Illinois passes bill allowing psychologists to prescribe medications

[nitemagi]

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Regarding the DoD study, I have not seen evidence of morbidity or mortality, but there is strong evidence that it was expensive, and that the close level of supervision (including a FT clinical year with direct supervision by a psychiatrist) is lacking in all civilian programs and proposed programs. Even the graduates of the program itself stated that they didn't think a civilian program was a good idea since the military medical model (including team treatment) was unlikely to be reproducible in the civilian world (which it hasn't) -- with direct implications that this close supervision was what made them safe to practice.

http://www.dod.mil/pubs/foi/Personnel_and_Personnel_Readiness/Personnel/966.pdf

 

[Therapist4Chnge]

Why dont you give me the citation that this is untrue?

That's not how it works....

1. You made a claim and implied it was fact.
2. I asked you to provide actual proof of your claim.
3. You demanded I provide proof for the negative...instead of producing actual proof of your claim.

Please feel free to provide a citation from a legitimate source or admit your statement is completely inaccurate and purposefully inflammatory.

No mention they expanded the program either.

That isn't the point. You claimed, "The Dept of Defense in Hawaii discontinued this program with psychologists due to the increased morbidity and mortality with psychologists prescribing." You cannot arbitrarily move the goal posts just because you cannot defend your statements.

 

[CoconutIsland]

I am hearing that midlevels want total independence. This is not true for PAs at all. Granted they would like some autonomy, but they are not searching for complete independence. That is not what the physician assistant and supervising physician relationship is about. PAs also have gone through didactic training and clinical rotations in medicine.

 

[AnnoyedByFreud]

I am hearing that midlevels want total independence. This is not true for PAs at all. Granted they would like some autonomy, but they are not searching for complete independence. That is not what the physician assistant and supervising physician relationship is about. PAs also have gone through didactic training and clinical rotations in medicine.

I actually think some PA groups are making a similar move as the NPs. PAs might not be able to assert independence outright, but there are some groups that are asking for a lot of autonomy, like PAs for tomorrow. You say tomato, I say tomato.

 

[JourneyAgent]

I actually think some PA groups are making a similar move as the NPs. PAs might not be able to assert independence outright, but there are some groups that are asking for a lot of autonomy, like PAs for tomorrow. You say tomato, I say tomato.

Does it ever occur to you in your constant internet buzzing about this business of celebrating a push for autonomy, independence, and separation from physician guided team based care that...perhaps, at least a fraction, of your efforts should be directed at training to some marginal level of comparative competence with the people you seek to outbid in the market place?

I've watched some of your comments closely and it appears that you think you can do the work of a fellowship trained child psychiatrist with your NP degree. With a straight tone. No shame whatsoever.

At least PA's and psychologists have some measure of healthy partisan split on the subject. But from nursing camps it's a pure form of radical liberation theology. No doubt. No self-reflection about lack of proper training. All radical push for power.

Any form of radicalism is worthy of 2nd guessing. Ambition has it's place. But if it supersedes caution then it's just plain dangerous.

I guess I'm just waiting for one shred of NP doubt about not having residency training and wanting to be independent. Kind of like 4th year medical students pushing for no residency and just going for it. Double freedom rockets going up in the face of common sense.

Everyone thinks that would be ridiculous and yet under the NP propaganda machine it somehow magically becomes patient advocacy.

That's some serious faith based work you guys are at. Praise God.

 

[edieb]

Does it ever occur to you in your constant internet buzzing about this business of celebrating a push for autonomy, independence, and separation from physician guided team based care that...perhaps, at least a fraction, of your efforts should be directed at training to some marginal level of comparative competence with the people you seek to outbid in the market place?

I've watched some of your comments closely and it appears that you think you can do the work of a fellowship trained child psychiatrist with your NP degree. With a straight tone. No shame whatsoever.

At least PA's and psychologists have some measure of healthy partisan split on the subject. But from nursing camps it's a pure form of radical liberation theology. No doubt. No self-reflection about lack of proper training. All radical push for power.

Any form of radicalism is worthy of 2nd guessing. Ambition has it's place. But if it supersedes caution then it's just plain dangerous.

