Oregon wants prescribing rights for Psychologists

[ronin12]

I also don't want to get dragged into this, but here I am again anyhow.

Just a couple points of my own:

1. I absolutely do not believe that psychologist prescribing has not caused adverse effects. The most likely scenario is that they're unable to either ask the correct questions, or make the proper medical observations to note this. Give me 100 patients on meds prescribed by psychologists, and I promise you, I'll find screw-ups in management and adverse effects six ways to Sunday.

2. Bluemirage is completely correct. Leaked emails and the like from the psychologist prescriber advocates make it very clear that their field (psychology) is in dire financial state, and that their turf is quickly being eroded by mid-levels. They want the prescriber piece of the pie, and they're citing underserved areas to get it. Make no mistake, they want full autonomy and have fought bills requiring oversight and limited formulary.

3. The DoD study, commonly cited by psychologists as proof of their safety is, ironically, quite the opposite. It's ironic because one thing that psychology does well, research, was in nearly all ways thrown out the window since they obtained favorable anecdotal results (not data). They prescribed a limited formulary (SSRIs) to non-medically comorbid, non-child, non-geri patients under supervision by a physician. It's completely ungeneralizable.

4. The claim that they're interested in serving the underserved is bogus. In the long run, this will hurt psychiatric patients, as more states adopt this program, causing less med students to pursue psychiatry. The shortage then will get worse, not better.

5. I recently passed the oral boards in psychiatry. I realized once again while studying for this brutal test, the tremendous amount of information that I have yet to study, and how much work I need to feel comfortable. The thought that a non-residency without proper medical training standards amounting to a couple weeks of real residency is atrocious. Add to this the fact that they want to prescribe to children and geri populations and in the hospital (all of which is done commonly with advanced fellowship training AFTER residency in psychiatry) makes it orders of magnitudes worse.

6. There's a lot more, but I just don't want to get into it more than I already have. It's a political move for a field that has problems. In some ways I don't blame them, their niche is eroding, and they don't police their own admission numbers. They need to do something to guarantee an income to the graduates of the phd and psyd programs.

Thank you for posting such elequant and comprehensive analysis. it proves unfortunate state of affairs with field of psychology and in desparation they are looking for alternate modes of income. it shows total disregard for ethical and professional standards among people who are pushing for this outrageous legislation, which clearly will do harm to pts.
Best way forward is to become more proactive in fighting this "lisence to kill ", through education to the public and political action in affected states. we will never be able to convince them , how wrong they are in their pursue of quackry, because they are desparate.

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[whopper]

3. The DoD study, commonly cited by psychologists as proof of their safety is, ironically, quite the opposite. It's ironic because one thing that psychology does well, research, was in nearly all ways thrown out the window since they obtained favorable anecdotal results (not data). They prescribed a limited formulary (SSRIs) to non-medically comorbid, non-child, non-geri patients under supervision by a physician. It's completely ungeneralizable.

If that is the case, (& I figured the NAMI site would've mentioned it, which it didn't--that's not a criticism of you Anasazi, I believe you, that's a criticism of the NAMI site), then that really is atrocious.

Like I mentioned, the antipsychotics & mood stabilizers by standard of care require people with medical training to prescribe them on a level that requires medical residency training. 3.5 weeks of pseudo-residency just doesn't cut it. Even with the SSRIs, there will be cases now & then of medical problems occurring 2ndary to SSRI use.

 

[Bluemirage]

I also don't want to get dragged into this, but here I am again anyhow.

Just a couple points of my own:

1. I absolutely do not believe that psychologist prescribing has not caused adverse effects. The most likely scenario is that they're unable to either ask the correct questions, or make the proper medical observations to note this. Give me 100 patients on meds prescribed by psychologists, and I promise you, I'll find screw-ups in management and adverse effects six ways to Sunday.

2. Bluemirage is completely correct. Leaked emails and the like from the psychologist prescriber advocates make it very clear that their field (psychology) is in dire financial state, and that their turf is quickly being eroded by mid-levels. They want the prescriber piece of the pie, and they're citing underserved areas to get it. Make no mistake, they want full autonomy and have fought bills requiring oversight and limited formulary.

3. The DoD study, commonly cited by psychologists as proof of their safety is, ironically, quite the opposite. It's ironic because one thing that psychology does well, research, was in nearly all ways thrown out the window since they obtained favorable anecdotal results (not data). They prescribed a limited formulary (SSRIs) to non-medically comorbid, non-child, non-geri patients under supervision by a physician. It's completely ungeneralizable.

4. The claim that they're interested in serving the underserved is bogus. In the long run, this will hurt psychiatric patients, as more states adopt this program, causing less med students to pursue psychiatry. The shortage then will get worse, not better.

5. I recently passed the oral boards in psychiatry. I realized once again while studying for this brutal test, the tremendous amount of information that I have yet to study, and how much work I need to feel comfortable. The thought that a non-residency without proper medical training standards amounting to a couple weeks of real residency is atrocious. Add to this the fact that they want to prescribe to children and geri populations and in the hospital (all of which is done commonly with advanced fellowship training AFTER residency in psychiatry) makes it orders of magnitudes worse.

6. There's a lot more, but I just don't want to get into it more than I already have. It's a political move for a field that has problems. In some ways I don't blame them, their niche is eroding, and they don't police their own admission numbers. They need to do something to guarantee an income to the graduates of the phd and psyd programs.

Awesome post! I agree with ronin12...it was both eloquent and comprehensive. It is a definite reality check that all physicians (not just psychiatrists) have to be more proactive in defending our professions against non-MD's/DO's that wish to have the same practice rights through lobbying legislations rather than through education.

 

[ocasek]

Originally Posted by Whopper
Like I mentioned, the antipsychotics & mood stabilizers by standard of care require people with medical training to prescribe them on a level that requires medical residency training. 3.5 weeks of pseudo-residency just doesn't cut it. Even with the SSRIs, there will be cases now & then of medical problems occurring 2ndary to SSRI use.

Can't Nurse Practioners prescribe these drugs (independent of supervision in 15 states)? You can become a nurse practioner in two years if you already have a bachelors degree. They can function as a psychologist or a psychiatrist - doing medication or therapy. Seems to have both PhDs and MDs trumped.

 

[benjee]

Can't Nurse Practioners prescribe these drugs (independent of supervision in 15 states)? You can become a nurse practioner in two years if you already have a bachelors degree. They can function as a psychologist or a psychiatrist - doing medication or therapy. Seems to have both PhDs and MDs trumped.

why bother to see Nps or any health professions since the general public can order medicine online ??

 

[edieb]

Wow, I go away for a week and this thread is still going.... The reason I opposed SWs and LPCs getting testing rights is that they are wanting these rights without any additional training. Nowhere has anybody stated that psychologists want to Rx without additional years of training. However, Psychologists are obtaining an additional master's degree in psychopharmacology.

I am sure prescribing independently is very hard, but doable with an extra master's degree. I think if psychologists were obtaining a "license to kill", there would have already been lawsuits. Don't you?? In fact, I am sure prescribing psychologists have saved lives as a result of their ability to prescribe. No telling how many people in New Mexico and Lousiana have received quality mental health treatment (see therapy and meds) when they usually would have gone without. For evidence of psychologsts being all about the pateitns, look at the geographic distribution of Rx psychologists in New Mexico: All but one are in rural, underserved areas. Hence, these psychologists are heroes and should be saluted by you and me! I agree with you that psychologists do need to be able to effectively watch and treat side effects caused by these meds. Thus, I am glad that these psychologists are now planning to increase patient care even more by attempting to obtain rights to increase the breadth of the formulary they can prescribe to those dealing with other systems of the body to counter side effects of psychoactive meds they prescribe.

