Oregon wants prescribing rights for Psychologists

[LovinPsych]

You're still in college, aren't you?

Where exactly are you going with this ? Attempting to analyze me ?

Back on topic.

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[silas2642]

Where exactly are you going with this ? Attempting to analyze me ?

Back on topic.

Ahhh, and he dodges the question! What year are you, a sophomore? I am not trying to analyze you (how is that even coming close to analysis)-- I am totally not qualified to even come close to analyzing you, I'm just asking you what level of education you have as you engage in this debate, as it is a relevant question. If for instance, you are a high school student or college student that makes your opinion a little less relevant than say, OldPsychDoc's or DocSamson's who have been in this game a long time and have a reputation for being pretty reasonable despite the fact that DocSamson trained at Longwood.

 

[Faebinder]

You have your opinion and I have mine . We are trained differently yes but that doesn't handicap us from learning how to write prescriptions . Seriously , I am noticing it's like a threat to some of you .

I disagree completely with you . It does help bridge the gap between the shortage of psychiatrists and written prescriptions from psychologists . If a patient or potential patient has mental health issues and problems , they may need medication so you rather them go without medicine just so only psychiatrists will be the only ones to write them? Seriously , what if some people can not afford to travel to see a psychiatrist but can see a psychologist and get some treatment . I said before perhaps our ability to write prescriptions could be limited , that still leaves a wide gap for psychiatrists in comparison to psychologists . Trust me i don't like being lumped up with the opposite ( psychiatrists ) in the first place , it's frustrating cause we are " nothing " alike in my opinion . Cause I am a Psychology Student on a mission to become a Clinical Psychologist not a psychiatrist . Perhaps only certain types of psychologists could write them , there's ways around this .

Obviously you don't subscribe to the "First do no harm."

 

[LovinPsych]

Ahhh, and he dodges the question! What year are you, a sophomore? I am not trying to analyze you (how is that even coming close to analysis)-- I am totally not qualified to even come close to analyzing you, I'm just asking you what level of education you have as you engage in this debate, as it is a relevant question. If for instance, you are a high school student or college student that makes your opinion a little less relevant than say, OldPsychDoc's or DocSamson's who have been in this game a long time and have a reputation for being pretty reasonable despite the fact that DocSamson trained at Longwood.

So then the fact I am not all the way into my journey makes my opinion less relevant ? How shallow is that ? I am a freshman in college , I am not a he , I am a she thanks .


" First do no harm " , and that means psychologists shouldn't be trained to learn to write prescriptions ? I keep noticing alot of my points are being avoided hmmm.

 

[silas2642]

So then the fact I am not all the way into my journey makes my opinion less relevant ? How shallow is that ? I am a freshman in college , I am not a he , I am a she thanks .


" First do no harm " , and that means psychologists shouldn't be trained to learn to write prescriptions ? I keep noticing alot of my points are being avoided hmmm.

The fact that you're a freshman psychology student in college means that your opinion is less educated, and yes, kind of less valuable. It's just kind of the way the real world works-- you count a lot as a human being and I can tell from these posts that you are full of passion, optimism, and that you are in all liklihood going to do something good with your life, but right now in reality, your opinion doesn't count because you don't know anything. You just don't know that you don't know.

I just finished my second year of medical school and I'll be hitting the wards as a third year-- I know that I am pond scum and that my opinion means close to nothing and I know volumes more than you do. My opinion isn't going to mean a lot because I don't have a very great fund of knowledge and the reason I'm there is to learn.

You stated your opinion and we get it-- you think that psychologists can get to learn how to write prescriptions. Fine, but this is based on a very limited amount of experience. There is a high amount of complexity to psychotropic medications and it takes YEARS of intense training to safely prescribe these medications. Right now the standard for most seems to be 4 years of med school followed by 4 years of residency. Psychologists want to skip the med school and do a little masters followed by like a year of supervision and then go completely solo. Bull crap. People are going to get hurt, and doctors don't like to see people get hurt, which is why they go into medicine-- trust me, no one goes into it for the money or prestige anymore.