I guess I'm just waiting for one shred of NP doubt about not having residency training and wanting to be independent. Kind of like 4th year medical students pushing for no residency and just going for it. Double freedom rockets going up in the face of common sense.

Everyone thinks that would be ridiculous and yet under the NP propaganda machine it somehow magically becomes patient advocacy.

That's some serious faith based work you guys are at. Praise God.

edit

 

[AnnoyedByFreud]

Does it ever occur to you in your constant internet buzzing about this business of celebrating a push for autonomy, independence, and separation from physician guided team based care that...perhaps, at least a fraction, of your efforts should be directed at training to some marginal level of comparative competence with the people you seek to outbid in the market place?

I've watched some of your comments closely and it appears that you think you can do the work of a fellowship trained child psychiatrist with your NP degree. With a straight tone. No shame whatsoever.

At least PA's and psychologists have some measure of healthy partisan split on the subject. But from nursing camps it's a pure form of radical liberation theology. No doubt. No self-reflection about lack of proper training. All radical push for power.

Any form of radicalism is worthy of 2nd guessing. Ambition has it's place. But if it supersedes caution then it's just plain dangerous.

I guess I'm just waiting for one shred of NP doubt about not having residency training and wanting to be independent. Kind of like 4th year medical students pushing for no residency and just going for it. Double freedom rockets going up in the face of common sense.

Everyone thinks that would be ridiculous and yet under the NP propaganda machine it somehow magically becomes patient advocacy.

That's some serious faith based work you guys are at. Praise God.

Woah. Glad to hear you've been watching me closely? Honestly, I enjoy these discussions because I like playing devil's advocate on these forums, as I think much of the hubbub about NPs comes from a visceral emotional reaction and feeling threatened. I also think that people have a very naive idea of what NP supervision is in practice (it typically consists of retroactive chart review, or a sheet of paper that says "I will got to Dr. So-and-So if I think I need help", etc.) The reality is that all NPs I know collaborate because that is the responsible thing to do, regardless of the laws of their state. This makes people wonder, are these laws doing what they're supposed to do? Why do they vary so widely? How come states with "independent practice" don't have poorer outcomes?

I am all for NP residencies, by the way. I have also made many posts about how I think NP programs should be more consistent and that I am attending a top school for this reason. I tire of the "NPs are terrible because they want independent practice" arguments when I know of many, many PAs who want the equivalent. That was my point.

You're right about one thing, though, I am definitely not ashamed that I'm becoming a psych NP.

Off to continue buzzing...

 

[JourneyAgent]

Woah. Glad to hear you've been watching me closely? Honestly, I enjoy these discussions because I like playing devil's advocate on these forums, as I think much of the hubbub about NPs comes from a visceral emotional reaction and feeling threatened. I also think that people have a very naive idea of what NP supervision is in practice (it typically consists of retroactive chart review, or a sheet of paper that says "I will got to Dr. So-and-So if I think I need help", etc.) The reality is that all NPs I know collaborate because that is the responsible thing to do, regardless of the laws of their state. This makes people wonder, are these laws doing what they're supposed to do? Why do they vary so widely? How come states with "independent practice" don't have poorer outcomes?

I am all for NP residencies, by the way. I have also made many posts about how I think NP programs should be more consistent and that I am attending a top school for this reason. I tire of the "NPs are terrible because they want independent practice" arguments when I know of many, many PAs who want the equivalent. That was my point.

You're right about one thing, though, I am definitely not ashamed that I'm becoming a psych NP.

Off to continue buzzing...

There are layers of self-contradictions in this post.

Bottom line. Your political position is to seize independent practice rights and to doctorize the titling process and nothing more. You all lack the infrastructure, the desire, or the recruitment strategy to push for longer, harder, real medical training of the sort that prepares one adequately for independence. Any attempt to obfuscate that fact is worse than your claims of our naivete. It's deliberately fraudulent.

For this you should feel shame, but doubtless, you do not. It's a pubescent phase of your profession's development of which you revel in only for now, while you lack the knowledge of the precarious possibilities of poor clinical preparation. Made even more dangerous by numbers and collusion with the people who write the checks. A devious trick of persuasion, because it is always spuriously put to the public in mother Teresa like terms.