 

[silas2642]

Wow, I go away for a week and this thread is still going.... The reason I opposed SWs and LPCs getting testing rights is that they are wanting these rights without any additional training. Nowhere has anybody stated that psychologists want to Rx without additional years of training. However, Psychologists are obtaining an additional master's degree in psychopharmacology.

I am sure prescribing independently is very hard, but doable with an extra master's degree. I think if psychologists were obtaining a "license to kill", there would have already been lawsuits. Don't you?? In fact, I am sure prescribing psychologists have saved lives as a result of their ability to prescribe. No telling how many people in New Mexico and Lousiana have received quality mental health treatment (see therapy and meds) when they usually would have gone without. For evidence of psychologsts being all about the pateitns, look at the geographic distribution of Rx psychologists in New Mexico: All but one are in rural, underserved areas. Hence, these psychologists are heroes and should be saluted by you and me! I agree with you that psychologists do need to be able to effectively watch and treat side effects caused by these meds. Thus, I am glad that these psychologists are now planning to increase patient care even more by attempting to obtain rights to increase the breadth of the formulary they can prescribe to those dealing with other systems of the body to counter side effects of psychoactive meds they prescribe.

I am all for psychologists prescribing psychotropic medications as long as they go through four years of medical school and complete four years psych residency. Otherwise, they should stay within their scope of practice.

 

[benjee]

Wow, I go away for a week and this thread is still going.... The reason I opposed SWs and LPCs getting testing rights is that they are wanting these rights without any additional training. Nowhere has anybody stated that psychologists want to Rx without additional years of training. However, Psychologists are obtaining an additional master's degree in psychopharmacology.

I am sure prescribing independently is very hard, but doable with an extra master's degree. I think if psychologists were obtaining a "license to kill", there would have already been lawsuits. Don't you?? In fact, I am sure prescribing psychologists have saved lives as a result of their ability to prescribe. No telling how many people in New Mexico and Lousiana have received quality mental health treatment (see therapy and meds) when they usually would have gone without. For evidence of psychologsts being all about the pateitns, look at the geographic distribution of Rx psychologists in New Mexico: All but one are in rural, underserved areas. Hence, these psychologists are heroes and should be saluted by you and me! I agree with you that psychologists do need to be able to effectively watch and treat side effects caused by these meds. Thus, I am glad that these psychologists are now planning to increase patient care even more by attempting to obtain rights to increase the breadth of the formulary they can prescribe to those dealing with other systems of the body to counter side effects of psychoactive meds they prescribe.

So, air hostesses are same as pilots since they work on aeroplanes.Someone who received PHd in English can pescribed medicine too. Just like what i suggested before, there is no need to have any health professions including psychologists or DNPs or PAs since general public can just order medicine online or buy it on the street.

 

[Anasazi23]

Wow, I go away for a week and this thread is still going.... The reason I opposed SWs and LPCs getting testing rights is that they are wanting these rights without any additional training. Nowhere has anybody stated that psychologists want to Rx without additional years of training. However, Psychologists are obtaining an additional master's degree in psychopharmacology.

I am sure prescribing independently is very hard, but doable with an extra master's degree. I think if psychologists were obtaining a "license to kill", there would have already been lawsuits. Don't you?? In fact, I am sure prescribing psychologists have saved lives as a result of their ability to prescribe. No telling how many people in New Mexico and Lousiana have received quality mental health treatment (see therapy and meds) when they usually would have gone without. For evidence of psychologsts being all about the pateitns, look at the geographic distribution of Rx psychologists in New Mexico: All but one are in rural, underserved areas. Hence, these psychologists are heroes and should be saluted by you and me! I agree with you that psychologists do need to be able to effectively watch and treat side effects caused by these meds. Thus, I am glad that these psychologists are now planning to increase patient care even more by attempting to obtain rights to increase the breadth of the formulary they can prescribe to those dealing with other systems of the body to counter side effects of psychoactive meds they prescribe.

There's so many things wrong with this paragraph - it demonstrates a fundamental lack of understanding of the responsibility of prescribing.

Let's put to bed just your one area of oft-quoted spin: that psychologists are prescribing in underserved areas and are "heroes."

From your own post:

Prescribing Psychologists
Who is licensed in New Mexico as a prescribing psychologist?

Lic # License Type Location
William Bernstein, Ph.D 0012C RxP Conditional Prescription Santa Fe, NM
Steven M. Cobb, Ph.D. 0005C RxP Conditional Prescription Roswell, NM
Rosalie S. Davis, Ph.D. 0008C RxP Conditional Prescription Albuquerque, NM
Marlin C. Hoover, Ph.D. 0007C RxP Conditional Prescription Flossmoor, IL
C. Alan Hopewell, Ph.D. 0009C RxP Conditional Prescription Fort Worth, TX
Stuart S. Kelter, Psy.D. 0004C RxP Conditional Prescription Las Cruces, NM
Elaine Levine, Ph.D. 0001 RxP Prescription Certificate Las Cruces, NM
James M. Mash, Ph.D. 0013C RxP Conditional Prescription Taos, NM
Robert C. Mayfield, Ph.D. 0010C RxP Conditional Prescription Las Cruces, NM
E. Mario Marquez, Ph.D. 0002 RxP Prescription Certificate Albuquerque, NM
Robert E. Sherrill, Jr., Ph.D. 0011C RxP Conditional Prescription Farmington, NM
Soterios J. Soter, Ph.D. 0006C RxP Conditional Prescription Evanston, IL
Thomas C. Thompson, Ph.D. 0003 RxP Prescription Certificate Las Cruces, NM
Marianne G. Westbrook 0014C RxP Conditional Prescription Hobbs, NM

Let's look at the populations of some of these cities:

Santa Fe, NM; 72,056 (4th largest in NM)
Roswell, NM: 45,293
Albuquerque, NM 845,913 (Largest in NM)
Forth Worth, TX 720,250 (17th largest city in US)
Las Cruces, NM 89,722
Evanston, IL 74,360
I didn't check the rest of them, as I already made my point.
(estimates from wikipedia)

10 of the 14 psychologists live or claim practice in these cities. So, they aren't moving to rural, underserved areas, as you claim.

Thanks for playing. And they're not "heroes."

And to educate you on "lawsuits." Most cases take years to get to trial, so we should start to see them rolling in within the next few years. This doesn't count settlements, and hospital-named suits (which keep the practitioner's name off the suit list).

 

[edieb]

At least half of this cities are small (Hobbs, Roswell, Las Cruces, Farmington) and those psychologists practicing in those cities are seeing persons who would likely not get any psychiatric meds otherwise. I imagine if you ask those in under-served areas getting their scripts from Rx psychologists, whether they would rather psychologists prescribe or wait for weeks and weeks for an appointment, I imagine they would want psychologists to continue to prescribe.

Also, keep in mind, that when there are long wait times for appointments, providers feel pressured to compress appointment times to see more people which further decreases patient care. Therefore, psychologists prescribing helps psychiatrists improve patient care because that helps ciphen off patients in big cities further reducing the glut of people to see psychiatrists. As a result, psychiatrists feel less pressure to compress the duration of patient appointments, and, as a result, can spend longer amounts of time w/ patients thereby increasing quality of care!! Everybody wins with Rx psychologists.

Law suits may take years, but I am sure the American Psychiatric Assn would root out all the ones in the pipelines so that they can use these as ammunition. The fact that they haven't produced any of this ammo says a lot.


Who is licensed in New Mexico as a prescribing psychologist?

