Medical Psychologists on path to getting prescribing privileges, AMA/APA oppose

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Perhaps the poster was advertising, but we can let the person defend that claim. The site www.thelastpsychiatrist.com is just a blog like any other, and they are only worth what they are worth...someone's opinion. Anyone who is confused about whether or not DVPA is a mood stabilizer probably could not understand the description of its pharmacology! It is similar to saying that Ambien isn't a sleeper because it is not a benzo?? I wouldn't get too fired up about tha validity of that site..it is just opinion and is only meant to be. Luckily for last poster most Americans don't know what bollocks really means!! Most Americans refuse to understand why Brits laugh at us when we say we are using our fanny-pack too..... :cool:
 

DrFocker

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I think we're making a mountain out of a mole hill. My back up plan is law school. Can you imagine the kind of bucks you can earn for Psychologist mal-practice? Not only would I be making crazy cash, I would be performing a service to the community! I can see my cross examination now: "So you're telling me you don't have a medical degree?, then how can you safely prescribe medications? I have a medical degree and I could have seen that (interaction) (side effect), why didn't you?" Can you imagine the possibilities here!?
 

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$100K+ in the first year for a clinical psychologist is double the national average...maybe it's because the position is in Louisiana.


Licensed Clinical or Counseling Psychologist

Company: PBHS Location: Alexandria, LA 71301
Salary/Wage: 80,000.00 - 100,000.00 USD Status: Full Time, Employee
Job Category: Healthcare - Social Services/Mental Health Relevant Work Experience: Less than 1 Year
Industry: Hospitals/Ambulatory Health Care Services Education Level: Doctorate

Job Description

Psychological and Behavioral Health Services (PBHS) is currently recruiting a doctoral level licensed/license eligible psychologist to join our practice in Central Louisiana. Our practice was established in 1996 and is owned and operated by psychologists. We are presently comprised of five licensed psychologists and two licesure candidates that will be licensed in early 2005. We presently provides a variety of professional services through our office complex, as well as consultative/contractual services to a variety of different hospitals and facilities. Although traditional assessment and treatment activities are regularly completed, our practice specializes in providing high quality psychological and behavioral services to individuals with mental ******ation and/or developmental disabilities.

The current position offers two separate components. The first is providing psychological services to the state's largest developmental center that is located less than 1/2 mile from our office. We presently provide the facility with seven full time psychologists who function in a wide array of clinical and administrative duties (discussed below). the second is that of a psychologist in our group practice where individuals can pursue their own additional clinical interests.

Pinecrest Developmental Center (PDC) is located on an exctensive campus and is the home of aopproximately 600 residents. The facility is divided into three separate units with approximately 200 individuals on each unit. Each unit is provided with two full time doctoral level psychologists who provide crutial servies across a range of areas. As unit psychologists, we serve as the primary clinical supervisors for approximately seven bachelors and masters level "Team Leaders", each of whom coordinate multidisciplinary services for the individuals in their caseloads. We are directly involved in the development of comprehensive psychological evaluations, completion of functional analyses of behavioral concerns, and subsequent development and monitoring of behavioral supports. During the past year, team leaders have also been taking a more direct role in the oversight of "active treatment". This would include selection, development, and oversight of most learning-based (skill acquisition) objectives and other supports provided by the team to improve the individual's independence, quality of life, and ability to transition to a less restriced living environment.

PDC is also an APA approved doctoral level internship site. Involvement in this program is also available and is run/supervised by our psychologists. Additionally, PDC is the training site for many doctoral level students from LSU's clinical psychology program. As such, opportunities for involvement in ongoing research projects are often available. The influx of new students and interns ads a fresh element to the facility as well as training and research opportunities.

Our group practice is well established and provides opportunities for our psychologists to pursue other clinical interests. We work to support an environment where "clinicians can be clinicians". Psychologists currently engage in a variety of activities including individual/marital/family assessment and intervention, disability evaluations, child custody evaluations, and select forensic activities. We also provide contractual services to facilities such as physical rehabilitation hospitals, correctional settings, local mental health centers, and developmetal centers. We are open to providing support for the pursuit of essentially any clinical activities that our psychologists are competent to provide.