 

[psm1776]

Hate to interrupt the intelligent dicourse but - FYI, LovinPsych is still in HS - see signature in post #251

WOOHOO! Almost time to graduate from HS ( Class of 2009 )! Argosy University here I come ( Class of 2013 ) !

I'm vastly misunderstood, but no matter what others say I hold my own .

Thanks for playing.

 

[Therapist4Chnge]

(the RxP bills want psychologist to have 400 "contact hours" which can be - and is - done entirely online - that's embarrassingly pitiful).

I believe the states vary on how much online training is allowed, though I am completely against ANY online component for any graduate level training, particularly in the healthcare field.

Clinical practica were in the medical centers and were full-time for a year. RxP bills such as Missouri's suggest a "weekly supervision" of undetermined length with any person who has prescription privileges (a dermatologist would be eligible) which could also be over the phone, and the supervisor could be anywhere in the country.

How is this different than what is required of NP/PA supervision (in non-NP independent practice states)?

Their training was by medical professionals (not psychologists) designed by medical professionals (not psychologists) and they were supervised by medical professionals (not psychologists).

It is my understanding that many people teaching in medical schools are not physicians, yet they are the experts in their area in which they teach; many of the same professors are teaching in the RxP programs. The supervision is done by an MD/DO.

They practiced in medical centers (not psychology private practice offices), surrounded by medical professionals, labs, facilities, all available for consultation. The RxP bills would have psychologists practice anywhere they please. In fact, it would give RxP to someone who may have never stepped foot in a hospital in his life, except maybe to be born.

Because it was in the military then extra consultations with the psychologist and other medical professionals were free. The patients could very easily be referred to physicians nearby.

How would this be different than another prescriber using a private practice? Both would have to refer for labs, as they would not do that on-site. Consultations would also be handled in the same fashion.

The prescribing psychologists were free of all financial pressures since their income was the same no matter what they did. (One of the Louisiana prescribing psychologists says he sometimes writes 15-20 prescriptions a day, and some of them write 25 per day ... so much for psychologists not being "prescription mills").

N=1.

I am sure no other prescribing professionals have ever been in such a situation. Insurance is billed based on the consultation and not the receipt of a prescription.

As they were in the military, they did not treat anyone under 18 or over 65, nor did they treat anyone with a serious medical or psychiatric illness. Now would the RxP devotees agree to THAT in their bills?

And yet none of the non-military prescribers that work in hospitals and private practices treating (child and adult) patients with a wider range of demographics have been cited for any infractions, official complaints, or anything else that be be construed as inadequate treatment.

By the way, if you think the DoD undertook this project because anyone in the military wanted this or thought it was a good idea, guess again.

....and yet the results allowed thousands of people to receive services that they may not have been able to receive, and/or receive in a timely manner.

It was all politics: The godfather of RxP in APA, Patrick DeLeon, is a former aide to Sen. Daniel Inouye of Hawaii, who sat on the powerful Appropriations Committee and had oversight duties of the military budget. It was he who "asked" the military to undertake this.

I'm not sure if you've ever worked on the Hill or with PACs, but everything that passes through the halls is the result of 'horse trading', so singling out one bill over another is disengenuine.

 

[silas2642]

Hate to interrupt the intelligent dicourse but - FYI, LovinPsych is still in HS - see signature in post #251



Thanks for playing.

I remember my high school graduation party... those were the days.

 

[LovinPsych]

The fact that you're a freshman psychology student in college means that your opinion is less educated, and yes, kind of less valuable. It's just kind of the way the real world works-- you count a lot as a human being and I can tell from these posts that you are full of passion, optimism, and that you are in all liklihood going to do something good with your life, but right now in reality, your opinion doesn't count because you don't know anything. You just don't know that you don't know.

I just finished my second year of medical school and I'll be hitting the wards as a third year-- I know that I am pond scum and that my opinion means close to nothing and I know volumes more than you do. My opinion isn't going to mean a lot because I don't have a very great fund of knowledge and the reason I'm there is to learn.