Lic # License Type Location
William Bernstein, Ph.D 0012C RxP Conditional Prescription Santa Fe, NM
Steven M. Cobb, Ph.D. 0005C RxP Conditional Prescription Roswell, NM
Rosalie S. Davis, Ph.D. 0008C RxP Conditional Prescription Albuquerque, NM
Marlin C. Hoover, Ph.D. 0007C RxP Conditional Prescription Flossmoor, IL
C. Alan Hopewell, Ph.D. 0009C RxP Conditional Prescription Fort Worth, TX of
Stuart S. Kelter, Psy.D. 0004C RxP Conditional Prescription Las Cruces, NM
Elaine Levine, Ph.D. 0001 RxP Prescription Certificate Las Cruces, NM
James M. Mash, Ph.D. 0013C RxP Conditional Prescription Taos, NM
Robert C. Mayfield, Ph.D. 0010C RxP Conditional Prescription Las Cruces, NM
E. Mario Marquez, Ph.D. 0002 RxP Prescription Certificate Albuquerque, NM
Robert E. Sherrill, Jr., Ph.D. 0011C RxP Conditional Prescription Farmington, NM
Soterios J. Soter, Ph.D. 0006C RxP Conditional Prescription Evanston, IL
Thomas C. Thompson, Ph.D. 0003 RxP Prescription Certificate Las Cruces, NM
Marianne G. Westbrook 0014C RxP Conditional Prescription Hobbs, NM

 

[benjee]

It seems in some states ,the legislation of allowing non-Mds prescribing medicine is schizophrenic because on one hand , strict regulations are put on MDs in prescribing and on the other, allowing non-Mds ( without adequate medical knowledge) to prescribe.When complications arise ( medications from these non-Mds prescribers) , clients will be sent to hospitals ,treated by mds, of course not by non-Mds.

 

[whopper]

I am all for psychologists prescribing psychotropic medications as long as they go through four years of medical school and complete four years psych residency

Which is what I did. I have a bachelor's of science in psychology, was thinking of getting a Ph.D. in it.

But I decided to go to medical school & do residency so I could prescribe medications.

3.5 weeks of pseudoresidency for psychologists does not equate with 4 years of real residency.
Seeing someone with hepatic encephalopathy get misdiagnosed by the ER doctor as psychotic, and having to argue with that ER doctor that the person needs to be put on the medical floor is not something I'd expect a psychologist prescriber to be able to do.

Nor would I expect them to be able to interpret labs on a level that an M.D. could--to the point where cases of preventable medical harm or negligence could've been avoided, deal with the harmful side effects of several psychiatric meds, do consult liason psychiatry, among several other psychiatric roles.

The roles that I do think psychologist prescribers could do don't necessitate their need IMHO under the way the laws are written for the states that allow it, or give enough training. As I mentioned before, several treatment teams have a psychologist working with them. Several psychologists refer to MDs to prescribe a psychiatric med.

Anasazi's post on the GAO study really changed my perspective on this issue. SSRIs only? No medical problems? No child or Geri populations? That really does not equate with someone being able to prescribe all psychotropics to any population within a state.

 

[Therapist4Chnge]

...and around and around we go.....

Oregon is 1 step closer with their bill, so it will be interesting if Missouri and some of the other states who have bills in the works step up in the next legislative cycle.

It seems that things are moving forward, which is why I think the APA (iatry) and AMA should be focusing on how to reach the best compromise (collaboration instead of independence), as the scare tactics don't seem to be working.

 

[whopper]

Just saw this in google news....

http://www.oregonlive.com/politics/oregonian/index.ssf?/base/news/1241493908299610.xml&coll=7

Oregon House passes bill allowing psychologists to prescribe drugs
The legislation would require therapists get master's in psychopharmacology

This particular article mentions 800 hrs of training--which is not the figure I saw in the previous link describing the Oregon law--which would be 10 weeks of pseudoresidency training. 2.5 months. Still not enough IMHO.

This type of bill has already been attempted & failed in several states.
http://www.nami.org/Template.cfm?Se...tManagement/ContentDisplay.cfm&ContentID=8375

Since 1990, 12 states have rejected legislation to grant psychologists prescription privileges. These states (some of which have rejected prescribing legislation on multiple occasions) include Alaska, California, Connecticut, Florida, Georgia, Hawaii, Illinois, Louisiana, Missouri, Montana, Tennessee, and Texas. Not surprisingly, the state and federal chapters of the American Psychiatric Association and American Psychological Association have worked strenuously and expended considerable resources in opposition or support respectively of these legislative initiatives.

 

[Therapist4Chnge]

800 is better, but I think if the AMA is a bit more willing to talk, then they can get it raised in other proposed bills.

 

[whopper]

I think the best & least arduous route a psychologist prescriber that would give the needed medical training would be an NP degree. One could do a combined nursing/psychology major while in the bachelor's level.

 

[Faebinder]

800 is better, but I think if the AMA is a bit more willing to talk, then they can get it raised in other proposed bills.

Nope, I even hope they drop it to 400. The more hours they are forced to do, the less they realize they are in the end undertrained.

Things are only going to get more complicated. Soon we might see serious medications given for prevention of mental disorders. Can you imagine psychologists prescribing alpha1 blockers for prevention of PTSD? The minute someone's BP drops to dangerous levels we will see some serious retaliation.

 

[Bluemirage]

Just saw this in google news....

http://www.oregonlive.com/politics/oregonian/index.ssf?/base/news/1241493908299610.xml&coll=7



This particular article mentions 800 hrs of training--which is not the figure I saw in the previous link describing the Oregon law--which would be 10 weeks of pseudoresidency training. 2.5 months. Still not enough IMHO.

This type of bill has already been attempted & failed in several states.
http://www.nami.org/Template.cfm?Se...tManagement/ContentDisplay.cfm&ContentID=8375

Doesn't this bill also have to pass through the senate before it becomes official? Hopefully people with some sense will do the right thing for Oregon patients and get this bill stopped to protect them from substandard medical care. I cannot believe the politicians are buying into this. Psychologists wanting RX rights are pushing this purely for financial reasons without having to go through medical school. It's quite interesting watching what is happening in Louisiana. Apparently, the current RX psychologists are so worried about hanging onto to their new increase in income and privileges that they are trying to keep other psychologists out by pushing to have the Louisiana Medical Board oversee their activities rather than the Louisiana Psychology Board. This would be a great move for patient care for the state since it would probably mean more meaningful and rigorous training in the future for psychologists that want to RX but it is also a glimpse at the true motives behind this push for Psychologist RX.

 

[whopper]

Doesn't this bill also have to pass through the senate before it becomes official?

Yes, and it could still be vetoed by the governor.

Monday's vote was 47-11.

If this vote was a gauge of how the senate will vote, and often times in politics the vote of one house is a close gauge to how another will vote, then it'll most likely pass the senate. In fact it may pass to a degree where the governor can't veto it.

The data in psychotherapy show "that medication and therapy are more effective than either one alone," said Rep. Bill Kennemer, R-Oregon City, a key backer of House Bill 2702 and a former practicing psychologist. "It's hard to see this as other than a turf battle."

And medical care shouldn't be a turf battle. Patients should receive both if both are needed. However allowing medications without the proper training is not the answer.

I've got plenty of patients who were in need of surgery, and the surgeon played turfing. The answer was to call up the dept heads & hospital administration, let them know what was going on, not for me--a psychiatrist to cut open the person & do surgery.

 

[appelsoranjes]

I'm all for psychologists prescribing, but I admit the requirements are pretty ridiculous.

For starters, there should be a more stringent admissions requirement for entering the masters training program (some type of MCAT-light, or standardized test) - not all psychologists are created equal, and I'd hate to see the droves of PhD/PsyDs produced by the professional schools (some of which don't even consider GPA or GRE when admitting students) churning out money hungry pill-pushers.

These training programs should ideally only be available through AMA-accredited medical schools and/or nursings schools, *NOT* by the "california school of professional psychology" or "argosy university" - which are the only two "universities" offering this training.

Additionally, the training should be beefed up to an intense two-year *full time* program, with clinical hours and supervision required for at least a year post-masters. The fact that you can earn this degree online is pretty pathetic.

