Medical psychologists prescribing in primary care?

[Pharmohaulic]

How do you as family Medicine physicians feel about specially trained psychologists prescribing either independently or in collaborations with family/ primary care physicians?

I know one of the reasons for this move is to fill the gap and meet the needs for the many mental health patients out there who have to wait to get care and it ends up often falling in the hands of the primary care physicians.

I know that some family Medicine docs like this idea for the above mentioned reason and in state's such as new mexico where prescribing rights have been approved for psychologists, it has worked out great!

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[JustPlainBill]

How do you as family Medicine physicians feel about specially trained psychologists prescribing either independently or in collaborations with family/ primary care physicians?

I know one of the reasons for this move is to fill the gap and meet the needs for the many mental health patients out there who have to wait to get care and it ends up often falling in the hands of the primary care physicians.

I know that some family Medicine docs like this idea for the above mentioned reason and in state's such as new mexico where prescribing rights have been approved for psychologists, it has worked out great!

Well, we already have specially trained medical psychologists -- they're called psychiatrists and they have prescriptive rights already -- don't see a need to duplicate the effort.

 

[Pharmohaulic]

Well, we already have specially trained medical psychologists -- they're called psychiatrists and they have prescriptive rights already -- don't see a need to duplicate the effort.

A psychologist and psychiatrist are different fields though lol

 

[Pharmohaulic]

Well, we already have specially trained medical psychologists -- they're called psychiatrists and they have prescriptive rights already -- don't see a need to duplicate the effort.

These prescribing psychologists would get their PhD in psychology and then go for an additional 2.5 yeah post doctoral masters in psychopharmacology wchin includes the medical sciences and course work necessary to prescribe

 

[JustPlainBill]

A psychologist and psychiatrist are different fields though lol

Everyone is entitled to their opinion. Most psychologists I've met were more counseling heavy since they had no prescriptive authority/training.....psychiatrists have the whole package and can do both...usually they're focused on serious disease process and have allowed the psychologists to pursue/handle the cases that needed counseling. If the psychologists now want prescriptive authority, this strikes me as yet another attempt to undermine physicians, much like the whole DNP movement wanting independent practice rights.....

Everyone wants to be a doctor but no one wants to go to medical school.

 

[deleted87716]

"Scope expansion," in any other setting, would be considered "bait-and-switch." Think about it.

 

[Pharmohaulic]

Everyone is entitled to their opinion. Most psychologists I've met were more counseling heavy since they had no prescriptive authority/training.....psychiatrists have the whole package and can do both...usually they're focused on serious disease process and have allowed the psychologists to pursue/handle the cases that needed counseling. If the psychologists now want prescriptive authority, this strikes me as yet another attempt to undermine physicians, much like the whole DNP movement wanting independent practice rights.....

Everyone wants to be a doctor but no one wants to go to medical school.

These medical psychologists would similar in concept to a dentist or podiarist for instance. They would have the necessary medical knowledge and training to prescribe a limited formulary of meds. to treat within their scope and area of expertise and that's it. They wouldn't be trying to replace physicians as nurse practitioners are.

A podiatrist can practice medicine and treatment on the lower extremity and that's it. A dentist can practice medicine and treat the teeth/ oral cavity and that's it. But the podiatrist for instance isn't accused of trying to take over an orthopedic surgeons job nor are they trying to do so.

 

[JustPlainBill]

These medical psychologists would similar in concept to a dentist or podiarist for instance. They would have the necessary medical knowledge and training to prescribe a limited formulary of meds. to treat within their scope and area of expertise and that's it. They wouldn't be trying to replace physicians as nurse practitioners are.

A podiatrist can practice medicine and treatment on the lower extremity and that's it. A dentist can practice medicine and treat the teeth/ oral cavity and that's it. But the podiatrist for instance isn't accused of trying to take over an orthopedic surgeons job nor are they trying to do so.

Not so sure about the podiatry claim....I recall that in Texas there was a move by a certain group of podiatrists to begin moving out of just foot to begin including more of the LE.

The dentist example is a poor choice. Has been a separate field for quite some time and stays well within their boundaries.....

Again, I view this as yet another attempt to bypass medical school/residency yet enjoy the privileges of being a physician yet at the same time having a back door escape hatch (I'm not a doctor) if things go bad....

 

[Promethean]

If you have a family med doc there, why would you need the psychologist to do any prescribing? Family med docs are fully trained and competent to prescribe psych meds in a primary care setting. They already fill this role. They may not have time to provide extensive counselling services, thus the opportunity to involve a psychologist or social worker or psych nurse in their practice. But if the patient needs a specialist to prescribe for them, they probably need a real, fully trained psychiatrist to take on that role. Not a new kind of midlevel/hybrid provider.

