Pmhnp to psy.d/phd

[wannabe123]

I’m terribly interested in psychology and would love to one day become a psychologist. It’s sad to see how low the wages are for such highly trained clinicians. I feel like the only way to compensate for the low wage, is to gain prescriptive authority as a pmhnp then jump to a PhD/psy.d program to complete my education, and go into private practice in a state where PMHNP’s have full autonomy. Is this a bad idea? Are there better ways to earn higher wages as a psychologist?
Side note - I know it sounds like I’m trying to piecmill together a career as a psychiatrist without medschool.. I’m not I want to be a psychologist with the income of a psychiatrist

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[psych.meout]

I’m terribly interested in psychology and would love to one day become a psychologist. It’s sad to see how low the wages are for such highly trained clinicians. I feel like the only way to compensate for the low wage, is to gain prescriptive authority as a pmhnp then jump to a PhD/psy.d program to complete my education, and go into private practice in a state where PMHNP’s have full autonomy. Is this a bad idea? Are there better ways to earn higher wages as a psychologist?
Side note - I know it sounds like I’m trying to piecmill together a career as a psychiatrist without medschool.. I’m not I want to be a psychologist with the income of a psychiatrist

Well, you can understand our confusion when you're saying this here, but lament that you "missed the boat" for med school in a different part of this forum.

Getting into a good doctoral program and completing all the training and requirements aren't necessarily easier than med school. It's just different.

 

[wannabe123]

Well, you can understand our confusion when you're saying this here, but lament that you "missed the boat" for med school in a different part of this forum.

Getting into a good doctoral program and completing all the training and requirements aren't necessarily easier than med school. It's just different.

Yes, I apologize for being a little misleading. Im just trying to direct whoever's commenting toward a particular answer. In that case, I just wanted to know what the best route to enhance an NP education would be without hearing everyone say "just go to med school." I guess I should be more straight forward. In regards to this, Im genuinely curious. I have pretty much narrowed down the career route I want to pursue to what I had posted previously, and what I have just posted (the Psychologist/PMHNP) route, I just need a little more insight, thanks.

 

[deleted343839]

I want to be a psychologist with the income of a psychiatrist

Nothing else you've posted indicates that you want to be a psychologist. I sympathize with the income problem, but your solution is misguided.

Im 20 years old by the way with no medical school prerequisites completed, and all the nursing prerequisites done.

You posted this on another board (initially Psychiatry, I think, before the thread was moved). I don't think you know what you want. It's not too early for you to rule out medical school. You are probably looking at the same amount of time before you could matriculate into an M.D. or Ph.D. program.

 

[WisNeuro]

I’m not I want to be a psychologist with the income of a psychiatrist

Then become a psychologist with good business skills. However, if you also want to sling overhyped placebos, then there are several ways to gain prescriptive authority.

 

[DD214_DOC]

A PMHNP already can prescribe as a result of existing, so your statement is a bit confusing. Regardless, a PMHNP's training and education really are not sufficient to fully appreciate pharmacologic interventions, especially the wisdom and knowledge to know when NOT to prescribe.

I disagree with the blanket statement above about, "overhyped placebos", as medication can be extremely beneficial as an additional treatment modality -- when used appropriately.

I would say either actually want to become a psychologist and go that route, go to medical school, or don't bother. I routinely have to clean up disasters transferred to me from various PMHNPs far too often to recommend this is a viable option.

 

[artsyann]

A PMHNP already can prescribe as a result of existing, so your statement is a bit confusing. Regardless, a PMHNP's training and education really are not sufficient to fully appreciate pharmacologic interventions, especially the wisdom and knowledge to know when NOT to prescribe.

I disagree with the blanket statement above about, "overhyped placebos", as medication can be extremely beneficial as an additional treatment modality -- when used appropriately.

I would say either actually want to become a psychologist and go that route, go to medical school, or don't bother. I routinely have to clean up disasters transferred to me from various PMHNPs far too often to recommend this is a viable option.

