Sorry, the whole speech was too long to post in one thread:
Psychologists have been prescribing safely since 1974:
first in the State Health System of New York, then in the United
States Indian Health Service, followed by the Department of Defense
and the States of Louisiana and New Mexico. In every setting, the
evidence is clear and unmistakable: psychologists prescribe safely
and effectively. The psychologists in Hawaiis Community Health
Centers provide culturally-appropriate mental health care and serve
as the psychopharmacology experts to the primary care physicians in
the Centers. All of the CHC medical directors support this bill!...
A More Global Perspective: The prescriptive authority (RxP)
agenda is unquestionably important for the future of professional
psychology and will be determinative as to the type of care which our
patients will ultimately be able to receive. In our judgment,
however, equally important in the long run as its potential for
improving the availability of high quality psychological care is its
catalytic role in developing an appreciation within the practitioner
community for the enormity of the unprecedented changes that are
occurring within the nations healthcare environment. As a number of
our distinguished former APA Presidents have demonstrated (i.e., Joe
Matarazzo, Charlie Spielberger, Norine Johnson, and Ron Levant),
psychology is one of the nations bona fide healthcare professions,
not merely a mental health speciality. As one of the learned
professions, collectively we have a special societal responsibility
to provide proactive vision in defining the parameters of the all
important psychosocial-behavioral-economic-cultural gradient of
healthcare. For professional psychology, it is absolutely critical
that our practitioners understand how they can position their
practices and clinical expertise to become an integral component of
their own local healthcare environment.
The AMA News recently reported: Managing Mental Health:
Primary care physicians increasingly are diagnosing and treating
depression. Insurers are responding. Even if youre not a
psychiatrist especially if youre not you soon could be hearing
from health plans about depression. While employers and plans for
years have developed disease management and behavioral health
carve-outs that were supposed to manage mental illness costs, their
efforts are getting more aggressive in the face of evidence that
depression can exacerbate physical conditions, and vice versa,
thereby costing employers and plans a lot of money. Their efforts
are also getting more aggressive in the face of evidence that in an
overwhelming number of cases, its a primary care physician who is
diagnosing and treating depression.... And at least one plan, Aetna,
promises to pay extra for depression screenings, as long as doctors
go through the plans training program....
Insurers are looking at primary care physicians for two
reasons. First, the primary care physician often is going to be the
treating physician. The National Business Group on Health, a
coalition of large employers... is saying that 67% of psychotropic
drugs are prescribed by primary care physicians. Cigna, citing its
own research, says 80% of the estimated 122 million annual
antidepressant prescriptions are written by primary care physicians.
The National Business Group on Health... also said 51.6% of patients
treated for major depression are seen in the general medical
sector, defined as primary care physicians and other non-psychiatric
physicians. The report quotes American Academy of Family Physicians
research saying 42% of all clinical depression diagnoses are made by
primary care doctors.... Employers and insurers also have seen the
studies saying that depression can make other conditions worse, as
well as chronic illnesses leading to a case of depression. Theyve
also seen the studies saying how much that can cost. This is not a
new phenomena. During its deliberations on the Fiscal Year 1980
Department of Defense Appropriations bill (long before patient
medical records could be computerized and routinely compared), the
Senate Appropriations Committee noted that: The Committee has become
aware of statistics that indicate that from 30 to 50 percent of those
labeled as having mental health problems presently receive
treatment from the general health care system, rather than from a
practitioner specifically trained in a mental health specialty.
Rendering appropriate psychotherapy is a highly complex procedure
which has the potential for resulting adverse consequences, as well
as for successful intervention.
Can Quality Care Truly Be Cost-Effective? The rapidly
evolving emphasis on integrating psychological care into our primary
healthcare system can perhaps be viewed as being primarily driven by
the economics involved, as was predicted decades ago by another
former APA President, Nick Cummings. The Centers for Medicare and
Medicaid Services (CMS) recently reported that patients with five or
more chronic conditions account for 23% of its beneficiaries but 68%
of its spending, seeing an average of 13 different doctors and
filling 50 prescriptions a year. By the year 2020, 25% of the
American population will be living with multiple chronic conditions;
the costs for managing them will reach $1.07 trillion. This is at a
time when almost 46 million Americans are uninsured and an additional
16 million have health coverage that does not adequately protect them
from catastrophic health expenses. Fifty-four percent of the
under-insured report going without needed care. From a political
frame of reference, poll after poll indicates that the escalating
cost of health care in our nation continues to be one of the top two
or three items of concern for the voting public. The cost of family
health insurance is rising faster than wages, with average premiums
increasing 71% during the past five years. The challenge for
psychology as we enter the 21st century is to position our profession
to effectively be on the cutting-edge of the public policy and
clinical debates that are unfolding as our elected officials grapple
with the underlying issues of access, quality of care, and
cost-containment. Russ Newman and the Practice Directorate are
critical to our future. Aloha,
Pat DeLeon, former APA President Division 42 February, 2006
Psychologists have been prescribing safely since 1974:
first in the State Health System of New York, then in the United
States Indian Health Service, followed by the Department of Defense
and the States of Louisiana and New Mexico. In every setting, the
evidence is clear and unmistakable: psychologists prescribe safely
and effectively. The psychologists in Hawaiis Community Health
Centers provide culturally-appropriate mental health care and serve
as the psychopharmacology experts to the primary care physicians in
the Centers. All of the CHC medical directors support this bill!...