 

[Therapist4Chnge]

I agree with all of the above, good post.

 

[Solideliquid]

Nope, I even hope they drop it to 400. The more hours they are forced to do, the less they realize they are in the end undertrained.

Things are only going to get more complicated. Soon we might see serious medications given for prevention of mental disorders. Can you imagine psychologists prescribing alpha1 blockers for prevention of PTSD? The minute someone's BP drops to dangerous levels we will see some serious retaliation.

You know I understand your argument but I'm tired of seeing these straw men being propped up on this forum. Please don't try to bring up examples that seem "scary" because the same could happen to any of us and we probably wouldn't do anything different. So you put someone on terazosin (off-label use anyhow) and their BP drops, they call you from their home to tell you this. OK are you going to call them back to your office so you can hook them up to an IV? C'mon.....

The one thing you should be talking about is the *possibility* of side effects, and whether or not psychologists would have enough knowledge to make the patient well informed about specific possible physiological processes and side effects.

 

[lifespanps]

I am in support of trained psychologists obtaining prescription privileges in Oregon. There are not enough psychiatrists in Oregon to meet the population's needs. When you do find a qualified psychiatrist, they often have waiting lists a mile long. When a patient is able to find one, often they do not accept insurance and charge exorbitant rates. Since the field of psychiatry has done little to reach out to the public, psychiatrists are now finding that other professionals (e.g., NP and psychologists) are trying to meet the needs of those who go unserved. It seems that psychiatrists are very worried about turf. They lost their market on therapy in the 60s and 70s and now hold on to one thing..medication. But, in all honesty, when psychologists do obtain privileges, there will still be the same demand for psychiatrists. Psychiatrists will have an increased role in consultation. In Oregon, if one reads the bill closely, prescribing psychologists will need 2-years of didactic training, 1-year of supervised practice, and additional year of collaborative agreement with an MD. This amounts to 4 additional years of training on top of their 5 years for postgraduate study for a total of 9 years. Even when they get prescription authority, they will be required to consult with a child psychiatrist prior to writing any prescriptions for kids. There are many additional safeguards as well (e.g., the board must have an MD from Oregon Health Sciences). This seems like lots of training for a limited ability to prescribe. So, everyone in this post should relax a bit and realize that these psychologists will not have free reign. In fact, this bill presents a wonderful new opportunity for psychiatrists entering practice. A psychiatrist could engage in some wonderful supervision and collaboration. This could present a nice diversity in service delivery.

 

[Faebinder]

You know I understand your argument but I'm tired of seeing these straw men being propped up on this forum. Please don't try to bring up examples that seem "scary" because the same could happen to any of us and we probably wouldn't do anything different. So you put someone on terazosin (off-label use anyhow) and their BP drops, they call you from their home to tell you this. OK are you going to call them back to your office so you can hook them up to an IV? C'mon.....

The one thing you should be talking about is the *possibility* of side effects, and whether or not psychologists would have enough knowledge to make the patient well informed about specific possible physiological processes and side effects.

At least I would be aware enough of the meds they are on and the conditions they have that prevent me from putting them on the medication. You are talking as if dropping someone's BP is always a benign thing. That's where MIs (rebound tachycardia, undiscovered proxysmal afib) and strokes (mini ones usually) happen. Forget the treatment... First do no harm.

 

[whopper]

LifespanPS, disagree with you, and I fully acknowledge that if there is a shortage something should be done about it. It hurts patients, and doctors should not let our turfing battles hurt patients.

prescribing psychologists will need 2-years of didactic training, 1-year of supervised practice, and additional year of collaborative agreement with an MD. This amounts to 4 additional years of training on top of their 5 years for postgraduate study for a total of 9 years.

Yes, psychologists who may take this option may already have extensive years of training--all of which could possibly have no medical basis in it whatsoever. You could graduate with a Ph.D. in psychology, and in most programs, would not be required to take a Biology, Chemistry, Organic Chemstric, Physics, Biochemistry, Calculus program etc. Most programs do require at least some physiologically based psychology courses, but a psychologist could squeek by on a minimum of 1 to a handful based on the program. Even if one picked a majority of the physiologically based courses, that's still no where enough--I know becuase that's what I did as an undergrad, and it barely prepared me for medschool, where courses such as histology, anatomy, physiology (not of the brain), infectious disease were the cornerstones.

From my own experience, no psychology major ever took any of the above course unless they were already pre-med, because the above classes are usually weed out classes that can wreck someone's GPA.

The same argument that several years of schooling that are non-medical could be used for an art major with a Ph.D.

In reality, these psychologist prescribers will only have 2 years of medical academic training while MDs have a minimum of about 6 (I'm counting the pre-med courses as 2 years because some pre-meds weren't biology majors). MDs also have much more rigorous standards such as taking the MCATs & USMLEs which are horrendously difficult to pass.

That 1 year of supervised practice does not meet ACGME residnecy guidelines. If someone simply works under a doctor, and that doctor is not required to do morning rounds, grand rounds, scheduled clinical lectures, morning report, M&Ms, an internal medicine rotation, etc, its not going to compare at all with a residency that does require this--for 4 years and at more intense hours. As I mentioned, the requirements for psychologists really puts them at only a few months vs the 80 hrs/week of residency. In medical school, during the 4th year several medstudents can to do electives for a few months with the same level of supervision as this 1 year of "supervised practice" which pretty much amounted to the medstudent just sitting on their butt, reading magazine articles, watching Jerry Springer, or just shadowing a doctor while in a daydream, while the MD did all the brain work.

Even when they get prescription authority, they will be required to consult with a child psychiatrist prior to writing any prescriptions for kids

Which nullifies the need for that psychologist to prescribe. The psychologist could've worked in tandem with the child psychiatrist, and the psychiatrist could've done the prescription.

I have no argument that psychologists are good, perhaps even superior (in general) vs psychiatrists in several aspects of mental health, however prescriptions are not one of those areas.

 

[FamMan]

The fact that Oregon seems to be going ahead with this decision is very unsettling and to me speaks more about the lack of understanding among politicians about the rigors and value of a medical education.
The true losers here unfortunately are patients.
I do hope this trend does not continue. When a patient has pathology requiring medication they trust that the prescriber will know the full impacts of the medication and know more about how it affects the rest of the patient's organs on a level that goes far deeper than a laundry list of medical words.
In terms of polypharmacy or recognizing signs and symptoms or ruling out MS, ALS, Myasthenia Gravis, Hepatic encephalopathy, Meningitis, Parkinsons, electrolyte imbalance, ketoacidosis, thyroid pathology, delirium, chronic subdural hematoma, possible CNS tumors just to name a few or the relative severity and implications of contraindications and how to recognize them. And thats not even getting into correctly diagnosing or treating the "Psychiatric" conditions. The bottom line is you cant assume the primary care doc already has weeded out the differential and your going to be getting cookie cutter one dimensional Psych patients. There is going to be a lot of mistreated people and they are going to be the ones that pay. Not always in terms of acute ramifications but in terms of not getting adequate/appropriate care and paying the price in terms of quality of life.

This is not a turf war. A turf war implies two groups of equal ability to provide a service battling. This is not the case here. The thing is, they do not know the enormity of the magnitude of what they don't know and legislators in Oregon unfortunately do not as well.

 

[Solideliquid]

At least I would be aware enough of the meds they are on and the conditions they have that prevent me from putting them on the medication. You are talking as if dropping someone's BP is always a benign thing. That's where MIs (rebound tachycardia, undiscovered proxysmal afib) and strokes (mini ones usually) happen. Forget the treatment... First do no harm.

I guess my point was that we shouldn't be using medication side effect as a reason to block RxP. And no, I didn't mean to imply that dropping someone's BP is benign, only that it happens with A1 blockers, A2 blockers (thousands of kids are on these drugs), neuroleptics, etc etc the list goes on. "Forget the treatment... first do no harm"? Obviously we should be very careful to not, for example place someone on ziprasidone if they have a history of arrhythmia.

