pa/msw

[jwtaylor]

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i am really interested in clinical medicine and mental health in particular. i have very little desire to be an MD, especially a psychiatrist. i had considered a clinical psych doctorate (psyd or phd) but it doesn't exactly provide enough biomedical training for me. i was considering an MSW because of the psychosocial training it offers. my goal here is to be able to provide cognitive behavioral psychotherapy but also have an aptitude in clinical medicine. i can see where the PA would allow me to work closely with medications and such and provide me with the medical training i desire if for nothing else than just interest. i just dont know where someone with that sort of skill set would be employed or how well they would fit into the current treatment models. i guess an appropriate follow up would be, does psychiatric PA training provide a solid foundation in psychotherapy models? and do psychiatric PA's regularly provide psychotherapy?

 

[deleted6669]

i am really interested in clinical medicine and mental health in particular. i have very little desire to be an MD, especially a psychiatrist. i had considered a clinical psych doctorate (psyd or phd) but it doesn't exactly provide enough biomedical training for me. i was considering an MSW because of the psychosocial training it offers. my goal here is to be able to provide cognitive behavioral psychotherapy but also have an aptitude in clinical medicine. i can see where the PA would allow me to work closely with medications and such and provide me with the medical training i desire if for nothing else than just interest. i just dont know where someone with that sort of skill set would be employed or how well they would fit into the current treatment models. i guess an appropriate follow up would be, does psychiatric PA training provide a solid foundation in psychotherapy models? and do psychiatric PA's regularly provide psychotherapy?

a pa with an interest in psych can do additional training in psych and have a scope of practice essentially identical to that of a psychiatrist.

 

[ProZackMI]

i am really interested in clinical medicine and mental health in particular. i have very little desire to be an MD, especially a psychiatrist. i had considered a clinical psych doctorate (psyd or phd) but it doesn't exactly provide enough biomedical training for me. i was considering an MSW because of the psychosocial training it offers. my goal here is to be able to provide cognitive behavioral psychotherapy but also have an aptitude in clinical medicine. i can see where the PA would allow me to work closely with medications and such and provide me with the medical training i desire if for nothing else than just interest. i just dont know where someone with that sort of skill set would be employed or how well they would fit into the current treatment models. i guess an appropriate follow up would be, does psychiatric PA training provide a solid foundation in psychotherapy models? and do psychiatric PA's regularly provide psychotherapy?

I'm a psychiatrist, so my first inclination is to say "go to med school and become a psychiatrist!" We could use more sharp, American-born and educated psychiatrists. However, if you don't want to go that route, look for a PsyD program that is more biomedically-based. Another option, do a PsyD or PhD and then go for a post doc MS in psychopharm as more states are granting med-psychologists RxPs.

An MSW/PA combo would be a waste of time. What do you want? To be a therapist or a PA? PAs don't do psychotherapy and rarely specialize. You could do an MSN and be ANP (advanced nurse practitioner) with a speciality in psych. That would give you more training than a PA degree, which is geared toward primary care medicine.

BTW, MSWs typically don't make much money, so if that's important to you, don't waste your time. An NP or PA can make a lot more money. Ultimately, you'll have to decide what your primary goal is. If you go the PA route, don't bother with psych.

 

[deleted6669]

"PAs don't do psychotherapy and rarely specialize."

zack- you need to stop generalizing about pa's and what they do. in prior posts you have admitted you have very little contacts with pa's. most pa's today specialze. look in any pa journal. there are lots of ads for pa's in surgery, interventional rads, nephrology, em, rheumatology, neurology psych, etc at real hospitals like the mass general, dana farber, cook county,the mayo clinic, etc
pa's can and do provide psychotherapy with additional training and residencies. you obviously prefer np's and that's fine...talk about them but stop generalizing about the pa field since you obviously know NOTHING about it. by the way here is a link to SOME of the residencies pa's can do when we are busy not specializing: www.appap.org
and here is the professional society of psych pa's that doesn't exist because pa's don't specialize.....

http://www.psychpa.com/

also a link to an article about psych pa's in a psychiatry journal(one of many that come up with a simple websearch)
http://pn.psychiatryonline.org/cgi/content/full/38/13/5