An additinal draw to the state of Louisiana is the fact that we have legislation passed that has allowed us to pursue limited prescriptive privileges. Training programs are established and ongoing. One of our owners has already completed the courses and two others are in the process at this time.

This position may be filled by either a licensed psychologist, or one that is license eligible in Louisiana. Individuals looking for postdoctoral supervision towards licensure are encouraged to apply. However, we are interested in recruiting individuals who are ready to make a longer term commitment to their professional development.

More pecific details on this opportunity will be provided to qualified and interested candidates, and are beyond the scope of this posting. You must have a doctoral degree in psychology to qualify for this position. The starting compenstaion for a licensed psychologist is $80k/yr based upon 2000hr/year. Candidates pending licensure would be paid $60-70k DOE. Additional compensation may be gained by providing additional hours at PDC or by completing additional clinical activities through the practice. Outside clinical activities are paid based upon an 80/20 split of all collections. It is common for licensed clinicians to exceed $100K during their first year. your final compensation is limited primarily by your motivation. Interested parties should be prepared to provide a brief letter of interest, contact information, and a current vitae (in WORD format for e-mail attachments). The position is available immediately.

Source: http://jobsearch.monster.com/getjob...cy=US&brd=1,1862,1863&lid=&fn=&q=psychologist
 
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Janusdog

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PublicHealth said:
More pecific details on this opportunity will be provided to qualified and interested candidates, and are beyond the scope of this posting. You must have a doctoral degree in psychology to qualify for this position. The starting compenstaion for a licensed psychologist is $80k/yr based upon 2000hr/year. Candidates pending licensure would be paid $60-70k DOE. Additional compensation may be gained by providing additional hours at PDC or by completing additional clinical activities through the practice. Outside clinical activities are paid based upon an 80/20 split of all collections. It is common for licensed clinicians to exceed $100K during their first year. your final compensation is limited primarily by your motivation.

Source: http://jobsearch.monster.com/getjob...cy=US&brd=1,1862,1863&lid=&fn=&q=psychologist
Bullocks, as it were. What this is saying is that compensation is ultimately based on productivity. When they say "it is common for licensed clinicians to exceed 100k during their first year", I say, how much of that 2000 hours is direct service? The people I know with this kind of arrangement who make that kind of money work their butt off -- to the tune of neglecting themselves and their family. One thing that limits psychologists' income is the fact that our hours are 50 minutes, one client per, unless you juggle two people at once for testing and that's difficult. Psychiatrists can theoretically see 4 people an hour, versus our one. I don't know too many psychologists who can listen (50 min X 8) and truly listen.

My first job was something advertised like this. It was pure BS -- I made no money for four months because it was dependent on collections, not billed hours, and I had to wait for that money. The other interesting trap is that a supervising psychologist makes money off his/her underlings with a percentage taken from the actual provider for overhead/owner tax. These guys do really well but the clinician in the front line doesn't.

That, and it's in Louisiana.

ETA: If their clinicians have outside clinical activity above and beyond the 2000 hours of their full-time job, that tells me that they most likely need something on the side to make ends meet. My suspicion is that the job posters also include these outside activities in their 'salary' range. And then they take 20% of your business too.
 

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Janusdog said:
Bullocks, as it were. What this is saying is that compensation is ultimately based on productivity. When they say "it is common for licensed clinicians to exceed 100k during their first year", I say, how much of that 2000 hours is direct service? The people I know with this kind of arrangement who make that kind of money work their butt off -- to the tune of neglecting themselves and their family. One thing that limits psychologists' income is the fact that our hours are 50 minutes, one client per, unless you juggle two people at once for testing and that's difficult. Psychiatrists can theoretically see 4 people an hour, versus our one. I don't know too many psychologists who can listen (50 min X 8) and truly listen.

My first job was something advertised like this. It was pure BS -- I made no money for four months because it was dependent on collections, not billed hours, and I had to wait for that money. The other interesting trap is that a supervising psychologist makes money off his/her underlings with a percentage taken from the actual provider for overhead/owner tax. These guys do really well but the clinician in the front line doesn't.