May my words haunt the back of your mind as you move from this safe academic perch into seeing complex medical/psych patients with no one around to help by your own accord and design.

 

[Therapist4Chnge]

May my words haunt the back of your mind as you move from this safe academic perch into seeing complex medical/psych patients with no one around to help by your own accord and design.

I feel like there was a lot of hand-waving and possibly a wand and wizard's hat involved in writing this post.

 

[AnnoyedByFreud]

There are layers of self-contradictions in this post.

Bottom line. Your political position is to seize independent practice rights and to doctorize the titling process and nothing more. You all lack the infrastructure, the desire, or the recruitment strategy to push for longer, harder, real medical training of the sort that prepares one adequately for independence. Any attempt to obfuscate that fact is worse than your claims of our naivete. It's deliberately fraudulent.

For this you should feel shame, but doubtless, you do not. It's a pubescent phase of your profession's development of which you revel in only for now, while you lack the knowledge of the precarious possibilities of poor clinical preparation. Made even more dangerous by numbers and collusion with the people who write the checks. A devious trick of persuasion, because it is always spuriously put to the public in mother Teresa like terms.

May my words haunt the back of your mind as you move from this safe academic perch into seeing complex medical/psych patients with no one around to help by your own accord and design.

Hmm... considering that I am a masters student who has zero interest in the DNP (If I pursue doctoral training it will be a PhD)... I think you might be tilting at windmills. I also think you're confusing me with Mary Mundinger.

The rest of this post... I don't even know where to begin, people should just read it and absorb it, I suppose.

 

[AnnoyedByFreud]

.

 

[billypilgrim37]

Other than just not clicking on a thread (self-control on the internet clearly not being a strength for me), is there a way to ignore a thread like you can ignore a user?

 

[JourneyAgent]

I feel like there was a lot of hand-waving and possibly a wand and wizard's hat involved in writing this post.

What else does one have. Saddled with more debt than the 2 of you combined and then some. And the years ahead longer than behind that just by themselves are longer than the NP curriculum. With longer hours and more work for less pay before I can say I'm ready to see patients on my own. What else does one have when the political tide swings powerfully in the direction of faster, cheaper, more while you're making huge investments that have no out only an epic through. More costly in money and effort than can be imagined by glib and guiltless political usurpers.

What else...but to cut off the head of a chicken and curse your enemy in strange tongues.

Really. It's perfectly reasonable.

 

[vistaril]

Other than just not clicking on a thread (self-control on the internet clearly not being a strengt for me), is there a way to ignore a thread like you can ignore a user?

why ignore it? This(psych nps) will become a much bigger issue in the future, and however one feels about it their role working within different areas of clinical psych is only going to increase.

And it matters to us. Some areas are more immune to it than others right now, but it's going to converge on is in such a way but all but the hard core researchers are going to be impacted heavily in the future.

 

[billypilgrim37]

why ignore it?

Because these threads devolve into ******* fests. Nothing meaningful has been said since Grover revived it (it had almost died!). At least no one has started talking about islamofascists again. These threads usually continue until somebody becomes such a dick that a mod finally shuts it down.

I wouldn't say that psych NPs are an "issue." They're a pretty valuable part of a well-run treatment team. They're not physicians, and they're not supposed to be. I'd much rather live in a world where the psychiatrists were able to focus their time on the treating the sickest patients and supervising other folks with less-but-enough education and good, trustworthy skills. Whether payment structures will ever be adjusted to make this a reality is another issue. I've met NPs that have incredibly annoying attitudes and short wiener syndrome, but the ones I've worked with have not suffered such calamities. If we could just make the 2% of NPs who have snotty attitudes shut up, the other 98% of them seem pretty great.

I have no idea what will happen with prescribing psychologists. I know the idea of the ones in my psychopharm class ever writing a prescription for lithium (no matter how many online classes they take) scares the hell out of me. I would say the same about most PCPs too. Not because they COULDN'T learn. It's just really evident they aren't going to.