I agree. I can attest as a former patient of a PMHNP, it was a disaster. I was overprescribed so many medications I did not need. I ended up firing her and take zero medications. I did take some for a bit, that did zip for my anxiety. She wanted to treat my anxiety with an antipsychotic! When I questioned that, she got belligerent for questioning her "expertise". The fact that years later I am still not on any meds and doing great proved she was dangerous with an Rx pad. She actually threatened me if I refused to take her drug cocktail. Nope. Not having that. I found out after the fact, the therapists in the same practice didn't even refer clients to her. She is that bad.

 

[WisNeuro]

I see pretty bad regimens all over the place, no real pattern to whether or not it's a PCP, psychiatrist, or NP of some sort. I think they all have to clean up their house before they start getting up on their high horses.

 

[Fan_of_Meehl]

A PMHNP already can prescribe as a result of existing, so your statement is a bit confusing. Regardless, a PMHNP's training and education really are not sufficient to fully appreciate pharmacologic interventions, especially the wisdom and knowledge to know when NOT to prescribe.

I disagree with the blanket statement above about, "overhyped placebos", as medication can be extremely beneficial as an additional treatment modality -- when used appropriately.

I would say either actually want to become a psychologist and go that route, go to medical school, or don't bother. I routinely have to clean up disasters transferred to me from various PMHNPs far too often to recommend this is a viable option.

As a practicing psychotherapist, I'd say that our version of 'shotgun and the kitchen sink too' polypharmacy is the case who has, say, 6 or 7 diagnoses and no individualized clinical case formulation (and treatment plan utilizing transdiagnostic empirically-supported principles of behavior change). For every case prescribed Zyprexa, Ativan, Depakote, Prozac, (et al. and ad nauseam) there's a psychotherapy case out there whom a therapist has diagnosed as having bipolar d/o, PTSD, ADHD, impulse control disorder, 'sexual addiction,' OCD, intermittent explosive disorder (et al. and ad nauseam). Sloppy thinking is sloppy thinking...and it respects no particular professional boundaries.

 

[psych.meout]

As a practicing psychotherapist, I'd say that our version of 'shotgun and the kitchen sink too' polypharmacy is the case who has, say, 6 or 7 diagnoses and no individualized clinical case formulation (and treatment plan utilizing transdiagnostic empirically-supported principles of behavior change). For every case prescribed Zyprexa, Ativan, Depakote, Prozac, (et al. and ad nauseam) there's a psychotherapy case out there whom a therapist has diagnosed as having bipolar d/o, PTSD, ADHD, impulse control disorder, 'sexual addiction,' OCD, intermittent explosive disorder (et al. and ad nauseam). Sloppy thinking is sloppy thinking...and it respects no particular professional boundaries.

 

[DD214_DOC]

I see pretty bad regimens all over the place, no real pattern to whether or not it's a PCP, psychiatrist, or NP of some sort. I think they all have to clean up their house before they start getting up on their high horses.

I don't disagree with you, but messes are more likely to occur when someone has considerably less training, education, and experience. I do not make excuses for my own profession and call out other psychiatrists just as much. In fact, I'm probably even more harsh towards my peers.

Nobody can take a short cut and arrive at the same level of expertise, knowledge, and skill. The lost time actually does matter.

 

[WisNeuro]

I don't disagree with you, but messes are more likely to occur when someone has considerably less training, education, and experience. I do not make excuses for my own profession and call out other psychiatrists just as much. In fact, I'm probably even more harsh towards my peers.

Nobody can take a short cut and arrive at the same level of expertise, knowledge, and skill. The lost time actually does matter.

I think we all want to be able to say this, because it sounds right. But, we really don't know. Healthcare, across the spectrum, does a terrible job at outcomes research. We'd like to think that we do a better job than midlevels, but it's all just baseless assumption. Maybe there are certain healthcare niches that midlevels can do with similar levels of patient safety and outcomes to what has been the status quo? As I said, I haven't noticed much of a difference between bad prescribing habits whether it's NPs, psychiatrists, PCPs, etc. so, it's hard for me to demonize one group above and beyond another for what some of their less competent peers are doing. I'd be more than happy to change my thinking if there is adequate data out there to persuade me, though.