You stated your opinion and we get it-- you think that psychologists can get to learn how to write prescriptions. Fine, but this is based on a very limited amount of experience. There is a high amount of complexity to psychotropic medications and it takes YEARS of intense training to safely prescribe these medications. Right now the standard for most seems to be 4 years of med school followed by 4 years of residency. Psychologists want to skip the med school and do a little masters followed by like a year of supervision and then go completely solo. Bull crap. People are going to get hurt, and doctors don't like to see people get hurt, which is why they go into medicine-- trust me, no one goes into it for the money or prestige anymore.

Alright , let's say all of that is true , fair enough but I must ask why point out my opinion doesn't have much value if yours and everyone else's here on certain levels don't either? I don't find that relevant because of the nature of your posters you've brought a topic on . makes no sense to me , I am failing to find that logic ?

You got one thing right for sure , I am full of passion , optimism and I will do something great with my life .

Perhaps I've not myself clear enough , I disagree with not getting proper knowledge of medicine , that's crazy . I disagree with skipping as well . I personally think we should be allowed to prescribe but with proper education . I do believe it should be limited and overseen by psychiatrists . I fail to see how it's possible without med school , but maybe I am missing something....

 

[LovinPsych]

Hate to interrupt the intelligent dicourse but - FYI, LovinPsych is still in HS - see signature in post #251



Thanks for playing.

I've graduated duh , 2009 is already here , not like I said 2010 my gosh read already . I've gotta update my life on a stupid forum get over yourself .

The arrogance of alot of college and med students sicken me .

 

[benjee]

Hate to interrupt the intelligent dicourse but - FYI, LovinPsych is still in HS - see signature in post #251



Thanks for playing.

Oh, god. No wonder the mindset is completely different. The kid have no idea of "Do No Harm first" means.

 

[silas2642]

I believe the states vary on how much online training is allowed, though I am completely against ANY online componentt for any graduate level training, particularly in the healthcare field.



How is this different than what is required of NP/PA supervision (in non-NP independent practice states)?



It is my understanding that many people teaching in medical schools are not physicians, yet they are the experts in their area in which they teach; many of the same professors are teaching in the RxP programs.


How would this be different than another prescriber using a private practice? Both would have to refer for labs, as they would not do that on-site. Consultations would also be handled in the same fashion.



N=1.

I am sure no other prescribing professionals have ever been in such a situation. Insurance is billed based on the consultation and not the receipt of a prescription.



And yet none of the non-military prescribers that work in hospitals and private practices treating (child and adult) patients with a wider range of demographics have been cited for any infractions, official complaints, or anything else that be be construed as inadequate treatment.



....and yet the results allowed thousands of people to receive services that they may not have been able to receive, and/or receive in a timely manner.



I'm not sure if you've ever worked on the Hill or with PACs, but everything that passes through the halls is the result of 'horse trading', so singling out one bill over another is disengenuine.

Yes, but this happens pretty much only in the first year during basic sciences like biochemistry, molecular biology, etc. When you get to the real "meat" of med school, it's pretty much all physicians who are teaching the med students. And don't think that we don't bitch about PhD's teaching us the basic sciences-- we complain plenty. We hate memorizing crazy little details about obscure proteins that are completely irrelevant to the practice of medicine.

So this Oregon bill was proposing like what, 400 hours of supervised clinical training? Is this some kind of joke or something? Because that is the equivalent of like a med school rotation. Its enough to get your feet wet and sort of get the idea, but certainly not enough to have a clue as to what you're doing.

 

[Therapist4Chnge]

*MOD NOTE: Please keep this professional....I think we are old enough for that, right?*

....and back to the discussion.

 

[benjee]

I've graduated duh , 2009 is already here , not like I said 2010 my gosh read already . I've gotta update my life on a stupid forum get over yourself .

The arrogance of alot of college and med students sicken me .

yeah, even you've graduated, you still need to go thru meds school and medical training first before you can prescribe. sorry for all these hassle you need to go thru. good luck .