I really don't care who is prescribing SSRIs to adults. A monkey can throw an SSRI at a relatively healthy adult safely, so I'm pretty sure a psychologist could as well. I don't see there being much value in letting them do so. You have stated before what you think that value is, and I have found it profoundly unconvincing. So it goes. Most of the risk we assume involves our sickest patients. Many of our patients are pretty easy to treat (or at least not so difficult that it requires a lot of expertise or clinical experience). It's going to take a LOT of data to show any differences when you have so many "easy" cases watering down any sorts of differences. What the marginal value of whatever added expertise psychiatrists bring to the table is only going to matter in a relatively small number of cases in most private-insurance accepting private practices.

Given that adult psychiatrists and pediatricians do a terrible job at child psychiatry, I would be scared of anyone but child psychiatrists seeing children for anything more complicated than simple ADHD. I could imagine a good, well-supervised NP doing a good job with this with some experience.

Of course, when people are doing 15 minute med checks, there isn't enough time to use any sort of real skills anyway, and I'm not surprised if there's no difference between a psychiatrist, an NP, a psychologist, a plumber, and a golden retriever prescribing medications in 15 minutes. The patients are either healthy enough that they're hard to screw up, or they're so sick that you can't figure out anything useful in 15 minutes anyway.

 

[F0nzie]

BP that was REAL.

If 15 minutes is all we get, I would support training golden retrievers to dispense SSRIs and replace us all.

 

[heyjack70]

Because these threads devolve into ******* fests. Nothing meaningful has been said since Grover revived it (it had almost died!). At least no one has started talking about islamofascists again. These threads usually continue until somebody becomes such a dick that a mod finally shuts it down.

I wouldn't say that psych NPs are an "issue." They're a pretty valuable part of a well-run treatment team. They're not physicians, and they're not supposed to be. I'd much rather live in a world where the psychiatrists were able to focus their time on the treating the sickest patients and supervising other folks with less-but-enough education and good, trustworthy skills. Whether payment structures will ever be adjusted to make this a reality is another issue. I've met NPs that have incredibly annoying attitudes and short wiener syndrome, but the ones I've worked with have not suffered such calamities. If we could just make the 2% of NPs who have snotty attitudes shut up, the other 98% of them seem pretty great.

I have no idea what will happen with prescribing psychologists. I know the idea of the ones in my psychopharm class ever writing a prescription for lithium (no matter how many online classes they take) scares the hell out of me. I would say the same about most PCPs too. Not because they COULDN'T learn. It's just really evident they aren't going to.

I really don't care who is prescribing SSRIs to adults. A monkey can throw an SSRI at a relatively healthy adult safely, so I'm pretty sure a psychologist could as well. I don't see there being much value in letting them do so. You have stated before what you think that value is, and I have found it profoundly unconvincing. So it goes. Most of the risk we assume involves our sickest patients. Many of our patients are pretty easy to treat (or at least not so difficult that it requires a lot of expertise or clinical experience). It's going to take a LOT of data to show any differences when you have so many "easy" cases watering down any sorts of differences. What the marginal value of whatever added expertise psychiatrists bring to the table is only going to matter in a relatively small number of cases in most private-insurance accepting private practices.

Given that adult psychiatrists and pediatricians do a terrible job at child psychiatry, I would be scared of anyone but child psychiatrists seeing children for anything more complicated than simple ADHD. I could imagine a good, well-supervised NP doing a good job with this with some experience.

Of course, when people are doing 15 minute med checks, there isn't enough time to use any sort of real skills anyway, and I'm not surprised if there's no difference between a psychiatrist, an NP, a psychologist, a plumber, and a golden retriever prescribing medications in 15 minutes. The patients are either healthy enough that they're hard to screw up, or they're so sick that you can't figure out anything useful in 15 minutes anyway.

gosh darnit. excellent post. seriously. thank you.

 

[vistaril]

Because these threads devolve into ******* fests. Nothing meaningful has been said since Grover revived it (it had almost died!). At least no one has started talking about islamofascists again. These threads usually continue until somebody becomes such a dick that a mod finally shuts it down.

