at the top may have more info ,I haven't poked around in there in a bit, so YMMV.

-t

 

[halflife]

Appreciate the information. I was referring more to the apparent strife between the fields on this webboard, because it does not seem to equal my experience in practise. I work with psychologists daily and they are well prepared to get additional medical training required to prescribe.

 

[Therapist4Chnge]

Appreciate the information. I was referring more to the apparent strife between the fields on this webboard, because it does not seem to equal my experience in practise. I work with psychologists daily and they are well prepared to get additional medical training required to prescribe.

I agree with you. I think it is getting better here, and i hope to get more cross posting because both groups have a lot to offer to each other. I'm lucky that I work with some great psychologists an psychiatrists. In the past it was a different experience, but just like mechanics...there are good and bad, and a bunch in between. I've learned a good deal from everyone I work with now, and hope to find that kind of setup wherever I end up.

-t

 

[PGY2Psych]

Appreciate the information. I was referring more to the apparent strife between the fields on this webboard, because it does not seem to equal my experience in practise. I work with psychologists daily and they are well prepared to get additional medical training required to prescribe.

Is there a movement in NZ to allow psychologists to prescribe psychotropics?

 

[halflife]

Is there a movement in NZ to allow psychologists to prescribe psychotropics?

Not to the strength there is here, to the best of my knowledge. I am finding the discussion here highly interesting, thank you 🙂

T1/2

 

[DSMMad]

Status
02/23/2007 INTRODUCED.
03/15/2007 To SENATE Committee on BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT.
04/18/2007 From SENATE Committee on BUSINESS, PROFESSIONS AND ECONOMIC DEVELPMENT with author's amendments.
04/18/2007 In SENATE. Read second time and amended. Re-referred to Committee on BUSINESS, PROFESSIONS & ECONOMIC DEVELOPMENT.
04/23/2007 In SENATE Committee on BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT: Failed passage.
04/23/2007 In SENATE Committee on BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT: Reconsideration granted.

 

[positivepsych]

From the Fresno Bee:

"This year's hottest clash has been a renewal of the years-long conflict between psychiatrists and psychologists over legal authority to prescribe psychotropic drugs. This year's version of the psychologists' perennial bid for drug-prescribing power was Senate Bill 993, carried by Sen. Sam Aanestad, R-Penn Valley. It didn't get far, attracting just a single vote in the Senate Business, Professions and Economic Development Committee. The psychiatrists joined forces with other drug-prescribing medical specialists to administer a fatal dose of political medicine to the psychologists' bill."