Defining scope of practice without coming across like an arrogant berk

[deleted106747]

Wondering what strategies people have used in multidisciplinary settings to clarify psychologist scope of practice and level of training to clarify to staff without the background? I'm at a job I'm very much enjoying, but I'm finding that leadership & staff lack clarity on how I'm different than a MA level psychologist (I live in a state where they are called psychologists), an LMSW, or a BCBA. Example: I'll discuss an assessment service I provide and someone will chime in that the BCBA could be invited to provide similar documentation, or I'm equated professionally with MA level providers. Obviously, this affects my ego as I'm narcissistic enough to have made it through a PhD program, but I'm also concerned with issues like scope, billing, and professional identity. In this case, I followed up via email, but I have concerns that I'll start coming across like I think I'm great because I'm fully licensed as these are ongoing issues. How have others communicated their professional identity to staff that don't know the difference?

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[erg923]

With all due respect, whatever you say will probably mean dick to them. I'm not sure we can just say/assert this (as true as it may be) and have it have much impact. I mean you can cite ethics codes, training, the limited literature on this, professional standards, stuff from Pearson, etc. But I think your work product, and how this translates to better treatment/treatment planning than the others guys is mostly what will matter.

 

[ClinicalABA]

Wondering what strategies people have used in multidisciplinary settings to clarify psychologist scope of practice and level of training to clarify to staff without the background? I'm at a job I'm very much enjoying, but I'm finding that leadership & staff lack clarity on how I'm different than a MA level psychologist (I live in a state where they are called psychologists), an LMSW, or a BCBA. Example: I'll discuss an assessment service I provide and someone will chime in that the BCBA could be invited to provide similar documentation, or I'm equated professionally with MA level providers. Obviously, this affects my ego as I'm narcissistic enough to have made it through a PhD program, but I'm also concerned with issues like scope, billing, and professional identity. In this case, I followed up via email, but I have concerns that I'll start coming across like I think I'm great because I'm fully licensed as these are ongoing issues. How have others communicated their professional identity to staff that don't know the difference?

How is your job supposed to be different than the MA level practitioners? Do you have a job description/contract that specifies your responsibilities?

In regards to your specific example of the BCBA and the assessment are there clear institutional policies that dictate who does s certain types of assessment (e.g. FAs or FBAs). In most cases, if a less expensive professional can perform the task sufficiently, then it doesn’t make sense to pay you more to do the same thing.

 

[deleted106747]

With all due respect, whatever you say will probably mean dick to them. I'm not sure we can just say/assert this (as true as it may be) and have it have much impact. I mean you can cite ethics codes, training, the limited literature on this, professional standards, stuff from Pearson, etc. But I think your work product, and how this translates to better treatment/treatment planning than the others guys is mostly what will matter.

True, and I think my work does serve this purpose. But it's practicalities that come up repeatedly - things like, let's have the BCBA submit a decisional capacity evaluation - that I'm looking to address. Because at my worksite they really don't know. They aren't trying to be dismissive or insulting; it's our field's continual failure to define its parameters and scope. What I'm interested in is the actual language that people use in these situations: "No they can't do that, but I can" is starting to sound repetitive as I've said it multiple times.

How is your job supposed to be different than the MA level practitioners? Do you have a job description/contract that specifies your responsibilities?

In regards to your specific example of the BCBA and the assessment are there clear institutional policies that dictate who does s certain types of assessment (e.g. FAs or FBAs). In most cases, if a less expensive professional can perform the task sufficiently, then it doesn’t make sense to pay you more to do the same thing.

No, the agency does not fully understand the differences. They know based on their experiences, but it's all kind of esoteric at this point. I'm starting a behavioral health program, for the most part.

 

[erg923]

No, the agency does not fully understand the differences.

So...why did they hire you rather than a BCBA and/or another MA?

 

[PsyDr]

Caveat: I am not well known for my diplomacy.

When I have been confronted on this issue, I have responded by asking technical questions based upon the literature to the person who is my supposed equal. If they respond, I change technical jargon and ask more questions.

 

[deleted106747]

So...why did they hire you rather than a BCBA and/or another MA?

Because the people I work with directly are not the people who hired me. I'm sorry I was not clearer on that, and to clarify further, what I'm asking for in this thread is the language and choices people have made to clarify their scope of practice, not open a discussion about whether or not I am more or less qualified than another professional in my job.

Caveat: I am not well known for my diplomacy.

When I have been confronted on this issue, I have responded by asking technical questions based upon the literature to the person who is my supposed equal. If they respond, I change technical jargon and ask more questions.

Thank you for giving me something useful that I can move forward with. I like this, and I think it can be done in a diplomatic way.

 

[Sanman]

In general, my approach is usually to identify a need that the team is struggling with and fill it. That has included attending medical rounds so that I can address emotional concerns of cancer patients given bad news, completing decisional capacity evaluations when facilities did not have two physicians available, addressing rehab needs and working with rehab therapists to address the needs of difficult or cognitively impaired patients, and treating vent patients that were struggling with being weaned off of oxygen. Taking on these difficult issues led to more reliance on my services rather than other clinicians.

 

[deleted106747]

In general, my approach is usually to identify a need that the team is struggling with and fill it. That has included attending medical rounds so that I can address emotional concerns of cancer patients given bad news, completing decisional capacity evaluations when facilities did not have two physicians available, addressing rehab needs and working with rehab therapists to address the needs of difficult or cognitively impaired patients, and treating vent patients that were struggling with being weaned off of oxygen. Taking on these difficult issues led to more reliance on my services rather than other clinicians.

Thank you, appreciate the feedback.