But this doesn't seem like a thread where someone is asking a question. This seems like a thread where someone has already decided what they want the answer to be, and they are asking for others to agree with them.

We don't need to establish a back door short cut to being a psychiatrist. There is already a clear route to that specialty.

 

[kbeitz]

Presciptive license and authority is a losing battle for physicians. The real problem is putting out the fires caused by unrestricted licensing. All these prescribers and not a physician to spare.

 

[Pharmohaulic]

If you have a family med doc there, why would you need the psychologist to do any prescribing? Family med docs are fully trained and competent to prescribe psych meds in a primary care setting. They already fill this role. They may not have time to provide extensive counselling services, thus the opportunity to involve a psychologist or social worker or psych nurse in their practice. But if the patient needs a specialist to prescribe for them, they probably need a real, fully trained psychiatrist to take on that role. Not a new kind of midlevel/hybrid provider.

But this doesn't seem like a thread where someone is asking a question. This seems like a thread where someone has already decided what they want the answer to be, and they are asking for others to agree with them.

We don't need to establish a back door short cut to being a psychiatrist. There is already a clear route to that specialty.

No the topic just interested me and I know some family docs are onboard, so I wasnt sure how you all felt.

 

[primadonna22274]

I want medical psychologists to do THERAPY. CBT, ACT, DBT--whatever gets the job done and makes it easier for me to do MY JOB.
Group meetings co-led with a behaviorist would be awesome from my perspective. Get all my difficult pain patients in one 90-min visit once every month and then the rest of the time I can focus on their chronic care management, HCM etc.
Pipe dream? Maybe. Let a girl have her fantasy


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[SLC]

I want medical psychologists to do THERAPY. CBT, ACT, DBT--whatever gets the job done and makes it easier for me to do MY JOB.
Group meetings co-led with a behaviorist would be awesome from my perspective. Get all my difficult pain patients in one 90-min visit once every month and then the rest of the time I can focus on their chronic care management, HCM etc.
Pipe dream? Maybe. Let a girl have her fantasy


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We do this in my residency clinic and it works soooo well!

 

[bobtheweazel]

Not so sure about the podiatry claim....I recall that in Texas there was a move by a certain group of podiatrists to begin moving out of just foot to begin including more of the LE.

It was the Texas board of podiatric medicine trying to redefine foot in a more favorable way. But it's because Texas is one of the more restrictive states for pods. In most states pods can do pretty much anything below the knee and in Fl and Ca they can do soft tissue up to the hip. In TX, if a wound is an inch above the ankle, it's off limits yo a pod.

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[Mass Effect]

These medical psychologists would similar in concept to a dentist or podiarist for instance. They would have the necessary medical knowledge and training to prescribe a limited formulary of meds. to treat within their scope and area of expertise and that's it. They wouldn't be trying to replace physicians as nurse practitioners are.

What? Sure they would. They would be trying to replace psychiatrists, unless you haven't heard that psychiatrists are physicians.

 

[Pharmohaulic]

What? Sure they would. They would be trying to replace psychiatrists, unless you haven't heard that psychiatrists are physicians.

They would be a physician extender not a physician.

 

[JustPlainBill]

They would be a physician extender not a physician.

Said the NPs 10 years ago....you're flogging a dead horse.

 

[SansaStarkMD]

They would be a physician extender not a physician.

Lmao.

 

[deleted343839]

I want medical psychologists to do THERAPY. CBT, ACT, DBT--whatever gets the job done and makes it easier for me to do MY JOB.
Group meetings co-led with a behaviorist would be awesome from my perspective. Get all my difficult pain patients in one 90-min visit once every month and then the rest of the time I can focus on their chronic care management, HCM etc.

That's essentially what I and many other clinical health psychologists do (sadly we have had to distinguish ourselves from fringe "medical psychologists" who claim to be able to function as attending physicians). I've always been appointed in subspecialty medicine departments rather than psych. My colleagues are physicians, and I value our teamwork.

The OP posts this and similar questions repeatedly on the psychology and psychiatry boards and apparently hasn't gotten the answer s/he is looking for yet. Anyway, despite a vocal minority, most psychologists are not interested in practicing medicine-lite.

 

[Mass Effect]

They would be a physician extender not a physician.

How'd that work out for the NPs?

 

[d2305]

There is a psychologist here that went to pa school to prescribe.