That, and it's in Louisiana.

ETA: If their clinicians have outside clinical activity above and beyond the 2000 hours of their full-time job, that tells me that they most likely need something on the side to make ends meet. My suspicion is that the job posters also include these outside activities in their 'salary' range. And then they take 20% of your business too.
Bottom line: Become a psychiatrist?
 

Pharmohaulic

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I will not attempt to continue any negative dialogue. Believe it or not, it was not my intention. We agree to disagree. I think that's about the end of it. As a final point, though, you should take a sincere look at your own intentions. Yes, I gave up psychology because I found it unfulfilling. I don't blame others for this. It was my own experience. If others find this insulting, then frankly, so be it. I recognized that the medical model was more in alignment with what I think is proper treatment of patients, and was simply more interesting to me.

After reading the DoD report years ago and more recently, I agree that to psychologists, the study is promising. But as a scientist, it is one tiny baby step in the "proof" that psychologists are so desparately seeking stating that they are as competent prescribers as physicians.

Sasavan, I bet that if we had a beer together at the local Irish pub, it would actually be quite fun and that we'd get along great. Unfortunately, I think the internet (particularly web boards) have a way of making what are often innocuous words seem more hostile and sarcastic. And, also allow people to say things that would be deemed socially inappropriate. In those respects, I may be a victim or such propagation.

I flew to visit my parents yesterday here in Florida and as chance would have it, sat next to a clinical psychologist on the plane - a very nice woman who is a professor at a small liberal arts college in the south. I asked her her opinion about prescription privilages....she stated, "Oh, I think that what psychologists and the APA are doing is inappropriate. If people want to be the best prescribers, they certainly should go to medical school." I can see people cringing in their computer chairs from here, but the salient point is this: Despite research that may or may not be generalizable, despite the fact that NPs or PAs may be prescribing, etc, there is a non-quantifiable component to healthcare in general, and psychiatric practice in particular. Lots of psychiatrists or prescribing psychologists can give medication and not hurt, but many not help much either. In these qualitative respects, people can disagree, and that's OK.

The fact that you're seeking medical school to pursue psychiatry after your PhD (congratulations, btw), tells me, and other readers, something. Perhaps after some time off and soul-searching, you'll find that you prefer the medical model as well, or will see the astounding complexities and information overload experienced in medical school to be eye-opening. You may see that to read about diseases in a book to be informative, but to SEE these same conditions on your clinical rotations and their subtle manifestations is actually disconcerting. Or perhaps not.

Either way, I wish you luck. We all have our passions and are willing to stick up for them. This same enthusiasm should serve our patients well, as long as they don't become dogmatic and destructive.

p.s. And as for my signature, I never intended it to bring so much angst to so many people. I explained myself more fully in another post, but suffice it to say that I'm simply a fan of the show, that's it.
I also think (and I am not trolling, I just have a very big interest on this topic and research it often) but I think there is a double standard here... What I'm referring to is what makes psychiatry up on their golden pedestal where they can get additional training in psychotherapy and psychosocial interventions, yet they are dead set against their psychologist counterparts getting additional biomedical training to possibly be able to prescribe? That appears to be as if they (many but not all) just want to be at the top of the totem poll and don't want any competition.

Also, many psychiatrists tout that they do psychotherapy and do psychological testing when they realistically have minimal to no training and yet claim to do CBT DBT so on and so forth. Why is it ok for them encroach on psychologists territory and claim to do all these things when they have little training and see it as OK and yet will be the first ones to point fingers at medical psychologists having too little training to prescribe (When realistically their training is more thorough than nurse practitioners). If they don't want psychologists prescribing due to having what they believe is subpar training then fine, many of them should abide by their rules and stop claiming to do all this psychotherapy and whatnot when many of them realistically have little training.

Also, expanding on what I wrote about Nurse practitioners in my last paragraph. Did Nurse practitioners receive this same backlash when they lobbied for prescribing rights? Because it seems to me as if they do it on a daily basis with no word from psychiatrists or physicians for that matter and they are even going to the extent of overstepping their boundaries and fight for independent prescribing rights (which in my opinion is ridiculous) and still nobody is saying anything about that.
 