Each time we prescribe a medication the patient is taking a small risk of developing a horrible, possibly life threatening side effect. And in most cases when this occurs the patient will probably have to be placed under the care of a team of inpatient internal medicine doctors. An example would be DI from lithium, no psychiatrist would solely manage this side effect, so don't expect that since a psychologist couldn't, they shouldn't prescribe. Saying that they don't understand the pathological process is another story, and a relevant one.

 

[ronin12]

Another example of managed care/pharma pushing for cheap labor to cut cost and get more "quacks" to prescribe meds. I really didn't want to post another message but looking at few psychologist's posts, in which they are asking for collaboration/negotiations with psychiatrists to prescribe meds, i had no choice . how ignorant they are. Have anyone of us made through /macat/med school/usmle/residency/medicine and neurology rotations and psychiatry boards via negotiations and collaborations(back door entry).
This whole thing is undermining the very foundations of psychiatry as a medical specialty .If this gets traction in other states than psychiatry will look like a hurd of "quacks".very unfortunate.

 

[benjee]

I guess my point was that we shouldn't be using medication side effect as a reason to block RxP. And no, I didn't mean to imply that dropping someone's BP is benign, only that it happens with A1 blockers, A2 blockers (thousands of kids are on these drugs), neuroleptics, etc etc the list goes on. "Forget the treatment... first do no harm"? Obviously we should be very careful to not, for example place someone on ziprasidone if they have a history of arrhythmia.

Each time we prescribe a medication the patient is taking a small risk of developing a horrible, possibly life threatening side effect. And in most cases when this occurs the patient will probably have to be placed under the care of a team of inpatient internal medicine doctors. An example would be DI from lithium, no psychiatrist would solely manage this side effect, so don't expect that since a psychologist couldn't, they shouldn't prescribe. Saying that they don't understand the pathological process is another story, and a relevant one.

No, No , No. your concept is totally wrong. Don't treat prescribing medicine as a single entity. When someone prescribe ,he/she should consider the patient as a whole person, not only one aspect eg. either mental or medical apsects because they are all interact with each other. Like other posts mentioned certain illnesses can cause psychosis and certain mental can give somatic complains.When precribing medicine, he/she should monitor not only side effects, but also other apsects. If the patients is developing problem, you don't wait till last minute ( admitted in the hospital) and let other medical providers to tackle it and you will make the same very mistake next time.As a precriber, any potential problems from side effects or from interaction of medical illness should be attempted to prevent. It is soooo wrong to wait to last minute when problem already happen to send pt to hospital since it can be too late.Pt will pay the price .

 

[Solideliquid]

No, No , No. your concept is totally wrong. Don't treat prescribing medicine as a single entity. When someone prescribe ,he/she should consider the patient as a whole person, not only one aspect eg. either mental or medical apsects because they are all interact with each other. Like other posts mentioned certain illnesses can cause psychosis and certain mental can give somatic complains.When precribing medicine, he/she should monitor not only side effects, but also other apsects. If the patients is developing problem, you don't wait till last minute ( admitted in the hospital) and let other medical providers to tackle it and you will make the same very mistake next time.As a precriber, any potential problems from side effects or from interaction of medical illness should be attempted to prevent. It is soooo wrong to wait to last minute when problem already happen to send pt to hospital since it can be too late.Pt will pay the price .

uhhhh, what? You made my brain hurt.

 

[billypilgrim37]

Has anyone else noticed that the English skills in this thread have set an all-time low for the forum? 30% of the posts don't make sense, 30% of the posts use pitiful circular logic, 30% are just wisecracks, and the other 10% are people who thought they were posting on the "funniest chief complaint" thread.

 

[benjee]

uhhhh, what? You made my brain hurt.

sorry ,didn't mean to. Hope you feel better by now.

 

[edieb]

another example of managed care/pharma pushing for cheap labor to cut cost and get more "quacks" to prescribe meds. I really didn't want to post another message but looking at few psychologist's posts, in which they are asking for collaboration/negotiations with psychiatrists to prescribe meds, i had no choice . How ignorant they are. Have anyone of us made through /macat/med school/usmle/residency/medicine and neurology rotations and psychiatry boards via negotiations and collaborations(back door entry).
This whole thing is undermining the very foundations of psychiatry as a medical specialty .if this gets traction in other states than psychiatry will look like a hurd of "quacks".very unfortunate.

outrageous!

 

[nancysinatra]

Has anyone else noticed that the English skills in this thread have set an all-time low for the forum? 30% of the posts don't make sense, 30% of the posts use pitiful circular logic, 30% are just wisecracks, and the other 10% are people who thought they were posting on the "funniest chief complaint" thread.

Well then at least the math adds up for once. But an all-time low for the forum? Someone should do a search on that.

 

[Therapist4Chnge]

Another example of managed care/pharma pushing for cheap labor to cut cost and get more "quacks" to prescribe meds. I really didn't want to post another message but looking at few psychologist's posts, in which they are asking for collaboration/negotiations with psychiatrists to prescribe meds, i had no choice . how ignorant they are. Have anyone of us made through /macat/med school/usmle/residency/medicine and neurology rotations and psychiatry boards via negotiations and collaborations(back door entry).
This whole thing is undermining the very foundations of psychiatry as a medical specialty .If this gets traction in other states than psychiatry will look like a hurd of "quacks".very unfortunate.

I'm glad you are full of misinformed opinions and generalizations, but I'd ask you to refrain from insulting whole groups of professionals.

 

[ronin12]

I'm glad you are full of misinformed opinions and generalizations, but I'd ask you to refrain from insulting whole groups of professionals.

Reality Bites?

The professionals find inspiration within,Like a "true" psychologist who knows his professional strengths and tries to make a difference in that capacity.
"Quacks" have other motives, which are unfortunate.

 

[LADoc00]

So they still claim they are happy with their scope?

Here is the link to Oregan State Legislature.

Here is the proposed House Bill 2702. They vote on this Monday afternoon. Feel free to voice your opinion to someone. I guess maybe in the future they want to do ECT, VNS, TMS and heck why not some spinal taps.

I never once doubted this would eventually occur, even 10 years ago.

Definitely goes a very long way to eliminate psychiatry as any sort of real alternative for post medical school training...

 

[OldPsychDoc]

I never once doubted this would eventually occur, even 10 years ago.

Definitely goes a very long way to eliminate psychiatry as any sort of real alternative for post medical school training...

Won't they be elimating pathologists with technicians running computerized image analysis software and microarrays pretty soon?

You might want to keep your options open...

 

[zihuatanejo]

I never once doubted this would eventually occur, even 10 years ago.

Definitely goes a very long way to eliminate psychiatry as any sort of real alternative for post medical school training...

I am really not worried for myself. I will be able to cash in long before psychologists begin to replace psychiatrists en masse in a few decades or perhaps even sooner. What really upsets me about this whole thing is the injustice of it all and I don't even know who to blame. I definitely blame psychologists the least because they are doing what is best for them and advocating for their interests. I place most of the blame on greedy pharmaceutical companies, opportunistic politicians, and the impotent AMA and medical establishment who can't protect their own interests and advocate for physicans even when they have justice and the best arguments on their side.

I really don't know how anyone in good conscience could equate completing a premedical curriculum in college, taking the MCAT, completing four years of medical school, completing all the USMLE steps, a four year residency program, board certification exams, required CME, and board recertification exams with a two year master's degree in psychopharmacology and 800 hours of supervised prescribing. Why are only psychologists eligible for this route to prescriptive authority? Why not open it to Nurse Practitioners or Physician Assistants who have more medical training than psychologists or perhaps even to LPCs or SWs who arguably have as much medical training as psychologists? This slippery slope is bound to result in even more absurd legislation and outcomes.