 

[LovinPsych]

*MOD NOTE: Please keep this professional....I think we are old enough for that, right?*

....and back to the discussion.

Thank you , was thinking the samething.


I stand by my opinion on this matter .

 

[silas2642]

I've graduated duh , 2009 is already here , not like I said 2010 my gosh read already . I've gotta update my life on a stupid forum get over yourself .

The arrogance of alot of college and med students sicken me .

Hmmm... So are you in college now or are you starting college this fall? Don't drink too much. But don't study too hard either. You may not even like psychology.

 

[Therapist4Chnge]

Yes, but this happens pretty much only in the first year during basic sciences like biochemistry, molecular biology, etc. When you get to the real "meat" of med school, it's pretty much all physicians who are teaching the med students. And don't think that we don't bitch about PhD's teaching us the basic sciences-- we complain plenty. We hate memorizing crazy little details about obscure proteins that are completely irrelevant to the practice of medicine.

Who needs to learn the details anyway....note my ironic tone.

So this Oregon bill was proposing like what, 400 hours of supervised clinical training? Is this some kind of joke or something? Because that is the equivalent of like a med school rotation. Its enough to get your feet wet and sort of get the idea, but certainly not enough to have a clue as to what you're doing.

I happen to agree that these hours need to be increased, in addition to a number of other changes I'd like to see: the online component stripped, stricter training/supervision requirements, more uniformed curriculums, etc.

 

[silas2642]

Who needs to learn the details anyway....note my ironic tone.



I happen to agree that these hours need to be increased, in addition to a number of other changes I'd like to see: the online component stripped, stricter training/supervision requirements, more uniformed curriculums, etc.

Well, when it comes to like all the possible amino acid changes that they think may be changed in some obscure disease that only affects 100 people on a remote island, yeah, the details tend to be less important than say, the details of diabetes mellitus, or the details of pharm.

There is so much volume in med school-- you have to learn which details are important and which ones aren't. The ones that you learn in first year during the basic sciences pretty much aren't. But that's all med school stuff.

 

[LovinPsych]

Hmmm... So are you in college now or are you starting college this fall? Don't drink too much. But don't study too hard either. You may not even like psychology.

I'm in it now , taking summer classes to get a head start . Been accepted since March . I don't drink at all , refuse to touch it , it's poison imo . I took psychology in HS got nothing but 100s in it , the more I dig into the more i am falling inlove so i believe I will be just fine .

 

[Therapist4Chnge]

*MOD NOTE: Okay back on topic now....-t4c*

 

[CGOPsych]

I believe the states vary on how much online training is allowed, though I am completely against ANY online component for any graduate level training, particularly in the healthcare field.

I challenge you to cite or produce evidence that ANY RxP bill or state regulation of psychologist RxP would limited how much online training is allowed. The bills cite the RxP "master's degree" or APA-dictated 400-hour model. There's no variation ... these clowns want online medical school for psychologists to count as much as any other education.

CSPP (rebranded as "Alliant University") has reported that fully half of the RxP "master's degrees" it awards are done via online classes. The other schools also offer correspondence school medical training, including Nova Southeastern and Farleigh Dickinson.

That is beyond pathetic, it's dangerous, as is the RxP campaign as a whole. It shows how little respect these people have for medical training, and for themselves.

As I said before, these hucksters are the people who dumbed-down psychology training and now they want to dumb-down medical training.

 

[Therapist4Chnge]

I challenge you to cite or produce evidence that ANY RxP bill or state regulation of psychologist RxP would limited how much online training is allowed. The bills cite the RxP "master's degree" or APA-dictated 400-hour model. There's no variation ... these clowns want online medical school for psychologists to count as much as any other education.

I stand corrected. I believe an earlier iteration of what eventually became HB 1426 (Louisiana) had a section that spoke specifically to when, how, and where the classes should be taught. Unfortunately that part seems to have not made the final cut.

The other schools also offer correspondence school medical training, including Nova Southeastern and Farleigh Dickinson.