I wouldn't say that psych NPs are an "issue." They're a pretty valuable part of a well-run treatment team. They're not physicians, and they're not supposed to be. I'd much rather live in a world where the psychiatrists were able to focus their time on the treating the sickest patients and supervising other folks with less-but-enough education and good, trustworthy skills. Whether payment structures will ever be adjusted to make this a reality is another issue. I've met NPs that have incredibly annoying attitudes and short wiener syndrome, but the ones I've worked with have not suffered such calamities. If we could just make the 2% of NPs who have snotty attitudes shut up, the other 98% of them seem pretty great.

I have no idea what will happen with prescribing psychologists. I know the idea of the ones in my psychopharm class ever writing a prescription for lithium (no matter how many online classes they take) scares the hell out of me. I would say the same about most PCPs too. Not because they COULDN'T learn. It's just really evident they aren't going to.

I really don't care who is prescribing SSRIs to adults. A monkey can throw an SSRI at a relatively healthy adult safely, so I'm pretty sure a psychologist could as well. I don't see there being much value in letting them do so. You have stated before what you think that value is, and I have found it profoundly unconvincing. So it goes. Most of the risk we assume involves our sickest patients. .

Agreed, but that is *not* where most of our revenue comes from. And that's a big part of where the uncertainty over the future with psych nps lie.
You are in a somewhat(but not entirely) more insulated position being in child psychiatry.

 

[Therapist4Chnge]

What else does one have. Saddled with more debt than the 2 of you combined and then some. And the years ahead longer than behind that just by themselves are longer than the NP curriculum. With longer hours and more work for less pay before I can say I'm ready to see patients on my own. What else does one have when the political tide swings powerfully in the direction of faster, cheaper, more while you're making huge investments that have no out only an epic through.

Did someone threaten your life if you didn't choose to pursue a medical education? If so, I am truly sorry, as no one should be forced into pursuing higher education against their own will. Otherwise, it was definitely a choice....one in which that will lead to a guaranteed 6-figure income, income repayment options, and a far better lifestyle than 99.8% of the rest of the world's population.

More costly in money and effort than can be imagined by glib and guiltless political usurpers.

Ahh, thank you for the ad hominem attack.

I really don't care who is prescribing SSRIs to adults. A monkey can throw an SSRI at a relatively healthy adult safely, so I'm pretty sure a psychologist could as well.

So a monkey can, but you are only 'pretty sure' a psychologist could.... Way to stay classy billyp.

 

[Therapist4Chnge]

If 15 minutes is all we get, I would support training golden retrievers to dispense SSRIs and replace us all.

Sadly, having a GR present in the room is probably more beneficial than some of the SSRIs currently on the market. Yay failure to surpass placebo.

 

[billypilgrim37]

So a monkey can, but you are only 'pretty sure' a psychologist could.... Way to stay classy billyp.

You clearly don't read my posts with a Larry David voice (which is sometimes the best way!).

After two thousand posts, I'm pretty sure you know I'm not the enemy.

 

[billypilgrim37]

Sadly, having a GR present in the room is probably more beneficial than some of the SSRIs currently on the market. Yay failure to surpass placebo.

To be fair, trials of golden retrievers would likely have better methodologies than FDA registration trials used in those meta-analyses. If you added a golden retriever arm to TADS or TORDIA, you would probably see some separation.

 

[Therapist4Chnge]

You clearly don't read my posts with a Larry David voice (which is sometimes the best way!).

After two thousand posts, I'm pretty sure you know I'm not the enemy.

Indeed...I missed that completely. I also missed most of the last season of Curb...so I gotta get on that.

And now back to the topic at hand....Illinois!

 

[vistaril]

Sadly, having a GR present in the room is probably more beneficial than some of the SSRIs currently on the market. Yay failure to surpass placebo.

no doubt.....the lack of efficacy of our drugs is still one of the biggest issues for psychiatry as a field.

 

[Chimed]

Other than just not clicking on a thread (self-control on the internet clearly not being a strength for me), is there a way to ignore a thread like you can ignore a user?

Threads like this are why I stopped visiting this site so often over the last 6 or so months. It's funny, or maybe not so funny, that when I visited it again, the same old topics keep getting kicked around. Maybe this is why we're not seeing whooper or anasazi anymore.