 

[LADoc00]

Won't they be elimating pathologists with technicians running computerized image analysis software and microarrays pretty soon?

You might want to keep your options open...

Youre preaching to choir, I am the epitome of keeping every option on the table. When Im not stock piling dried goods, ammo and gold bullion equivalents, Im taking finance, law and management course. All the while learning Arabic and Italiano, while hitting the gym 5 days/week and deleting all my internet tracks. I would keep changing my cell phone number more often but it led to on call chaos. Considering 2nd passport country, but not quite there just yet.

 

[edieb]

This is only open to psychologists because psychologists are the pre-eminent providers of mental health care. With more training in the diagnosis and treatment of mental illness than any other specialty, including psychiatrists, we truly are equipped to prescribe. More importantly, however, with our extensive training in empirically supported therapies, will be able to unprescribe medications to our patients. Most psychiatrists are not trained to provide quality psychotherapeutic treatment to their patients. As a result, patients are victimize, thinking they must stay on medication for disorders that are curable with CBT (e.g., GAD, OCD, Dysthymia, non-endogenous MDD, Panic Disorder, et cetera). Psychiatrists seem to think everything is caused by some rogue neurtransmitter. However, psychologists, with our superior training in research, know this is not the case.

Psychiatrists have tried to impede psychologist scope of practice expansion at every turn. Opposition to RxP is an echo of psychiatry's resistance against psychologists' right to diagnosis and conduct therapy. However, we eventually got the right to do these and do them we have. As my professors say, we got the right to do them, and now they're "finger licking good!"

Psychologist prescribing is truly an evoloution in mental health care and the patient is the one who will benefit. With psychologists at the helm of mental health care, I rest assured that the # of persons on medication will decrease. When you see a psychiatrist, you're more than likely to walk out with a script, not so with a psychologist!!!

I am really not worried for myself. I will be able to cash in long before psychologists begin to replace psychiatrists en masse in a few decades or perhaps even sooner. What really upsets me about this whole thing is the injustice of it all and I don't even know who to blame. I definitely blame psychologists the least because they are doing what is best for them and advocating for their interests. I place most of the blame on greedy pharmaceutical companies, opportunistic politicians, and the impotent AMA and medical establishment who can't protect their own interests and advocate for physicans even when they have justice and the best arguments on their side.

I really don't know how anyone in good conscience could equate completing a premedical curriculum in college, taking the MCAT, completing four years of medical school, completing all the USMLE steps, a four year residency program, board certification exams, required CME, and board recertification exams with a two year master's degree in psychopharmacology and 800 hours of supervised prescribing. Why are only psychologists eligible for this route to prescriptive authority? Why not open it to Nurse Practitioners or Physician Assistants who have more medical training than psychologists or perhaps even to LPCs or SWs who arguably have as much medical training as psychologists? This slippery slope is bound to result in even more absurd legislation and outcomes.

 

[zihuatanejo]

I have decided that it is time for us to fight for our livelihoods. I have had enough of listening to the gloating of childish characters such as edieb. I will send an email to the Oregon state leadership and all of the Oregon state senators, in whose hands the future of psychiatry in Oregon and perhaps the rest of the country lies. We can't afford to lose this fight. I encourage all of you to send as many emails as you can outlining your concerns about allowing psychologists to prescribe and providing better suggestions for addressing the shortage of psychiatrists in underserved areas such as telepsychiatry, greater use of physician extenders such as NPs or PAs, or providing greater training in psychopharmacology for PCPs, or whatever other suggestions you can come up with. Below, I have included the names of the Oregon senate leadership, the names of all the senators, and a list of all the Oregon State Senators with their email addresses and other contact information.


Senate Leadership:
Senate President Peter Courtney - (D-Salem/Gervais/Woodburn)
Senate President Pro Tempore Senator Rick Metsger - (D-Welches)
Senate Majority Leader Senator Richard Devlin - (D-Tualatin)
Senate Republican Leader Senator Ted Ferrioli - (R-John Day)



Oregon State Senators

Below is a list of Oregon State Senators. Click on a senator name to find contact information including capitol/interim address, phone, fax, email, and web page addresses

Jason Atkinson-R
Alan C Bates-D
Suzanne Bonamici-D
Brian Boquist-R
Ginny Burdick-D
Margaret Carter-D
Peter Courtney-D
Richard Devlin-D
Jackie Dingfelder-D
Ted Ferrioli-R
Larry George-R
Fred Girod-R
Mark Hass-D
Betsy Johnson-D
Jeff Kruse-R
Rick Metsger-D
Laurie Monnes Anderson-D
Rod Monroe-D
Bill Morrisette-D
Frank Morse-R
David Nelson-R
Floyd Prozanski-D
Diane Rosenbaum-D
Martha Schrader-D
Bruce Starr-R
Chris Telfer-R
Joanne Verger-D
Vicki L Walker-D
Doug Whitsett-R
Jackie Winters-R



--------------------------------------------------------------------------------
Senator Jason Atkinson Back to Top
Party: R District: 2
Capitol Phone: 503-986-1702
Interim Phone: 541-955-0911
Capitol Address: 900 Court St. NE., S-415, Salem, OR, 97301
Interim Address: PO Box 1704, Grants Pass, OR, 97528
Email: [email protected]
Website: http://www.leg.state.or.us/atkinson

--------------------------------------------------------------------------------
Senator Alan C Bates Back to Top
Party: D District: 3
Capitol Phone: 503-986-1703
Capitol Address: 900 Court St. NE., S-205, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/bates

--------------------------------------------------------------------------------
Senator Suzanne Bonamici Back to Top
Party: D District: 17
Capitol Phone: 503-986-1717
District Phone: 503-627-0246
Capitol Address: 900 Court St. NE, S-403, Salem, OR, 97301
District Office Address: PO Box 990, Beaverton, OR, 97075
Email: [email protected]
Website: http://www.leg.state.or.us/bonamici

--------------------------------------------------------------------------------
Senator Brian Boquist Back to Top
Party: R District: 12
Capitol Phone: 503-986-1712
Capitol Address: 900 Court St NE, S-305, Salem,, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/boquist

--------------------------------------------------------------------------------
Senator Ginny Burdick Back to Top
Party: D District: 18
Capitol Phone: 503-986-1718
Capitol Address: 900 Court St. NE., S-213, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/burdick

--------------------------------------------------------------------------------
Senator Margaret Carter Back to Top
Party: D District: 22
Capitol Phone: 503-986-1722
Interim Phone: 503-282-6846
Capitol Address: 900 Court St. NE., S-209, Salem, OR, 97301
Interim Address: PO Box 3722, Portland, OR, 97208
Email: [email protected]
Website: http://www.leg.state.or.us/carter

--------------------------------------------------------------------------------
Senator Peter Courtney Back to Top
Party: D District: 11
Capitol Phone: 503-986-1600
Capitol Address: 900 Court St. NE., S-201, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/senate/senpres

--------------------------------------------------------------------------------
Senator Richard Devlin Back to Top
Party: D District: 19
Capitol Phone: 503-986-1700
Capitol Address: 900 Court St. NE., S-223, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/devlin

--------------------------------------------------------------------------------
Senator Jackie Dingfelder Back to Top
Party: D District: 23
Capitol Phone: 503-986-1723
Interim Phone: 503-493-2804
Capitol Address: 900 Court St. NE., S-407, Salem, OR, 97301
Interim Address: PO Box 13432, Portland, OR, 97213
Email: [email protected]
Website: http://www.leg.state.or.us/dingfelder

--------------------------------------------------------------------------------
Senator Ted Ferrioli Back to Top
Party: R District: 30
Capitol Phone: 503-986-1950
Capitol Address: 900 Court St. NE., S-323, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/ferrioli