NSU's program is residentially-based. Some reference materials, syllabi, and other resources are placed online, though the training is all done in the classroom and/or lab space. While I think the program still needs to make some improvements (require more practica hours [seperate from the licensing hours req], expand a few of the classes, and have more MD/DO instructors), it is a much better attempt than some of the other programs out there. I like the path that NM St. is going, though I have strong reservations for allowing ANY training that isn't 100% residential. As for Alliant and the like.....I don't agree with their offerings, format, or training.

 

[kugel]

Besides the DOD report (which I admit I hadn't read until today), what other data do we have? There prob is more. If it's in this thread, I admit I've missed it.

 

[billypilgrim37]

Besides the DOD report (which I admit I hadn't read until today), what other data do we have?

That's really the issue. The question, "Can psychologists prescribe psychotropics safely?", is an empirical one, and not one that is going to be settled by blood fights between overworked M3s and hypomanic teenagers. And we aren't going to have this data for a long time, and the data we will have for quite a while will be necessarily cherry-picked.

Unless there is somehow some sort of incentives to actually encourage people to work in under-served areas (other than less competition from other providers), it's hard to believe that simply expanding prescribing priveleges will result in significant improvements in access to care. There are many better policy ideas to expand access to psychiatric care than handing prescription pads to people who we don't know can prescribe safely yet. There are tons of questions on here about loan repayment plans and other incentive programs that would make much more sense.

Market failure. It's a beautiful thing.

 

[LovinPsych]

See , I keep seeing repeatedly what is wrong with psychologists writing prescriptions in between bashing or stabbing at one another but I don't see is , what is the harm in making medical school part of training as an option for inspiring psychologists ( who want to WRITE prescriptions ) so they can write prescriptions on a " limited basis " . I really don't know how many times I can keep writing that . I am talking on a "limited basis " with " medical school training " . I'll say it again....medical school training and on a limited basis " . ie overseen by " psychiatrists " . The ones with the full proper " background " to help keep from " malpractice " of the patients . l




Don't know how many more times , I can say it.....it keeps being dismissed and not "touched " on.

Which leaves me to believe I could be making points cause of what i have said before is only addressed aside from this ...


btw I also said perhaps only " certain " psychologists could write them ...

 

[whopper]

Lovinpsyche--several of us have no problem with psychologists prescribing if they get the right medical training.

The Oregon law IMHO isn't enough medical training.

 

[LovinPsych]

Lovinpsyche--several of us have no problem with psychologists prescribing if they get the right medical training.

The Oregon law IMHO isn't enough medical training.

From the way I've read here that hasn't been the " only " case here . I do agree the Oregon Law isn't enough medical training . But I can't ignore what all else has been said .

 

[Thorazine]

my opinion on this subject changes almost every day.

if psychologists want medical school training to write prescriptions, then GO TO MEDICAL SCHOOL. if you need physician oversight and supervision, then the physician can just write the script. and psychologists should NEVER be allowed to interpret labs, that is just ridiculous. it took me 2 years of basic science and 2 years of rotations in every field of medicine to learn that.

but i do see the benefit of having a psychologist being able to write prescriptions with a LIMITED FORMULARY if a physician isnt readily available.

we need to fix the distribution problem. maybe there needs to be some legislation where an ADEQUATELY trained psychologist can only prescribe if there is no psychiatrist in a certain mile radius. or psychologists should only be allowed to prescribe to patients they do long-term therapy with (if they also need meds). or physicians need to first evaluate a patient for co-morbid medical issues, and cherry pick patients for the RxP. i dont think psychologists should be allowed to do the 15-minute med check appointment that insurance companies have forced some psychiatrists into.

i dont know. i admit i know nothing even as i am about to start residency. but the laws on this just seem too lax. people will get the $$ in their eyes, and the few rigorous clinical RxP training programs could be overshadowed by the fly-by-night, for-profit online diploma mills. that is DEFINITELY not in the patient's best interest.