A More Global Perspective: The prescriptive authority (RxP)
agenda is unquestionably important for the future of professional
psychology and will be determinative as to the type of care which our
patients will ultimately be able to receive. In our judgment,
however, equally important in the long run as its potential for
improving the availability of high quality psychological care is its
catalytic role in developing an appreciation within the practitioner
community for the enormity of the unprecedented changes that are
occurring within the nations healthcare environment. As a number of
our distinguished former APA Presidents have demonstrated (i.e., Joe
Matarazzo, Charlie Spielberger, Norine Johnson, and Ron Levant),
psychology is one of the nations bona fide healthcare professions,
not merely a mental health speciality. As one of the learned
professions, collectively we have a special societal responsibility
to provide proactive vision in defining the parameters of the all
important psychosocial-behavioral-economic-cultural gradient of
healthcare. For professional psychology, it is absolutely critical
that our practitioners understand how they can position their
practices and clinical expertise to become an integral component of
their own local healthcare environment.
The AMA News recently reported: Managing Mental Health:
Primary care physicians increasingly are diagnosing and treating
depression. Insurers are responding. Even if youre not a
psychiatrist especially if youre not you soon could be hearing
from health plans about depression. While employers and plans for
years have developed disease management and behavioral health
carve-outs that were supposed to manage mental illness costs, their
efforts are getting more aggressive in the face of evidence that
depression can exacerbate physical conditions, and vice versa,
thereby costing employers and plans a lot of money. Their efforts
are also getting more aggressive in the face of evidence that in an
overwhelming number of cases, its a primary care physician who is
diagnosing and treating depression.... And at least one plan, Aetna,
promises to pay extra for depression screenings, as long as doctors
go through the plans training program....
Insurers are looking at primary care physicians for two
reasons. First, the primary care physician often is going to be the
treating physician. The National Business Group on Health, a
coalition of large employers... is saying that 67% of psychotropic
drugs are prescribed by primary care physicians. Cigna, citing its
own research, says 80% of the estimated 122 million annual
antidepressant prescriptions are written by primary care physicians.
The National Business Group on Health... also said 51.6% of patients
treated for major depression are seen in the general medical
sector, defined as primary care physicians and other non-psychiatric
physicians. The report quotes American Academy of Family Physicians
research saying 42% of all clinical depression diagnoses are made by
primary care doctors.... Employers and insurers also have seen the
studies saying that depression can make other conditions worse, as
well as chronic illnesses leading to a case of depression. Theyve
also seen the studies saying how much that can cost. This is not a
new phenomena. During its deliberations on the Fiscal Year 1980
Department of Defense Appropriations bill (long before patient
medical records could be computerized and routinely compared), the
Senate Appropriations Committee noted that: The Committee has become
aware of statistics that indicate that from 30 to 50 percent of those
labeled as having mental health problems presently receive
treatment from the general health care system, rather than from a
practitioner specifically trained in a mental health specialty.
Rendering appropriate psychotherapy is a highly complex procedure
which has the potential for resulting adverse consequences, as well
as for successful intervention.
Can Quality Care Truly Be Cost-Effective? The rapidly
evolving emphasis on integrating psychological care into our primary
healthcare system can perhaps be viewed as being primarily driven by
the economics involved, as was predicted decades ago by another
former APA President, Nick Cummings. The Centers for Medicare and
Medicaid Services (CMS) recently reported that patients with five or
more chronic conditions account for 23% of its beneficiaries but 68%
of its spending, seeing an average of 13 different doctors and
filling 50 prescriptions a year. By the year 2020, 25% of the
American population will be living with multiple chronic conditions;
the costs for managing them will reach $1.07 trillion. This is at a
time when almost 46 million Americans are uninsured and an additional
16 million have health coverage that does not adequately protect them
from catastrophic health expenses. Fifty-four percent of the
under-insured report going without needed care. From a political
frame of reference, poll after poll indicates that the escalating
cost of health care in our nation continues to be one of the top two
or three items of concern for the voting public. The cost of family
health insurance is rising faster than wages, with average premiums
increasing 71% during the past five years. The challenge for
psychology as we enter the 21st century is to position our profession
to effectively be on the cutting-edge of the public policy and
clinical debates that are unfolding as our elected officials grapple
with the underlying issues of access, quality of care, and
cost-containment. Russ Newman and the Practice Directorate are
critical to our future. Aloha,
Pat DeLeon, former APA President Division 42 February, 2006