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I also think (and I am not trolling, I just have a very big interest on this topic and research it often) but I think there is a double standard here... What I'm referring to is what makes psychiatry up on their golden pedestal where they can get additional training in psychotherapy and psychosocial interventions, yet they are dead set against their psychologist counterparts getting additional biomedical training to possibly be able to prescribe? That appears to be as if they (many but not all) just want to be at the top of the totem poll and don't want any competition.

Also, many psychiatrists tout that they do psychotherapy and do psychological testing when they realistically have minimal to no training and yet claim to do CBT DBT so on and so forth. Why is it ok for them encroach on psychologists territory and claim to do all these things when they have little training and see it as OK and yet will be the first ones to point fingers at medical psychologists having too little training to prescribe (When realistically their training is more thorough than nurse practitioners). If they don't want psychologists prescribing due to having what they believe is subpar training then fine, many of them should abide by their rules and stop claiming to do all this psychotherapy and whatnot when many of them realistically have little training.

Also, expanding on what I wrote about Nurse practitioners in my last paragraph. Did Nurse practitioners receive this same backlash when they lobbied for prescribing rights? Because it seems to me as if they do it on a daily basis with no word from psychiatrists or physicians for that matter and they are even going to the extent of overstepping their boundaries and fight for independent prescribing rights (which in my opinion is ridiculous) and still nobody is saying anything about that.
Somebody needs to ban this necromancer.
 
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Ceke2002

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How is speaking honesty equivalent to practicing magic?
1) You gave an opinion; that's not the same as 'speaking honesty'.
2) Second, you already started a thread about this exact subject, and then felt the need to dig up another thread that was already done and dusted 12 years ago. This to me feels like the necrobump equivalent of throwing your toys out of the pram, because people aren't rushing to agree with you.
3) Regarding your opinion on Psychiatrists and Psychotherapy ~ Do you think Psychiatrists just get their Board Certification/Fellowship/License/Whatever else, and then decide to stop learning? Because contrary to what you might think, it is more than possible for a Psychiatrist to also be a highly effective Psychotherapist, considering there are opportunities for further education and study.
 

Pharmohaulic

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1) You gave an opinion; that's not the same as 'speaking honesty'.
2) Second, you already started a thread about this exact subject, and then felt the need to dig up another thread that was already done and dusted 12 years ago. This to me feels like the necrobump equivalent of throwing your toys out of the pram, because people aren't rushing to agree with you.
3) Regarding your opinion on Psychiatrists and Psychotherapy ~ Do you think Psychiatrists just get their Board Certification/Fellowship/License/Whatever else, and then decide to stop learning? Because contrary to what you might think, it is more than possible for a Psychiatrist to also be a highly effective Psychotherapist, considering there are opportunities for further education and study.
OK, your use of big words doesn't impress more or intimidate me... Or trip me up for that matter because I know what they mean.

Also, yes exactly, u said it. They need further education to practice psychotherapy effectively... Many don't pursue this further education and just take the few didactic courses and then tour to be efficient psychotherapist.

This leads to point three how u stated psychiatrists can get additional training to proficient effective therapy.. Great, well the same is true for psychologists.. They can get additional biomedical training to be efficient psychopharmacologists.
 

Ceke2002

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OK, your use of big words doesn't impress more or intimidate me... Or trip me up for that matter because I know what they mean.

Also, yes exactly, u said it. They need further education to practice psychotherapy effectively... Many don't pursue this further education and just take the few didactic courses and then tour to be efficient psychotherapist.

This leads to point three how u stated psychiatrists can get additional training to proficient effective therapy.. Great, well the same is true for psychologists.. They can get additional biomedical training to be efficient psychopharmacologists.
Well I'd be a bit worried if you didn't understand the words I wrote, considering I'm typing the Queen's English, and nothing I've written so far has contained anything that should have someone, who isn't ESL, reaching for the Oxford Dictionary.