 

[LovinPsych]

my opinion on this subject changes almost every day.

if psychologists want medical school training to write prescriptions, then GO TO MEDICAL SCHOOL. if you need physician oversight and supervision, then the physician can just write the script. and psychologists should NEVER be allowed to interpret labs, that is just ridiculous. it took me 2 years of basic science and 2 years of rotations in every field of medicine to learn that.

I agree they should attend medical school to write prescriptions , just limited . I don't believe psychologists should have the same writing power as a psychiatrist . I am unsure if i agree with you take on the labs though .

but i do see the benefit of having a psychologist being able to write prescriptions with a LIMITED FORMULARY if a physician isnt readily available.

I do agree here too .

we need to fix the distribution problem. maybe there needs to be some legislation where an ADEQUATELY trained psychologist can only prescribe if there is no psychiatrist in a certain mile radius. or psychologists should only be allowed to prescribe to patients they do long-term therapy with (if they also need meds). or physicians need to first evaluate a patient for co-morbid medical issues, and cherry pick patients for the RxP. i dont think psychologists should be allowed to do the 15-minute med check appointment that insurance companies have forced some psychiatrists into.

I believe Clinical Psychologists should be the ones allowed to write prescriptions that are limited . What exactly is a 15 minute med check ?

i dont know. i admit i know nothing even as i am about to start residency. but the laws on this just seem too lax. people will get the $$ in their eyes, and the few rigorous clinical RxP training programs could be overshadowed by the fly-by-night, for-profit online diploma mills. that is DEFINITELY not in the patient's best interest.

I do agree here as well , the laws are way too lax and the outcome could be very deadly and costly . $$$ anymore is the rule of everything so this easily could get out of hand .

 

[Faebinder]

I agree they should attend medical school to write prescriptions , just limited . I don't believe psychologists should have the same writing power as a psychiatrist . I am unsure if i agree with you take on the labs though.

Really? You believe the clinical psychologist is trained to diagnose prolonged QTc interval from antipsychotics? What about the change of mental status from elevated ammonia secondary to depakote vs. the actual mental disease? At what point will you call the prolactin too elevated and stop haldol or risperdal? What's the white count drop that will prompt you to have clozaril stopped?

The list is endless and clearly if you insist on claiming equal lab interpretation capability or lack of importance of this ability to be up to snuff then you fit into the people that "don't know that they don't know what they don't know.."

 

[LovinPsych]

Really? You believe the clinical psychologist is trained to diagnose prolonged QTc interval from antipsychotics? What about the change of mental status from elevated ammonia secondary to depakote vs. the actual mental disease? At what point will you call the prolactin too elevated and stop haldol or risperdal? What's the white count drop that will prompt you to have clozaril stopped?

The list is endless and clearly if you insist on claiming equal lab interpretation capability or lack of importance of this ability to be up to snuff then you fit into the people that "don't know that they don't know what they don't know.."

Jesus christ... It's like you don't "read" well , I said for the millionth time I am unsure if I agree . UNSURE you know something that is uncertain . Before slamming me with big fancy medical questions , read my post say 5 times before you react . It just makes you come off like all you want to do is banter against what I say .

If Clinical Psychologists attend medical school to gain facts on such questions , wouldn't that help them qualify to read labs ? PLEASE correct me I am so wrong ....

Hence to what I said before they should attend medical school . If say the amount of time it takes to learn such labs , is equivalent to how long it takes for a psychiatrist to , then I'd say Clinical Psychologists are not qualified to do such . Read the post again before responding to this one . Thanks .

 

[grandslam521]

Jesus christ... It's like you don't "read" well , I said for the millionth time I am unsure if I agree . UNSURE you know something that is uncertain . Before slamming me with big fancy medical questions , read my post say 5 times before you react . It just makes you come off like all you want to do is banter against what I say .

If Clinical Psychologists attend medical school to gain facts on such questions , wouldn't that help them qualify to read labs ? PLEASE correct me I am so wrong ....

Hence to what I said before they should attend medical school . If say the amount of time it takes to learn such labs , is equivalent to how long it takes for a psychiatrist to , then I'd say Clinical Psychologists are not qualified to do such . Read the post again before responding to this one . Thanks .