 

[Armadillos]

Threads like this are why I stopped visiting this site so often over the last 6 or so months. It's funny, or maybe not so funny, that when I visited it again, the same old topics keep getting kicked around. Maybe this is why we're not seeing whooper or anasazi anymore.

When I first joined I read through tons of the old/archived stuff, those two were great and also the harvard C/L guy, I imagine he would have crushed vistaril months ago if he were still posting.

 

[Chimed]

When I first joined I read through tons of the old/archived stuff, those two were great and also the harvard C/L guy, I imagine he would have crushed vistaril months ago if he were still posting.

Doc Samson

 

[billypilgrim37]

Doc Samson

I would pay good money to see a Doc Samson v Vistaril thread.

 

[vistaril]

When I first joined I read through tons of the old/archived stuff, those two were great and also the harvard C/L guy, I imagine he would have crushed vistaril months ago if he were still posting.

if you want constant cheerleading I'm definately not your guy. I speak to some of the problems our field faces....I'm not saying I have solutions for such problems of course. But I don't mind pointing them out.

 

[heyjack70]

if you want constant cheerleading I'm definately not your guy. I speak to some of the problems our field faces....I'm not saying I have solutions for such problems of course. But I don't mind pointing them out.

You're actually pretty rude a lot of the time.

 

[Armadillos]

if you want constant cheerleading I'm definately not your guy. I speak to some of the problems our field faces....I'm not saying I have solutions for such problems of course. But I don't mind pointing them out.

Not sure who your accusing of constant cheerleading, you on the other hand just seem to try to piss on everything, have clearly implied many times that your professional development is complete as a PGY4 and that you really have nothing left to learn about psychiatry, then when you repeatedly got called out on all this stuff you hid behind a lie that you were actually at a big name program.

Your posting style is so lacking of insight and your claims are so exaggerated that you have to make up lies about yourself to weakly justify them and even then people repeatedly called out your lies because it was so obvious you weren't at a prestigious program.You would think that would prompt some self reflection about what it is about yourself that makes it so obvious you haven't received top quality training (thats not to say your program didn't offer it, you just clearly didn't take them up on the offer).

 

[StarbucksMD]

I'm starting to get Stockholm Syndrome from being trapped reading this thread for so long...

"Don't worry, be happy" ~Bob Marley

 

[DOC PENGUIN]

Indeed...I missed that completely. I also missed most of the last season of Curb...so I gotta get on that.

And now back to the topic at hand....Illinois!

Chicago is great this time of year.

 

[billypilgrim37]

Chicago is great this time of year.

Veronica Roth's young adult book series, Divergent, which is being made into a movie and will basically be the next Hunger Games-esque franchise, takes place in a dystopian Chicago many years into the future.

 

[DynamicDidactic]

To change the topic a little bit.

I do not support RxP out of concern for my field. However, a lot of the discourse is about lack of appropriate education/requirements on the prescribing end of things. However, the legislation overlooks stricter requirements on the psychology training end of the spectrum. I would like legislation to allow for only individuals from accredited programs and accredited internships. Maybe even board certification on top of that.

Again, I do not support the legislation but its not only opening the doors for more prescribers but a lot of poorly trained psychologists to prescribe. For goodness sake, our APA allows for a range of different training orientations, many not centered on training scientists. There are even online schools!

 

[notdeadyet]

Veronica Roth's young adult book series, Divergent, which is being made into a movie and will basically be the next Hunger Games-esque franchise, takes place in a dystopian Chicago many years into the future.

Saves money on sets...

I keed, I keed...

 

[DOC PENGUIN]

Veronica Roth's young adult book series, Divergent, which is being made into a movie and will basically be the next Hunger Games-esque franchise, takes place in a dystopian Chicago many years into the future.

i'm not a fan of the genre, but it seems like a refreshing contribution to adventure. I wonder Cook County General looks like in a Dystopian Chicago.

 

[Heist]

New happenings...

