sunkists

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Perhaps this question has been asked already.

As with any medical specialty, there are trends in how the field will pan out in the follow decades. For example, cardiology never used to be so intense until this whole health-nut, anti-cholesterol craze began and psychiatry used to be huge until managed care took away the better part of a 300K salary.

Clinical psychologists (PhDs) are beginning to gain prescription rights in a few states.

1) Do you foresee this happening in many other states? Or even all the states?

2) How will this affect a psychiatrists 15 years from now?

I've asked a few psychiatrists and they all seem to deny that they feel like their practice or client base is threatened. But perhaps they are all simply in... denial.

Any thoughts?
 

john182

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sunkists said:
Perhaps this question has been asked already.

As with any medical specialty, there are trends in how the field will pan out in the follow decades. For example, cardiology never used to be so intense until this whole health-nut, anti-cholesterol craze began and psychiatry used to be huge until managed care took away the better part of a 300K salary.

Clinical psychologists (PhDs) are beginning to gain prescription rights in a few states.

1) Do you foresee this happening in many other states? Or even all the states?

2) How will this affect a psychiatrists 15 years from now?

I've asked a few psychiatrists and they all seem to deny that they feel like their practice or client base is threatened. But perhaps they are all simply in... denial.

Any thoughts?
Sure, it's no problem. Psychiatry is moving quickly towards neurology, endocrinology and neuroradiology these days. Anyone who thinks that a psychiatrists is someone with a basic medical degree who read Jung is on crack.

Heck, so many medical doctors prescribe psychotropic meds totally inappropriately with medical training it's simply going to be a pharm company bonanza with a whole new marketing direction with clinical psychologists prescribing. If anything is going to happen, patient's will be worse off as the focus is simply on drug use - not the neuroendocrine basis for disease.

Or has someone in new Mexico who ratified this prescribing thing missed the past 20 years of psychiatry advancement?

If a family practitioner can't prescribe appropriately with a medical degree for depression, what makes a psychologist think they can? We are almost 50 years gone from believing in the orthodox behavioural theories - it can be deemed nothing but a step in the wrong direction in the 21st century to back away from the medical model (after all, psychiatry was criticised so much for being "non existent" - yet here we are with ventricular dilatation, basal ganglia degeneration and countless genetics studies and the solution is not more advanced neurological/radiological research, but allow psychologists to prescribe BECAUSE NOT ENOUGH PRESCRIBING IS THE PROBLEM?.

Madness, ironically.
 
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sunkists

sunkists

im a fatty
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neuroradiology? that seems cool. really?

how much of that broad knowledge base is applied in a solo psychiatry practice though?
 

birchswing

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Sure, it's no problem. Psychiatry is moving quickly towards neurology, endocrinology and neuroradiology these days. Anyone who thinks that a psychiatrists is someone with a basic medical degree who read Jung is on crack.

Heck, so many medical doctors prescribe psychotropic meds totally inappropriately with medical training it's simply going to be a pharm company bonanza with a whole new marketing direction with clinical psychologists prescribing. If anything is going to happen, patient's will be worse off as the focus is simply on drug use - not the neuroendocrine basis for disease.

Or has someone in new Mexico who ratified this prescribing thing missed the past 20 years of psychiatry advancement?

If a family practitioner can't prescribe appropriately with a medical degree for depression, what makes a psychologist think they can? We are almost 50 years gone from believing in the orthodox behavioural theories - it can be deemed nothing but a step in the wrong direction in the 21st century to back away from the medical model (after all, psychiatry was criticised so much for being "non existent" - yet here we are with ventricular dilatation, basal ganglia degeneration and countless genetics studies and the solution is not more advanced neurological/radiological research, but allow psychologists to prescribe BECAUSE NOT ENOUGH PRESCRIBING IS THE PROBLEM?.

Madness, ironically.
What did happen in the last 20 years in psychiatry?

In case it doesn't sound like that, it's a sincere question.
 

vistaril

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neuroradiology? that seems cool. really?
Absolutely....the interventional radiology guys keep screwing up this flouro guided procedure where they keep nicking the carotid. It was our week to be their backup(NS has next week) so we came and took care of it....

Seriously though, I don't think prescibing psychologists(although they really would be the ultimate MH practitioner) are the biggest threat. Psych np's are.....
 

sluox

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This is kind of an interesting old thread. My first reaction was OP has no clue what he/she is talking about--cardiology intensity has more to do with the emergence of interventional work than "health nut craze", and psychiatrists NEVER made 300k in the 80s prior to managed care. My second reaction is yeah prescribing psychology movement hasn't made much headway, and if this is the speed with which it's moving, I suspect it won't move very much in my career. Thirdly, in terms of daily practice, it seems like the last 10-20 yrs the main change is the complete DOMINANCE of psychopharm over psychotherapy nationally, so it appears that the medical model (and the underlying biological psychiatry as a theoretical foundation) has pretty much succeeded. Now some would argue that this is a *bad* thing, but it seems like this is the where things are going...
 

vistaril

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This is kind of an interesting old thread. My first reaction was OP has no clue what he/she is talking about--cardiology intensity has more to do with the emergence of interventional work than "health nut craze", and psychiatrists NEVER made 300k in the 80s prior to managed care. My second reaction is yeah prescribing psychology movement hasn't made much headway, and if this is the speed with which it's moving, I suspect it won't move very much in my career. Thirdly, in terms of daily practice, it seems like the last 10-20 yrs the main change is the complete DOMINANCE of psychopharm over psychotherapy nationally, so it appears that the medical model (and the underlying biological psychiatry as a theoretical foundation) has pretty much succeeded. Now some would argue that this is a *bad* thing, but it seems like this is the where things are going...
people get the timeline wrong on this kind of stuff....10-20 years ago isn't the breaking point. Hell 10 years ago things were almost exactly the same as they are now. 20 years ago(1994) they were the same in a lot of places, somewhat different in others. A better breaking point where the tide actually turned would be well well before that......

You guys need to start thinking pre-ssris....at least.