Paendrag said:
It comes down, you shouldn't do what you are not trained for. Psychologists shouldn't prescribe medications. Chiropractors shouldn't exist. M.D.s shouldn't give psychological tests. This is a problem in some areas now. M.D.s want the money from doing cognitive testing, so they give "expanded mental status exams" and then refer to a neuropsychologist (which limits what the neuropsychologist can be paid). Perform the job in which you are competent. Seems simple enough. Physicians are not trained to understand the psychometric properties of tests. They know little about normative samples, test design, and interpretation.
As a psychiatrist, I can honestly say that I am completely ignorant about administering any psychometric assessment to any patient. While in residency, we learn what the tests measure (or purport to measure) and what the results mean, but we don't learn to administer or score them. I am not competent to administer and score a WISC, WAIS, WPPSI, Binet, or even the Neuro-psych batteries. No way, no how. I know a few older psychiatrists, however, who administer and score IQ tests and they tell me it makes them feel more "academic" or something, whatever that means. I guess it's a nice divergence from doing 15 minute med-review evals and scribbling some psychotropic euphoria to another poor soul.
From a legal standpoint, I think in most states, psychiatrists, being the "top" mental health professional, are permitted to administer psychometric testing. I know Limited License Psychologists (LLPs) and Licensed Professional Counselors (LPCs) in Michigan include such testing within their scope of practice, so I'm going to assume an MD or DO can do it as well. I'm not sure about other states, but the practice of medicine, including psychiatry, is usually over-inclusive, while the practice of other professions, is usually exclusive and very limited.
Personally, I would never give an IQ or personality test; it's outside my scope of training and competence. I reserve that for the true professionals, the psychologists (PhD or PsyD, not master's level), whose training in this area is quite comprehensive. It's funny how physicians are permitted, by law, to do many things they are not qualified to do, whereas other practitioners are severely limited through statutory constraints. Example, any licensed physician is legally authorized to render any medical treatment to any patient. So, you get OB-GYNs and Internists treating endogenous depression or GAD w/ agoraphobia when they have no training to do so. Most of the SSRIs and Benzodiazepines are Rx'd by IM docs, FPs, and OB-GYNs.
Interestingly, however, even the medical boards recognize competence and scope of practice issues and would censure any physician who treats outside his/her area of expertise. In the case of an MD or DO administering psychometric tests, since such tests are not invasive and such administration would not or could not harm the patient, it's doubtful the Board of Medical Examiners would take any action.