--------------------------------------------------------------------------------
Senator Larry George Back to Top
Party: R District: 13
Capitol Phone: 503-986-1713
Capitol Address: 900 Court St. NE, S-307, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/georgel

--------------------------------------------------------------------------------
Senator Fred Girod Back to Top
Party: R District: 9
Capitol Phone: 503-986-1709
Capitol Address: 900 Court St. NE, S-421, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/girod

--------------------------------------------------------------------------------
Senator Mark Hass Back to Top
Party: D District: 14
Capitol Phone: 503-986-1714
District Phone: 503-641-2742
Capitol Address: 900 Court St. NE., S-419, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/hass

--------------------------------------------------------------------------------
Senator Betsy Johnson Back to Top
Party: D District: 16
Capitol Phone: 503-986-1716
Capitol Address: 900 Court St. NE., S-215, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/johnson

--------------------------------------------------------------------------------
Senator Jeff Kruse Back to Top
Party: R District: 1
Capitol Phone: 503-986-1701
Interim Phone: 541-673-7201
Capitol Address: 900 Court St. NE., S-316, Salem, OR, 97301
Interim Address: 636 Wild Iris Lane, Roseburg, OR, 97470
Email: [email protected]
Website: http://www.leg.state.or.us/kruse

--------------------------------------------------------------------------------
Senator Rick Metsger Back to Top
Party: D District: 26
Capitol Phone: 503-986-1726
Capitol Address: 900 Court St. NE., S-315, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/metsger

--------------------------------------------------------------------------------
Senator Laurie Monnes Anderson Back to Top
Party: D District: 25
Capitol Phone: 503-986-1725
Interim Phone: 503-618-3071
Capitol Address: 900 Court St. NE., S-413, Salem, OR, 97301
Interim Address: PO Box 1531 , Gresham, OR, 97030
Email: [email protected]
Website: http://www.leg.state.or.us/monnesanderson

--------------------------------------------------------------------------------
Senator Rod Monroe Back to Top
Party: D District: 24
Capitol Phone: 503-986-1724
Capitol Address: 900 Court St. NE, S-409, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/monroe

--------------------------------------------------------------------------------
Senator Bill Morrisette Back to Top
Party: D District: 6
Capitol Phone: 503-986-1706
Capitol Address: 900 Court St. NE., S-207, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/morrisette

--------------------------------------------------------------------------------
Senator Frank Morse Back to Top
Party: R District: 8
Capitol Phone: 503-986-1708
Capitol Address: 900 Court St. NE., S-311, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/morse

--------------------------------------------------------------------------------
Senator David Nelson Back to Top
Party: R District: 29
Capitol Phone: 503-986-1729
Interim Phone: 541-278-2332
Capitol Address: 900 Court St. NE., S-211, Salem, OR, 97301
Interim Address: 1407 NW Horn Ave., Pendleton, OR, 97801
Email: [email protected]
Website: http://www.leg.state.or.us/nelson_david

--------------------------------------------------------------------------------
Senator Floyd Prozanski Back to Top
Party: D District: 4
Capitol Phone: 503-986-1704
Interim Phone: 541-342-2447
Capitol Address: 900 Court St. NE., S-417, Salem, OR, 97301
Interim Address: PO Box 11511, Eugene, OR, 97440
Email: [email protected]
Website: http://www.leg.state.or.us/prozanski

--------------------------------------------------------------------------------
Senator Diane Rosenbaum Back to Top
Party: D District: 21
Capitol Phone: 503-986-1721
Interim Phone: 503-231-9970
Capitol Address: 900 Court St. NE., S-405, Salem, OR, 97301
Interim Address: 1125 SE Madison St., Suite 100B, Portland, OR, 97214
Email: [email protected]
Website: http://www.leg.state.or.us/rosenbaum

--------------------------------------------------------------------------------
Senator Martha Schrader Back to Top
Party: D District: 20
Capitol Phone: 503-986-1720
Capitol Address: 900 Court St. NE, S-425, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/schrader

--------------------------------------------------------------------------------
Senator Bruce Starr Back to Top
Party: R District: 15
Capitol Phone: 503-986-1715
Capitol Address: 900 Court St. NE., S-411, Salem, OR, 97302
Email: [email protected]
Website: http://www.leg.state.or.us/starrb

--------------------------------------------------------------------------------
Senator Chris Telfer Back to Top
Party: R District: 27
Capitol Phone: 503-986-1727
Capitol Address: 900 Court St. NE, S-423, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/telfer

--------------------------------------------------------------------------------
Senator Joanne Verger Back to Top
Party: D District: 5
Capitol Phone: 503-986-1705
Interim Phone: 541-756-4140
Capitol Address: 900 Court St. NE., S-401, Salem, OR, 97301
Interim Address: 3696 Broadway PMB 344, North Bend, OR, 97459
Email: [email protected]
Website: http://www.leg.state.or.us/verger

--------------------------------------------------------------------------------
Senator Vicki L Walker Back to Top
Party: D District: 7
Capitol Phone: 503-986-1707
Capitol Address: 900 Court St. NE., S-309, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/walker

--------------------------------------------------------------------------------
Senator Doug Whitsett Back to Top
Party: R District: 28
Capitol Phone: 503-986-1728
Interim Phone: 541-882-1315
Capitol Address: 900 Court St NE., S-303, Salem, OR, 97301
Interim Address: 23131 North Poe Valley Rd., Klamath Falls, OR, 97603
Email: [email protected]
Website: http://www.leg.state.or.us/whitsett

--------------------------------------------------------------------------------
Senator Jackie Winters Back to Top
Party: R District: 10
Capitol Phone: 503-986-1710
Capitol Address: 900 Court St. NE., S-301, Salem, OR, 97301
Email: [email protected]
Website: http://www.leg.state.or.us/winters

 

[DrFraud]

This is only open to psychologists because psychologists are the pre-eminent providers of mental health care. With more training in the diagnosis and treatment of mental illness than any other specialty, including psychiatrists, we truly are equipped to prescribe. More importantly, however, with our extensive training in empirically supported therapies, will be able to unprescribe medications to our patients. Most psychiatrists are not trained to provide quality psychotherapeutic treatment to their patients. As a result, patients are victimize, thinking they must stay on medication for disorders that are curable with CBT (e.g., GAD, OCD, Dysthymia, non-endogenous MDD, Panic Disorder, et cetera). Psychiatrists seem to think everything is caused by some rogue neurtransmitter. However, psychologists, with our superior training in research, know this is not the case.

Psychiatrists have tried to impede psychologist scope of practice expansion at every turn. Opposition to RxP is an echo of psychiatry's resistance against psychologists' right to diagnosis and conduct therapy. However, we eventually got the right to do these and do them we have. As my professors say, we got the right to do them, and now they're "finger licking good!"

Psychologist prescribing is truly an evoloution in mental health care and the patient is the one who will benefit. With psychologists at the helm of mental health care, I rest assured that the # of persons on medication will decrease. When you see a psychiatrist, you're more than likely to walk out with a script, not so with a psychologist!!!

The law could change tomorrow but before anyone new touches a script pad or d/cs any Rx, there better be a good malpractice insururer to back up your practice to make sure whoever is prescribed or unprescribe meds doesn't try to take your house when they start seeing a few local attorneys advertising about how easy it is to sue a psychologist for medication error.

Its also important to remember that reguardless of what the law says, a practioners prescription abiliy and scope will be limited by the malpractice umbrella that is purchased, and this could severly limit the scope for prescribing by psychologiests if anything larger than a one week Rx for ativan is ordered.

Basically, the short of it is that the larger the presciption scope that a practitioner wants, the more $$ it will cost to underwrite malpractice claims, and doing anything significant insofar as prescribing/unprescribing medications could and likely would be prohibitive for most practioners if they are not licensed medical doctors.

