[begin statement]
After much debate and consultation with medical professionals on all sides
of this issue, I have signed HB 1426. This bill, under very tight controls,
will give medical psychologists prescriptive authority.
By "medical professionals" you mean mostly, of course, the psychology proponents of prescription privilages.
I did not take the responsibility of this decision lightly. While the
opponents of the bill were persuasive, the proponents, including the
Speaker of the House and the President of the Senate, have assured me that
there are ample safeguards built into the legislation.
Ohhh, so the speaker and president of the senate used their infinate medical savvy and expertise to determine the safety of the patients that will be killed? Thank God!
In addition, Speaker Salter and President Hines have promised that if this law does not work as intended, they will move quickly on legislation to address any unintended problems.
Like I said in previous posts....rights through legislation, once obtained, are never taken away. Note the wording that they will "move quickly...to address any unintended problems." Read - prescriptive authority will not ever be taken away. In true governmental fashion, increased legislation will be rendered to band-aid the problem.
I signed this bill for a number of reasons:
In many areas of the state there is a shortage of mental health care
providers. I hope that this bill will encourage psychologists to extend care to underserved populations. I am committed to extending quality,
affordable health care to as many of our citizens as possible.
Keep hoping, hon.
Many physicians currently work in consultation with medical psychologists
and tell me they are comfortable prescribing in consultation with medical
psychologists.
How convincing.
A number of physicians have expressed this opinion to me and to members of
the Health and Welfare Committees. For these physicians, this bill will
mean little change to existing practice. Once a consultation occurs by
phone today, the doctor may call in a prescription to a pharmacist. Under
this law, after that conversation, the medical psychologist or the physician
may write the prescription.
By "doctor" I assume you mean physician? Or do you mean either physician or psychologist? Consultation by whom? Is this the "conversation" she alludes to? Am I the only one confused by this paragraph?
The law requires that the psychologist obtain the agreement of the primary
or attending physician. The primary or attending physician must render
proper medical advice and is under no obligation to concur with the
psychologist.
We are under no obligation to agree with psychologists' medical findings? *phew* I was getting worried there.
If a physician is uncomfortable with this arrangement, she or
he will not be required to give approval to the medical psychologist to
prescribe. In order to prescribe, approval of the physician is absolutely
necessary. Because of this mandatory relationship with the primary or
attending physician, the patient's total health care needs are provided for.
And how exactly is this "phone consultation" replacing physical exam? Are physicians going to have psychologists "present" their cases to them? We are now trusting psychologists to comprehensively gather medical data garnered from history, cursory physical, and clinical medical experience?
Although there is conveniently no mention of it, I assume, of course, that it is the physician that will be held medico-legally at trial. Not to worry though, I'm sure the "medical psychologist" will provide great backup.
Prescriptive authority is limited to only those drugs related to the
diagnosis and treatment of mental and emotional disorders. This is the
specific area of expertise for medical psychologists.
And who now determines what are drugs "related to the diagnosis and treatment of mental and emotional disorders." If a patient is depressed because of their poor sexual performance with their wife, can the "medical psychologist" prescribe Viagra? If a patient has hypothyroid-induced depression, can they prescribe Zoloft with Synthroid? What about psychosomatic pain? Are they going to be writing scripts for controlled pain meds?
What about off-label use of anti-convulsants for bipolar? "Medical psychologists" will now prescribe Topamax for these patients? Lamictal?
What about pregnant patients? Have they taken the necessary courses in obstetrics and gynecology? Are they going to medically manage the pregnant bipolar woman on Lithium? Who will interpret the lab results? The "medical psychologist?"
In addition, those eligible to prescribe are in a very elite group of individuals who have completed a graduate level course in psychopharmacology.
I'm comforted that this "elite group" has completed a graduate level course (!)in psychopharm. That's a good start, now how about pharmacology of the rest of the 18,000 drugs that are currently available for patient use.
The bill mandates that this prescriptive authority shall be given only to psychologists who have undergone specialized training in clinical psychopharmacology and who have passed a national proficiency examination in psychopharmacology approved by the Louisiana Board of Examiners of Psychologists and who hold from the board a current certificate of responsibility.
This speaks for itself.....Not being held to the same standards of physicians = tragic.
I expect that the State Board of Examiners of Psychologists will promulgate
tough rules to require documentation of the required consultation by medical
psychologists prior to prescribing medications. I expect the Board to
enforce the provisions of the law.
I'm glad that you expect this. I'm sure that their fellow psychologists will undoubtedly "promulgate tough rules," and be relentless vigorous in their demand for excellence.
Those who do not abide by the provisions that require prescriptions only after consultation, collaboration and concurrence with a primary or attending physician will lose their prescribing privileges and face misdemeanor charges as provided for in the law.
[end statement]
And will you be held responsible, Ms. Blanco, for negligent manslaughter when the first unseen interaction kills a patient that was amazingly overlooked in the physician-psychologist "phone consultation?"