It seems fairly clear you're not interested in having an actual discussion regarding this matter if you jump to the conclusion that someone is trying to impress or intimidate you with words simply because they decide to point out a few observations. But for the record, I'm Australian, and no I don't think Psychologists should have prescribing rights, and I also don't think NP's or PA's should be given them either. You want to prescribe medication, then do a medical degree and become a Doctor. I wouldn't trust a Psychologist, NP, or PA to prescribe medication without a medical degree, and I wouldn't trust a Psychiatrist to perform effective Psychotherapy without being assured that they had the requisite skills and education either.
 

st2205

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I also think (and I am not trolling, I just have a very big interest on this topic and research it often) but I think there is a double standard here... What I'm referring to is what makes psychiatry up on their golden pedestal where they can get additional training in psychotherapy and psychosocial interventions, yet they are dead set against their psychologist counterparts getting additional biomedical training to possibly be able to prescribe? That appears to be as if they (many but not all) just want to be at the top of the totem poll and don't want any competition.

Also, many psychiatrists tout that they do psychotherapy and do psychological testing when they realistically have minimal to no training and yet claim to do CBT DBT so on and so forth. Why is it ok for them encroach on psychologists territory and claim to do all these things when they have little training and see it as OK and yet will be the first ones to point fingers at medical psychologists having too little training to prescribe (When realistically their training is more thorough than nurse practitioners). If they don't want psychologists prescribing due to having what they believe is subpar training then fine, many of them should abide by their rules and stop claiming to do all this psychotherapy and whatnot when many of them realistically have little training.

Also, expanding on what I wrote about Nurse practitioners in my last paragraph. Did Nurse practitioners receive this same backlash when they lobbied for prescribing rights? Because it seems to me as if they do it on a daily basis with no word from psychiatrists or physicians for that matter and they are even going to the extent of overstepping their boundaries and fight for independent prescribing rights (which in my opinion is ridiculous) and still nobody is saying anything about that.
Psychologists haven't always done therapy. Psychiatry has relinquished most therapy to other practitioners over a few decades.

Regarding midlevels, you really need to peruse SDN. If you can't find an overall sentiment against mid-level providers, I'm not certain I have any intellectual discussion to sway you.
 

Pharmohaulic

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Well I'd be a bit worried if you didn't understand the words I wrote, considering I'm typing the Queen's English, and nothing I've written so far has contained anything that should have someone, who isn't ESL, reaching for the Oxford Dictionary.

It seems fairly clear you're not interested in having an actual discussion regarding this matter if you jump to the conclusion that someone is trying to impress or intimidate you with words simply because they decide to point out a few observations. But for the record, I'm Australian, and no I don't think Psychologists should have prescribing rights, and I also don't think NP's or PA's should be given them either. You want to prescribe medication, then do a medical degree and become a Doctor. I wouldn't trust a Psychologist, NP, or PA to prescribe medication without a medical degree, and I wouldn't trust a Psychiatrist to perform effective Psychotherapy without being assured that they had the requisite skills and education either.
So PA's and NP's don't prescribe in Australia like here in the states?
 
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MLT2MT2DO

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OK, your use of big words doesn't impress more or intimidate me... Or trip me up for that matter because I know what they mean.

Also, yes exactly, u said it. They need further education to practice psychotherapy effectively... Many don't pursue this further education and just take the few didactic courses and then tour to be efficient psychotherapist.

This leads to point three how u stated psychiatrists can get additional training to proficient effective therapy.. Great, well the same is true for psychologists.. They can get additional biomedical training to be efficient psychopharmacologists.
Yes, that further education is called medical school. Why is our society built on short cuts and entitlement? Why not work on being the best psychotherapist possible instead of figuring out backdoor ways of getting what you want without working for it?

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OK, your use of big words doesn't impress more or intimidate me... Or trip me up for that matter because I know what they mean.

Also, yes exactly, u said it. They need further education to practice psychotherapy effectively... Many don't pursue this further education and just take the few didactic courses and then tour to be efficient psychotherapist.

This leads to point three how u stated psychiatrists can get additional training to proficient effective therapy.. Great, well the same is true for psychologists.. They can get additional biomedical training to be efficient psychopharmacologists.
 
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