 

[jwtaylor]

you raise some good points. im just tired of not knowing what i want to do with my interests. im a philosophy major because i love philosophy. i dont necessarily want to do that for a profession (whatever profession that would even be). as far as psych classes, i've had a few and enjoy it. i currently work for a mental health agency and have for over a year. i take advantage of all of the continuing education opportunities that are geared towards masters and doctoral level providers. while they dont do anything towards any degrees, i learn a lot nonetheless. i dont think its arrogant to say that i'm more of an intellectual. my interests are very academic, but i also have a strong desire to be in the clinic with patients and clients. sometimes i watch nurse educators teaching some classes i go to and i think that i'd love to do their job. i want to research the emotional and physical damage behind humans rights violations. those are my interests and im struggling to assemble them into a "next step".

 

[ProZackMI]

"PAs don't do psychotherapy and rarely specialize."

zack- you need to stop generalizing about pa's and what they do. in prior posts you have admitted you have very little contacts with pa's. most pa's today specialze. look in any pa journal. there are lots of ads for pa's in surgery, interventional rads, nephrology, em, rheumatology, neurology psych, etc at real hospitals like the mass general, dana farber, cook county,the mayo clinic, etc
pa's can and do provide psychotherapy with additional training and residencies. you obviously prefer np's and that's fine...talk about them but stop generalizing about the pa field since you obviously know NOTHING about it. by the way here is a link to SOME of the residencies pa's can do when we are busy not specializing: www.appap.org
and here is the professional society of psych pa's that doesn't exist because pa's don't specialize.....

http://www.psychpa.com/

also a link to an article about psych pa's in a psychiatry journal(one of many that come up with a simple websearch)
http://pn.psychiatryonline.org/cgi/content/full/38/13/5

I don't prefer NPs to PAs, but I have worked with more psych ANPs. I've never encountered a PA who "specializes" in psychiatry. I would also disagree with your assessment that PAs have the same scope of practice as psychiatrists. Most PAs in MI, from what I've seen as a PHYSICIAN, work primary care (e.g., IM, FP). I do know a few at Beaumont who do emergency med and surg, but never met any psych PAs so far. By far, you see more ANP at CMH and at hospitals.

As far as the OP's question, an MSW/PA is probably unnecessary and wouldn't pay off. If you want to go the PA route, and will have adequate training, why bother with an MSW? Also, keep in mind, most psychiatrists, and presumably PAs, don't engage in psychotherapy. There is simply no time for that.

 

[guetzow]

Faculty at my PA Alma Mater are well published in psych, and local institutions (Including the VA) have psych clinics staffed with PAs.

RE: jwtaylor. Another great reason to become a PA is because PAs work in virtually all specialties (Not just FP/IM); more so than NPs. So, if you ever get annoyed by folks like prozack, you can always switch to another, more profitable, specialty 🙂

 

[ProZackMI]

Faculty at my PA Alma Mater are well published in psych, and local institutions (Including the VA) have psych clinics staffed with PAs.

RE: jwtaylor. Another great reason to become a PA is because PAs work in virtually all specialties (Not just FP/IM); more so than NPs. So, if you ever get annoyed by folks like prozack, you can always switch to another, more profitable, specialty 🙂

Yes, no surprise given the quality of care at most VAs.

 

[deleted6669]

Yes, no surprise given the quality of care at most VAs.

that's where the patients are... and if the docs aren't going to step up and provide the service someone has to......sorry if taking care of veterans doesn't make the lexus payment.....there's always the hysterical millionares obsessing about whether or not people like them...maybe you should limit your practice to them(if you haven't already).

 

[ProZackMI]

that's where the patients are... and if the docs aren't going to step up and provide the service someone has to......sorry if taking care of veterans doesn't make the lexus payment.....there's always the hysterical millionares obsessing about whether or not people like them...maybe you should limit your practice to them(if you haven't already).

Most veterans who aren't EtOH dependent or who don't have a Dx of polysub abuse seek tx from non VA providers, clinics, and hospitals. Why? It's a well known fact that the VA is primarily staffed with mid-levels and FMGs who have no clue what they're doing. VA care is substandard, low quality,and largely ineffective. Not surprising considering it's a governmental entity.