The problem is that no one wants to spend 4 years in undergrad, 5-7 years to obtain a doctorate in psychology, 4 years of medical school and 4 years of residency for a total of 17-19 years of schooling just to be a clinical psychologist that can prescribe. Perhaps a shorter route would be a 2 year masters degree in counseling, then head off to medical school.

 

[LovinPsych]

The problem is that no one wants to spend 4 years in undergrad, 5-7 years to obtain a doctorate in psychology, 4 years of medical school and 4 years of residency for a total of 17-19 years of schooling just to be a clinical psychologist that can prescribe. Perhaps a shorter route would be a 2 year masters degree in counseling, then head off to medical school.

That is a lot of darn years of schooling .....what would it entail for psychologists to have limited knowledge of medicine ? or is that not possible ?

Also how does the states that have passed this deal with it?

 

[psm1776]

What exactly is a 15 minute med check ?

15 med check= a sometimes necessary evil that psychiatrists do in order to practice medicine (see ancillary definition of "evil insurance companies")

arrogance = not knowing what a 15 med even is, all the while loudly proclaiming opinionated conjecture; while also rudely dismissing the posts of people who actually practice medicine.

Seriously, there is nothing wrong with not knowing and trying to educate yourself, but please at least try to maintain a respectful tone on this forum.
Especially since you don't know diddly. (did I even spell that right?)

 

[LovinPsych]

15 med check= a sometimes necessary evil that psychiatrists do in order to practice medicine (see ancillary definition of "evil insurance companies")

arrogance = not knowing what a 15 med even is, all the while loudly proclaiming opinionated conjecture; while also rudely dismissing the posts of people who actually practice medicine.

Seriously, there is nothing wrong with not knowing and trying to educate yourself, but please at least try to maintain a respectful tone on this forum.
Especially since you don't know diddly. (did I even spell that right?)

Unlike many " medical students " here I don't pretend to know " everything " . As for respect ? I agree but it goes both ways .

Anyways , good to know .

 

[PsyDGrrrl]

The question, "Can psychologists prescribe psychotropics safely?", is an empirical one, and not one that is going to be settled by blood fights between overworked M3s and hypomanic teenagers.

This.

 

[LovinPsych]

This ?

 

[psm1776]

That's really the issue. The question, "Can psychologists prescribe psychotropics safely?", is an empirical one, and not one that is going to be settled by blood fights between overworked M3s and hypomanic teenagers. And we aren't going to have this data for a long time, and the data we will have for quite a while will be necessarily cherry-picked.

Unless there is somehow some sort of incentives to actually encourage people to work in under-served areas (other than less competition from other providers), it's hard to believe that simply expanding prescribing priveleges will result in significant improvements in access to care. There are many better policy ideas to expand access to psychiatric care than handing prescription pads to people who we don't know can prescribe safely yet. There are tons of questions on here about loan repayment plans and other incentive programs that would make much more sense.

Market failure. It's a beautiful thing.

I know a lot of NP's, some are better than others, but I feel better about them prescribing than psychologists because they do have the basic science/medical background, just by virtue of their education. I think it's very hard to gain the acumen and intuitive sense of the art of prescribing in a completely theoretical framework ie online/classroom learning. Hands on knowledge is invaluable.

Also, time and data will tell - the facts are just not there.

Having said that - the more I learn, the less I seem to know.

 

[silas2642]

Really? You believe the clinical psychologist is trained to diagnose prolonged QTc interval from antipsychotics? What about the change of mental status from elevated ammonia secondary to depakote vs. the actual mental disease? At what point will you call the prolactin too elevated and stop haldol or risperdal? What's the white count drop that will prompt you to have clozaril stopped?

The list is endless and clearly if you insist on claiming equal lab interpretation capability or lack of importance of this ability to be up to snuff then you fit into the people that "don't know that they don't know what they don't know.."

Another question about this Oregon law-- what exactly are the restrictions on it? Are they allowed to write for any psychotropic medications? What happens are there are complications with a drug-- can they order the appropriate blood tests, ekgs, etc.? If there is no physician to back them up and they can't order these tests, where do the pts go, to their pcp?