 

[vistaril]

Not sure who your accusing of constant cheerleading, you on the other hand just seem to try to piss on everything, have clearly implied many times that your professional development is complete as a PGY4 and that you really have nothing left to learn about psychiatry, then when you repeatedly got called out on all this stuff you hid behind a lie that you were actually at a big name program.

Your posting style is so lacking of insight and your claims are so exaggerated that you have to make up lies about yourself to weakly justify them and even then people repeatedly called out your lies because it was so obvious you weren't at a prestigious program.You would think that would prompt some self reflection about what it is about yourself that makes it so obvious you haven't received top quality training (thats not to say your program didn't offer it, you just clearly didn't take them up on the offer).

well actually I suspect I have recieved much better training than you and perform much better work. But i'm not going to lose sleep over it either way. Always good to add another poster to the killfile(only two now...you and kumar)

 

[DOC PENGUIN]

well actually I suspect I have recieved much better training than you and perform much better work. But i'm not going to lose sleep over it either way. Always good to add another poster to the killfile(only two now...you and kumar)

Why do you assume that? You don;t even know this guy, how can you assume you do better work than he does.

 

[heyjack70]

Mods--can't we just ban Vistaril. Differing opinions aside, this user is repeatedly rude to almost everyone.

 

[slickster032]

New happenings...

What are they?

 

[HealthHare]

Assuming that RxP becomes ubiquitous throughout the nation in the next couple of decades, how badly will it affect the income potential of psychiatrists? I know that no one can predict the future, but is this something to seriously consider when weighing the pros and cons of this specialty?

 

[kumar28]

Mods--can't we just ban Vistaril. Differing opinions aside, this user is repeatedly rude to almost everyone.

Yeah I second that..there is something really off about this guy...well for starters he's a 4th resident who feels like he knows everything about everything in the field..imo..the guy really doesn't know jack shi$.

something tells me that he was picked on alot as a kid...i dunno..just sayin..

 

[vistaril]

Assuming that RxP becomes ubiquitous throughout the nation in the next couple of decades, how badly will it affect the income potential of psychiatrists? I know that no one can predict the future, but is this something to seriously consider when weighing the pros and cons of this specialty?

well that alone will have some downward pressure, but I don't think it will be massive(it wont be trivial perhaps either). I think there will be more meaningful downward pressures, especially psych nps. I also think another potential hit may come when rules concerning how you can bundle treatment in community mental health settings for medicare/aid are tightened up.

Keep in mind when one major employment area of psychiatrists sees a major hit in revenue, this has the real potential to bring salaries down in other areas as well.

 

[Armadillos]

well actually I suspect I have recieved much better training than you and perform much better work. But i'm not going to lose sleep over it either way. Always good to add another poster to the killfile(only two now...you and kumar)

I would hope you do so given that Im a medstudent, but the fact that a bunch of medstudents were able to so easily call you out on your "top program" BS should be telling.

 

[vistaril]

I would hope you do so given that Im a medstudent, but the fact that a bunch of medstudents were able to so easily call you out on your "top program" BS should be telling.

it's not particularly telling of my clinical abilities. I don't doubt that you will be a competent psychiatrist, and I don't doubt that I am as well.....but the main issue going forward as we practice over the next several decades is what is going to happen to help us translate that competency into better outcomes and better care for our patients. And that's the root of why I am skeptical some of the time.

 

[TexasPhysician]

Assuming that RxP becomes ubiquitous throughout the nation in the next couple of decades, how badly will it affect the income potential of psychiatrists? I know that no one can predict the future, but is this something to seriously consider when weighing the pros and cons of this specialty?

Hard to say. According to the bill, RxP gets unlimited prescribing abilities as I understand it. What would keep them from treating diabetes, strep throat, or any other condition?

If it truly becomes ubiquitous, many fields of medicine could be hurt by this.

 

[vistaril]

Hard to say. According to the bill, RxP gets unlimited prescribing abilities as I understand it. What would keep them from treating diabetes, strep throat, or any other condition?
.

the same thing that keeps me from having a practice full of patients with various non-psych illnesses.

 

[nitemagi]

the same thing that keeps me from having a practice full of patients with various non-psych illnesses.

Your bedside manner?