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What do you folks think about psychologists with further training being allowed to prescribe?
psisci said:BTW, I was trained in the same manner a NP is on how to do a physical assessment, but I would never prescribe for a person with many other medical problems (COPD, Diabetes, liver, kidney problems etc..).
Seaglass said:Sorry, but a study of 10 military doctors just ain't gonna cut it in this litigation-prone world to prove safety. How many patients could they possibly have treated?
PsyDRxPnow said:I know that 10-20 people are not going to cut it but how much will? Its obvious that it will take some time before RxP is more uniformed and more regulated but don?t you think that all fields regardless if its medicine or engineering, initially had to go through what RxP is going through now and eventually, will, you know where medicine and engineers stand now in regards to organization. RxP will eventually happen in all states, furthermore, I want to encourage the field of medicine who has overcome numerous obstacles to get to where they are today to encourage the American Psych. Association to gain prescription rights in other states and to teach us to do it better. Attacking RxP may just hinder it but will not stop its progress.
PACtoDOC said:I have a genuinely good idea to help you PsychD's to learn how to manage patients on medications. My suggestion would be that you apply to an MD or DO school, get accepted, and attend!! You see, only a bunch of behavioral gurus like you would have come up with an idea so senseless. I mean why don't we just start allowing PT's to prescribe medications related to rehabilitation, or Audiologists to prescribe drugs related to ENT? Or how about allowing midwives to do C-sections in emergency situation? Oh hell, I have the best option...why don't we just give pharmacists prescribing rights, and then everyone can just go to Eckerds and get their meds without having to see any physician?
Although it seems a solution to allow PsychD's to prescribe, it is nothing short of a disaster waiting to happen. How many dead or sick patients will it take to show that you cannot provide such care with a limited scope of training. Here are some examples as to why. Without medical training, you will be clueless about these common drug issues:
Ever heard of serotonin syndrome, neuroleptic malignant syndrome, acute dystonia, agranulocytosis, hepatic and renal insufficiency, hypothyroidism, chronic Lithium induced dermatitis, etc??? All these are MEDICAL problems caused by what most would term SIMPLE psych drugs, but yet how can you identify, treat, or otherwise help a patient with these problems when you are not trained to ID them. You simply CANNOT draw a dividing line between where psych drugs and psych conditions become general medical issues.
Even I as a PA, having far superior clinical and pharm training, do not pretend that I was capable of independent practice outside that which a physician only can provide. I really wanted though to be my own boss, prescribe what I felt the patient needed, and serve an underserved population with services they might not otherwise have. So you know what I did? I went to medical school!!! Sure I could have mustered up a few hundred PA's who felt like me, and convinced a few sympathetic rural congressmen to vote to allow independence for PA's, but it simply made more sense to do what most people do who want to practice medicine....GO TO MEDICAL SCHOOL!!!
And no, I can promise you that it will never pass in every state. Hell, even PA's who have real clinical and pharm training don't have script rights in all 50 states.
If there is some critical shortage of psychiatrists, then perhaps there should be more of a push by the government to create more Psychiatry residencies and give big tuition breaks for anyone willing to go into it!!
psisci said:In some states like NM, PharmD's with extra training can prescribe antibiotics, pain meds, etc...; anything that may be needed quickly.
psisci said:I think the blind part is not realizing that this is what we have been saying all along. Please read before you respond with such animosity and ignorance. I was called to the acute care portion of our hospital by the attending there for a consult along with the psychiatrist I work with. The problem was clear to both of us when we saw the patient and the record..withdrawl dyskinesias. The attending internal med doc did not know you can get this when 20 mg of Olanzapine is abruptly withdrawn!!! We all have limits, as they should have taught you well in med school, and we all need to be appropriately trained to do what we do...this is not an argument with anyone psych or MD.
psisci said:I see, you are not a doctor yet.......
chicoborja said:It seems as though whenever a non-physician allied health provider attempts to gain Rx privileges, the physician organizations oppose on the basis of safety...fair enough. However, a trend has begun to emerge that points to the conclusion that non-physicians are not necessarily unqualified or incompetent prescribers. Physicians opposed NPs, ODs, and PharmD's prescribing and no study has shown that with these practioners prescribing that quality of care has diminished. I do not know for sure but I imagine that physicians also opposed DPMs prescriptive authority and they too has not been shown to be hazardous. PsyDs are now trying to pursue a similar extension of scope within their own area and the same unfounded arguement persists. Of course a physcian prescriber is more proficent in the medical sciences; however, how often would this difference require the additional medical skills of the physician? Do not give me emotionally-charged anecdotal support of the neccesity of the additional medical expertise of the physician because it carries no weight. Anecdotal evidence is about as scientific as psychic hotline predictions. A study would need to be conducted using mock patients and having each practitioner assess and offer analysis and course of action for the situation. With a large enough sample size, statistical significance, effect size, etc. could yield useful information pertaining to the relevancy of proported differences in competency.
I see, you are not a doctor yet.......
Of course a physcian prescriber is more proficent in the medical sciences; however, how often would this difference require the additional medical skills of the physician?
PACtoDOC said:True. I will be next year, and you never will be. You will just be "playing one on television" professor. Funny though, I have years of prescribing these meds, so you want to start a war of titles? Wannabe!!
PsyDRxPnow said:Perhaps you should educate yourself a little more about other fields (psychology education) instead of just excessive nonfactual talking. I, as a 2nd yr. PsyD student, was required to take numerous ?hard science? classes during my undergrad and I am expected to take more in my PsyD program plus a post doctorate masters degree in psychopharmacology (RxP). But you (Pactodoc) do not bother to educate yourself because your just assuming that other people will take your word as a fact due to your higher education. I am frankly concerned for the safety of your future patients that is if you ever get to see any.
Let us help you become educated on psychology if you want but you should act more like a professional and just stop the propaganda.
You say that we are a few wannabe doctors but I think you?re a wannabe intellectual.
PACtoDOC said:Your the one passing on the rhetoric and propaganda!! Show me a curriculum that is standardized amond the pyschology profession where ALL undergrad and graduate Psych majors are required to take hardcore sciences!!
I have many a friend who got their degree in undergrad psychology and never had to take a hardcore science one. The distinction is between the BS versus the BA in psychology, and it is not standardized to ANY degree. So what that you took a few hardcore sciences. There are PLENTY of PsychD's around the country that have never taken A&P even at an undergrad level, never taken bio, or gen chem, or organic chem, or physics. Show me ANY Physician from a Derm to an OBGYN, and even a Podiatrist or an Optometrist, and I will confidently point to them as a person who has indeed been REQUIRED to take these courses!!!!! Don't try and relate your experience as a zebra on the entire pack of horses running beside you!!! When there is a standardized PHYSICAL SCIENCE based curriculum for ALL PsychD's to go through prior to prescribing, then I doubt the AMA and all other physician organizations will step in your way to prescribe. But until then, we will all protect our patients from dangerous people like you who think that you have the right to manipulate a system that has been in place for decades. No one has ever successfully fought the AMA at this level and achieved success, and you guys will not be the first I can promise you. You may have attained small victories in few states, but the war will be fought nationwide, and you will eventually either have to seriously STANDARDIZE a curriculum that incudes what I have outlined, or you will simply continue to be sofa therapists!!
There are no shortcuts to practicing medicine.....remember that!!!