PhD/PsyD Post doc. Master in psychopharmacology

[psych.meout]

Well I do know theres a relatively newer specialty of psychology, "medical psychology," which uses psychopharm training for psychologists to undertand the biolology of physical illness and how it effects psychological states to be able to tailor their treatments... as well as how medications they are on effect psychotherapy... hospitals and primary care centers are recognizing this training and hiring psychologists as specialists to consult and give advice... I suppose that would be usefull.

I guess my main question is, do you think all these psychopharm programs are going to fizzle out and dissapear? Or do you think there will always be people interested in them whether they decide to prescribe or not?

"Medical psychology" really isn't conceptualized well and is not common. It means lost of different things to different people. Psychopharmacology, behavioral genetics, and neuropsychology (which includes neuroanatomy and other neuro heavy topics) are just some of the courses in my program that emphasize biology in clinical psychology. We have external practica in neuro departments, psychiatry departments, transplant and bariatric clinics, and other medical specialties of academic health centers and VAs. Yet, mine is not a "medical psychology" program. Conversely, since medical psychology is not a protected term, a program could feasibly call themselves a "medical psychology" program and have far less actual focus on the biological bases of behavior than my non-medical program.

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[Healthinfo104]

"Medical psychology" really isn't conceptualized well and is not common. It means lost of different things to different people. Psychopharmacology, behavioral genetics, and neuropsychology (which includes neuroanatomy and other neuro heavy topics) are just some of the courses in my program that emphasize biology in clinical psychology. We have external practica in neuro departments, psychiatry departments, transplant and bariatric clinics, and other medical specialties of academic health centers and VAs. Yet, mine is not a "medical psychology" program. Conversely, since medical psychology is not a protected term, a program could feasibly call themselves a "medical psychology" program and have far less actual focus on the biological bases of behavior than my non-medical program.

Why is it not conceptualized well and not common?

I saw that there is an academy of medical psychology that states training standards to be a medical psychologist and certifies them and offers diplomat status to those who meet the standards (a phd in psychologogy, post doc psychopharm training and a reaidency)

 

[DD214_DOC]

Since med school coursework is taught by PhDs with incredible depth of knowledge in their very narrow band of interest (e.g., pharmacology, molecular bio/genetics, anatomy, etc), I don't know if that's true. I do think everyone is struggling to determine the question of depth vs. breadth.

The education and training in all of these topics doesn't consist of only the didactic work the first two years of medical school. The non-clinical work creates the foundation upon which one continues to build for several more years, which turns into tens of thousands of hours of didactic and clinical education, training, and experience -- before a physician is even able to practice independently. It's this process that turns the loosely-connected, "chunks" of knowledge you started with during the pre-clinical years into an integrated understanding. This level of knowledge and expertise in medicine and pharmacology requires a very long and time-consuming process to acquire, and isn't something one can shortcut to with a master's degree.

I'm not saying the above applies to every psychiatrist. A large portion of my caseload is cleaning up the messes other psychiatrists have made. Lazy and reckless psychiatrists who don't take what they do seriously or bother to keep up with their medical knowledge are the bane of my existence and an embarassment to my profession. They're the ones who make it seem like what we do is incredibly simple.

Anyway, we all know that nobody is going to change the opinion they already have. I have a great collaborative and personal relationship with the psychologists in my clinic. I consult them frequently when patients hand me psychological measures that I know I don't understand, and they gladly walk me through it and teach me. We discuss and consult each other on difficult cases and they're my typical, "go to" when I would like another set of eyes to help clarify a diagnosis if I'm stuck. They have more experience doing certain types of therapy, and I learn from them. They recognize and respect my areas of expertise that they do not possess and consult me or run things by me. I'm not sure why such a thing is a problem for so many people, but it works pretty well where I'm at.

 

[DD214_DOC]

That is our frustration with some psychiatrists and neurologists trying to use psych and neuro tests after taking a couple CEs and/or buying a program from a hack company and proporting to be an expert; concussion evaluation and cog rehab in particular.

I know better. These tests have to be interpreted alongside all the other data and in the context of what's going on clinically. This takes a lot of training and experience in that area, something I don't have.

 

[deleted343839]

Why is it not conceptualized well and not common?