And...hey...millionaires are people too; they get depressed and anxious just like anyone else. They also have excellent insurance...or...they pay with CASH! 😀

 

[deleted6669]

Most veterans who aren't EtOH dependent or who don't have a Dx of polysub abuse seek tx from non VA providers, clinics, and hospitals. Why? It's a well known fact that the VA is primarily staffed with mid-levels and FMGs who have no clue what they're doing. VA care is substandard, low quality,and largely ineffective. Not surprising considering it's a governmental entity.

And...hey...millionaires are people too; they get depressed and anxious just like anyone else. They also have excellent insurance...or...they pay with CASH! 😀

silly me...I though PTSD was a real problem among combat veterans, you know the ones who can't afford non-va care....thanks for setting me straight.....

 

[jwtaylor]

it is intriguing that this thread went this way. one of the clients at my work receives his psych care at the VA, and it is indeed substandard in my opinion. the care is also substandard by more experienced accounts. that being said, his psychiatrists are all FMG and the care leaves a lot to be desired. a lot of my interests have to do with ptsd and i highly regard the work done by dave grossman and jonathan shays in their research and work with vets. what i dislike about psychiatry is the fact that psychotherapy is not widely used by them. i agree that someone has to be prescribe the meds, but when psychotherapy is thrown into the mix that is the most effective course of treatment. and i understand how the managed care nightmare means that psychiatrists just dont have the time for psychotherapy. i think this is where the role of a PA comes into play. when there are more PA's working to assist a supervising psychiatrist maybe this opens the door for more patient contact, hence psychotherapy. i would just like to provide psychotherapy without being regarded as some psychologist who doesn't know the first thing about medicine. i just want a broad aptitude.

 

[lawguil]

It's a well known fact that the VA is primarily staffed with mid-levels and FMGs who have no clue what they're doing! 😀

You have to love the "well known facts" statement. Finish high school and maybe we'll meet someday in college!

 

[50960]

Hey Mr. Broad aptitude, I bet I know more clinical medicine relevant to psych then you ever will with that attitude. Look out we are coming to get you..... 😀

 

[jwtaylor]

psisci, what is your background? you have a phd or psyd or none of the above?

 

[50960]

Both of the above, I did a 5 yr residency inpatient with chronic patients, and shared resident title with an MD, and a psychiatrist. My residency was longer than most. I have since been involved in a MSCP program (master of science in clinical medicine and psychopharmacology) which is post doctoral fellowship work. I am a licensed psychologist.....let's rock. Anything can be found on the net these days, but if you know something about psychopharm you can tell me in your own writing what is different about mirtazapine, as opposed to other NE/5ht reuptake antidepressants??? I had 4 pts today begin this med....why 😀

 

[jwtaylor]

psisci i wasn't challenging you, haha, i was legitimately curious about what you do and what you do sounds like its really close to something i'd like to pursue. i have a bunch of questions i'd like to ask you, perhaps i'll pm you.

 

[50960]

"would just like to provide psychotherapy without being regarded as some psychologist who doesn't know the first thing about medicine. i just want a broad aptitude. " This was what I was responding to. I am happy to chat with you about what I do and how I did it. Basically I see 12-16 pts/ day 3x week in a medical clinic and manage their psychotropic meds by orders from their PCP's. I work in primary care.

😎

 

[DNP student]

RE: jwtaylor. Another great reason to become a PA is because PAs work in virtually all specialties (Not just FP/IM); more so than NPs. So, if you ever get annoyed by folks like prozack, you can always switch to another, more profitable, specialty 🙂

Let's see, I know NP's in cardiac surgery, cardiac medicine, ER, general surgery, psych, prmary care, pulmonary medicine, critical care. That's all I can think of right off hand, but I'm sure there's more.

 

[guetzow]

What part of "more so than NPs" is alien to your language? Furthermore, my previous posts have well documented that PAs have been in the specialties much longer and are further intrenched. Is that changing? of course it is. But if "I" was starting out, I would go with the more established/winning horse.