 

[edieb]

Go ahead, e-mail them. Unless you're a constituent, they are not going to listen and will probably resent a non-resident telling them, especially since you have no idea what issues the people in their region face...


Silly boy!

 

[zihuatanejo]

Go ahead, e-mail them. Unless you're a constituent, they are not going to listen and will probably resent a non-resident telling them, especially since you have no idea what issues the people in their region face...


Silly boy!

It is true that not all of us live in Oregon at this time. But, some of us might be interested in relocating to that state after residency or medical school. I, for one, love the pacific northwest, and could easily see myself relocating there. So, I would advise those of you who are residents of Oregon to clearly state that fact in your email. For those of you like me, who aren't residents of Oregon, you can instead emphasize that you were seriously considering relocating to Oregon after residency to practice as a psychiatrist or after medical school to enter a psychiatry residency program but that the recent passage of Oregon House Bill 2702, which allows psychologists to have prescriptive authority, has given you pause.

Thanks edieb for the helpful suggestions.

 

[Bluemirage]

I have decided that it is time for us to fight for our livelihoods. I have had enough of listening to the gloating of childish characters such as edieb. I will send an email to the Oregon state leadership and all of the Oregon state senators, in whose hands the future of psychiatry in Oregon and perhaps the rest of the country lies. We can't afford to lose this fight. I encourage all of you to send as many emails as you can outlining your concerns about allowing psychologists to prescribe and providing better suggestions for addressing the shortage of psychiatrists in underserved areas such as telepsychiatry, greater use of physician extenders such as NPs or PAs, or providing greater training in psychopharmacology for PCPs, or whatever other suggestions you can come up with.

FYI. For anyone that is interested in sending a letter/e-mail to these senators, I have attached a nice generic legislative letter created by someone in the American Psychiatric Association in post #142 of this thread that you can quickly fill in and e-mail out. The letter makes some very compelling arguments as to why psychologists should not be allowed to RX.

As for our friend Edieb, pay no attention to him. He's just an MD wannabe that is overcompensating for his insecurities because he did not have the fortitude to go through with his ambitions of getting his prereqs done and applying to medical school 2 years ago. Judging by his ignorant posts he obviously does not have any clue about the medical/biological sciences involved in RXing.

 

[Anasazi23]

Go ahead, e-mail them. Unless you're a constituent, they are not going to listen and will probably resent a non-resident telling them, especially since you have no idea what issues the people in their region face...


Silly boy!

Dear Silly boy,

Really? That's not what you said in this psychology thread:
http://forums.studentdoctor.net/showpost.php?p=7915192&postcount=574

or this one:

http://forums.studentdoctor.net/showpost.php?p=7944119&postcount=579

or in fact, this one either:

http://forums.studentdoctor.net/showpost.php?p=7980744&postcount=583

Let's talk straight up, and quit ignoring the elephant in the room.

1. You're upset that psychology as a career path generally sucks. Can't blame you there.

2. You don't give a rat's *** about patient care and "access." You care about increasing your income.

3. Besides increasing your income, you're interested in being a pseudo-para-professional medical provider, which at best, is all you can ever be with this.

I was in psychology grad school. I used to say I was going to get prescription rights too. Then I realized how cheap and stupid that was, and wanted to look at myself in the mirror without puking. I quit and went to med school to do it right.

Prescribing isn't as exciting as you think - trust me. It's not about ego, it's about doing right by the patient. It becomes routine and to any real doctor, is only a small part of their medical evaluation and treatment regimen.



Go to med school. You'll feel a lot better about yourself and will see this whole issue from a very different perspective once you learn to realize what you didn't know.

Or, you can continue along this path, trying to hide your psychiatrry-envy forever, all the while convincing yourself that you're somehow superior to an entire group with vastly more extensive medical training because you "unprescribe meds." Whatever helps you sleep at night I guess.

 

[ronin12]

Dear Silly boy,

Really? That's not what you said in this psychology thread:
http://forums.studentdoctor.net/showpost.php?p=7915192&postcount=574

or this one:

http://forums.studentdoctor.net/showpost.php?p=7944119&postcount=579

or in fact, this one either:

http://forums.studentdoctor.net/showpost.php?p=7980744&postcount=583

Let's talk straight up, and quit ignoring the elephant in the room.

1. You're upset that psychology as a career path generally sucks. Can't blame you there.

2. You don't give a rat's *** about patient care and "access." You care about increasing your income.

3. Besides increasing your income, you're interested in being a pseudo-para-professional medical provider, which at best, is all you can ever be with this.

I was in psychology grad school. I used to say I was going to get prescription rights too. Then I realized how cheap and stupid that was, and wanted to look at myself in the mirror without puking. I quit and went to med school to do it right.

Prescribing isn't as exciting as you think - trust me. It's not about ego, it's about doing right by the patient. It becomes routine and to any real doctor, is only a small part of their medical evaluation and treatment regimen.



Go to med school. You'll feel a lot better about yourself and will see this whole issue from a very different perspective once you learn to realize what you didn't know.

Or, you can continue along this path, trying to hide your psychiatrry-envy forever, all the while convincing yourself that you're somehow superior to an entire group with vastly more extensive medical training because you "unprescribe meds." Whatever helps you sleep at night I guess.

Right on the spot

It's a good idea to pass on this list to our colleagues and start sending emails to senators.
thanks

 

[FamMan]

Go ahead, e-mail them. Unless you're a constituent, they are not going to listen and will probably resent a non-resident telling them, especially since you have no idea what issues the people in their region face...


Silly boy!

I am from the NW and OR is one of the first places on my list. I will definitely email. Proof read with correct grammar, logical argument and all.

 

[kugel]

Who is licensed in New Mexico as a prescribing psychologist?

Lic # License Type Location
William Bernstein, Ph.D 0012C RxP Conditional Prescription Santa Fe, NM
Steven M. Cobb, Ph.D. 0005C RxP Conditional Prescription Roswell, NM
Rosalie S. Davis, Ph.D. 0008C RxP Conditional Prescription Albuquerque, NM
Marlin C. Hoover, Ph.D. 0007C RxP Conditional Prescription Flossmoor, IL
C. Alan Hopewell, Ph.D. 0009C RxP Conditional Prescription Fort Worth, TX of
Stuart S. Kelter, Psy.D. 0004C RxP Conditional Prescription Las Cruces, NM
Elaine Levine, Ph.D. 0001 RxP Prescription Certificate Las Cruces, NM
James M. Mash, Ph.D. 0013C RxP Conditional Prescription Taos, NM
Robert C. Mayfield, Ph.D. 0010C RxP Conditional Prescription Las Cruces, NM
E. Mario Marquez, Ph.D. 0002 RxP Prescription Certificate Albuquerque, NM
Robert E. Sherrill, Jr., Ph.D. 0011C RxP Conditional Prescription Farmington, NM
Soterios J. Soter, Ph.D. 0006C RxP Conditional Prescription Evanston, IL
Thomas C. Thompson, Ph.D. 0003 RxP Prescription Certificate Las Cruces, NM
Marianne G. Westbrook 0014C RxP Conditional Prescription Hobbs, NM

Using Yahoo Yellow Pages, I could not find any "Mash" in/near Taos,
nor any "Westbrook" in/near Hobbs,
nor any "Stuart Kelter" in/near Las Cruces,
nor any "Robert Mayfield" in/near Las Cruces,
nor any psychologist name Marquez in/near Albuquerque,
Could you tell me where they practice?
I realize Yahoo YP is not perfect.

Tinley, Il (where Marlin Hoover's office is) is a suburb of Chicago, hardly underserved.
Evanston, Il (where Dr Soter has an office) is even closer to Chicago.
Fort Worth is certainly not underserved.
(BTW, the others, I did find in the listed locations)