 

[psm1776]

What happens are there are complications with a drug-- can they order the appropriate blood tests, ekgs, etc.? If there is no physician to back them up and they can't order these tests, where do the pts go, to their pcp?

Even if they were able to order labs - I seriously doubt the ability to interpret them; for lack of experience. You know, I really even wonder if they could look at a rash and be able to tell if it's drug related or not.

Pretty tall order. There's a reason why physicians go through rigorous training - it's not *just* knowing psychoparm (& those rogue neurotransmitters) - way more complicated than that.

 

[whopper]

This thread is kinda like a chatroom--and several of the arguments are being repeated.

I agree they should attend medical school to write prescriptions , just limited . I don't believe psychologists should have the same writing power as a psychiatrist . I am unsure if i agree with you take on the labs though

Lab interpretation does require the whole gamut of medical school training since an abnormal lab can signify an abnormality in any system--respiratory, circulatory, immune, muscoskeletal, nervous system etc.

And psyche meds can affect any of the systems.

Most doctors do not become proficient in interpretating labs in over 1 year of post medical training in residency programs. The Oregon law's clinical training is nowhere near as structured as a residency, nor does its medical academic training come anywhere near that of medical school.

As I mentioned before, if psychologists want to prescribe, and don't want to go to medical school--get a PA or NP degree, that is not as difficult or as rigorous, and IMHO is a much better standard than the Oregon law and is accepted in all states (as far as I now--correct me if I'm wrong). In fact do so and work with a psychiatrist. I'd love to work with a psychologist since both of our fields don't teach elements of the other. It'd be a winning combination.

 

[LovinPsych]

This thread is kinda like a chatroom--and several of the arguments are being repeated.



Lab interpretation does require the whole gamut of medical school training since an abnormal lab can signify an abnormality in any system--respiratory, circulatory, immune, muscoskeletal, nervous system etc.

And psyche meds can affect any of the systems.

Most doctors do not become proficient in interpretating labs in over 1 year of post medical training in residency programs. The Oregon law's clinical training is nowhere near as structured as a residency, nor does its medical academic training come anywhere near that of medical school.

As I mentioned before, if psychologists want to prescribe, and don't want to go to medical school--get a PA or NP degree, that is not as difficult or as rigorous, and IMHO is a much better standard than the Oregon law and is accepted in all states (as far as I now--correct me if I'm wrong). In fact do so and work with a psychiatrist. I'd love to work with a psychologist since both of our fields don't teach elements of the other. It'd be a winning combination.

yes i so agree there i feel we'd help eachother . So doing a PA or NP would help this along ? Why doesn't the Oregon law state this perhaps? Sounds reasonable ...

 

[notdeadyet]

yes i so agree there i feel we'd help eachother . So doing a PA or NP would help this along ? Why doesn't the Oregon law state this perhaps?

Because becoming an NP or PA would require several full-time years of work. It's an entirely separate career path and competitive in its own right. It's not like a cert course.

 

[whopper]

Why doesn't the Oregon law state this perhaps? Sounds reasonable ...

That's a point why the Oregon law shouldn't be passed. There is a way that can be done in a manner that goes with the current laws.

A NP or PA degree is more work than the Oregon law for psychologists, but it provides a better level of training that's not as tough or as long as medschool. Its also safer. I can see a possibility that even if the Oregon law passes, it could be struck down later on by legal challenges, or struck down in a defacto sense by lawsuits. It would also limit such practitioners to only practice in states that have allowed for this, which would only be 3 if the law passes, and its been unsuccessful in several other states (at least 10 as far as I know). By getting an NP or PA degree, a psychologist could practice in (as far as I'm aware) any state in the country, and argue quite effectively that their degree is one already accepted by the medical community with a large pool of data to support its validity in training & effectiveness on the field.

 

[pingouin]

At this point, this thread is pretty much and not going anywhere productive. Closing it at this time per mod consensus.