I saw that there is an academy of medical psychology that states training standards to be a medical psychologist and certifies them and offers diplomat status to those who meet the standards (a phd in psychologogy, post doc psychopharm training and a reaidency)

For what it's worth, this group does not fall under the umbrella of the mainstream organizations representing specialty practice in psychology (eg, American Psychological Association, American Board of Professional Psychology). There's nothing wrong with that in theory, but I've read some of their stuff and they come off as amateurish, defensive, or obtuse. Take, for instance, this nonsense:

"The public equates “doctor” with those who can prescribe medications, order labs, conduct a physical exam, and formulate a differential diagnosis. Therefore arguably, to achieve parity, we need to be granted the option of RxP for our patients' welfare."

 

[Healthinfo104]

For what it's worth, this group does not fall under the umbrella of the mainstream organizations representing specialty practice in psychology (eg, American Psychological Association, American Board of Professional Psychology). There's nothing wrong with that in theory, but I've read some of their stuff and they come off as amateurish, defensive, or obtuse. Take, for instance, this nonsense:

"The public equates “doctor” with those who can prescribe medications, order labs, conduct a physical exam, and formulate a differential diagnosis. Therefore arguably, to achieve parity, we need to be granted the option of RxP for our patients' welfare."

Which is ironic because I had read somewhere else on their site that medical psychology SHOULD NOT be equated with just prescription privileges because medical psychology involves more than that... they said something along the lines of it involving the psychological assessment, evaluation and psychosocial intervention with people with medical illnesses or mental illness with a comorbid medical diagnoses that impacts their behaviors.

So back to what you were saying, is your post saying that they are not a real specialty?

 

[sfgucadoc]

Which is ironic because I had read somewhere else on their site that medical psychology SHOULD NOT be equated with just prescription privileges because medical psychology involves more than that... they said something along the lines of it involving the psychological assessment, evaluation and psychosocial intervention with people with medical illnesses or mental illness with a comorbid medical diagnoses that impacts their behaviors.

So back to what you were saying, is your post saying that they are not a real specialty?

I think the issue is that "medical psychology" and "clinical health psychology" overlap so much. Clinical health psychology is an ABPP-recognized specialty for boarding purposes. To further complexify things, there are health psychologists who are not clinicians who have their main professional identity in Div. 38, SBM, and other organizations that cover many of the same issues as "medical psychology." Part of the issue too is that "medical psychology" (I understand) as a term is a creation of the DEA and LA board 15 years ago when DEA needed language to use in assigning an Rx number to the newly minted prescribing psychologists in LA.

 

[deleted343839]

Which is ironic because I had read somewhere else on their site that medical psychology SHOULD NOT be equated with just prescription privileges because medical psychology involves more than that... they said something along the lines of it involving the psychological assessment, evaluation and psychosocial intervention with people with medical illnesses or mental illness with a comorbid medical diagnoses that impacts their behaviors.

So back to what you were saying, is your post saying that they are not a real specialty?

Their description sounds like clinical health psychology + prescribing privileges, and that does distinguish them because as a specialty clinical health psychology doesn't focus on RxP and has distanced itself from it.

Any group with money and members can start their own board and issue credentials in whatever way they choose. So sure, it's "real." Like I said, it lies outside of the mainstream organizations.

Please bookmark this thread or something because I have a feeling you're going to come back around to the topic at some point.

 

[Therapist4Chnge]

Part of the issue too is that "medical psychology" (I understand) as a term is a creation of the DEA and LA board 15 years ago when DEA needed language to use in assigning an Rx number to the newly minted prescribing psychologists in LA.

I only knew the term from LA, but I guess it's now being used in a broader context, which I think is a mistake.

 

[Healthinfo104]

Their description sounds like clinical health psychology + prescribing privileges, and that does distinguish them because as a specialty clinical health psychology doesn't focus on RxP and has distanced itself from it.

Any group with money and members can start their own board and issue credentials in whatever way they choose. So sure, it's "real." Like I said, it lies outside of the mainstream organizations.

Please bookmark this thread or something because I have a feeling you're going to come back around to the topic at some point.

I think that that is a poor decision for them along themselves stictly with prescribing rights. I think medical psychology shpuld focus moRe on using medical training for the purpose of making differentisl diagnosis and what not.

 

[smalltownpsych]

I'm not sure why such a thing is a problem for so many people, but it works pretty well where I'm at.

Hmmm...because we have too many ego-driven practitioners with low competence and ethics in each field and people will still pay for it? Just for example, I was teaching a class on psych assessment last night and I had to talk about projective testing and could not state that there are not licensed psychologists out there who think a knot hole in a tree means something. I also talked about Dr. Amen when talking about using brain scans as diagnostic tools.