Psychology to Psychiatry

[Doc4daze]

Here's the question? if a phychologist with a masters or (bachelor's) in phychology want to be a phychiatrist how do they go about it and how much longer does it take

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[abcxyz0123]

Here's the question? if a phychologist with a masters or (bachelor's) in phychology want to be a phychiatrist how do they go about it and how much longer does it take

about 25 years cos you need to relearn spelling in grade school first

 

[Doc4daze]

about 25 years cos you need to relearn spelling in grade school first

lol im at work and doing this on the fly i have about 4 minutes to type each one forgive me if my spelling is off im here for information not to be looked down upon so if that is your plan then why did you respond in the first place why dont you go learn proper etiquette.

 

[deuist]

med school = 4 years
psychiatry residency = 4 years

Therefore, regardless of previous education in psychology, you will need 8 years.

 

[Doc4daze]

I figured, but there is always the hope that im wrong. Thanks for confirming that the 8 years was the case

 

[edieb]

BTW, girlfriend, psychologists must have Ph.D.s. Neither a master's nor a bacehlor's qualifies you to be a psychologist. You have no writing skills and no spelling skills. Therefore, you are NObody.

 

[Poety]

BTW, girlfriend, psychologists must have Ph.D.s. Neither a master's nor a bacehlor's qualifies you to be a psychologist. You have no writing skills and no spelling skills. Therefore, you are NObody.

this reply was RUDE, YOU have no CUTHE

doc4daze, you could try and apply some of your credits toward your BA if you don't have it yet - are you in a program now? Are you already a psychologist? Are you trying to figure out psychiatry vs. psychology? If so, look at all the different avenues to achieving your goal, there is also a PsyD you can get which a lot of people wanting to do clinical work seem to pursue.

Sorry about the poor responses to your question, I'm shocked to see these on the psych forum and its not the norm.

good luck!

 

[deuist]

BTW, girlfriend, psychologists must have Ph.D.s. Neither a master's nor a bacehlor's qualifies you to be a psychologist.

Not true. In some states such as Florida, people with master's degrees can get licensed.


Oh, and by the way, you misspelled "bachelor."

 

[Poety]

Not true. In some states such as Florida, people with master's degrees can get licensed.


Oh, and by the way, you misspelled "bachelor."

Glad to see the usual gang is here giving helpful information

 

[sasevan]

Not true. In some states such as Florida, people with master's degrees can get licensed.

Oh, and by the way, you misspelled "bachelor."

Actually, this is not true.

In Florida to be a Licensed Psychologist (meaning Clinical or Counseling) one must have earned a PhD or a PsyD and completed 2,000 hours post-doc year as well as passed the EPPP (US prof psych exam) and the Florida State laws and regulations exam.

In Florida only a Licensed SCHOOL Psychologist just needs a Masters degree.

In Florida someone with an MS or MA in psychology CANNOT be licensed as a psychologist AT ALL; though some do register as Mental Health Counseling Interns in order to provide prof counseling services while they continue to pursue the PhD/PsyD and become a Licensed Psychologist which will afford them the privilege to provide psychotherapy/psychodiagnostic evaluations/psychometric testing.

Peace.

 

[sasevan]

I figured, but there is always the hope that im wrong. Thanks for confirming that the 8 years was the case

Hi Doc4daze,

Actually, if you choose to pursue this avenue it may take more than just the aforementioned 8 years.

I'm a psychologist (PsyD) and in my second (and last) year of pre-med reqs (8 credit hours of Biology, General Chemistry, Organic Chemistry, and Physics). Also, after completing pre-med reqs/taking MCAT there is the one (hopefully just one!) year of applying/interviewing for MD/DO school.

So, maybe 10-11 years is more of what you'll be looking at if you switch from psychology to psychiatry.

However, as someone who has chosen to do just that and knows of at least 3 others who have done the same, the process, though arduous, is well worth it if that is where you see yourself best able to provide for your patients' needs.

Best of luck.

 

[abcxyz0123]

lol im at work and doing this on the fly i have about 4 minutes to type each one forgive me if my spelling is off im here for information not to be looked down upon so if that is your plan then why did you respond in the first place why dont you go learn proper etiquette.

if your errors were due to you being short on time or simple typos, you wouldn't have spelled psychology and psychiatry wrong each time in the same exact way.

 

[Poety]

if your errors were due to you being short on time or simple typos, you wouldn't have spelled psychology and psychiatry wrong each time in the same exact way.

Seth be nice, we all knew what he/she meant

 

[abcxyz0123]

Seth be nice, we all knew what he/she meant

haha i know, im just messing around. its harder to show the whole 'serious tone' with a half cracked smile attitude online.

 

[PublicHealth]

Is this a spelling bee?

 

[PsyDRxPnow]

Actually, this is not true.

In Florida to be a Licensed Psychologist (meaning Clinical or Counseling) one must have earned a PhD or a PsyD and completed 2,000 hours post-doc year as well as passed the EPPP (US prof psych exam) and the Florida State laws and regulations exam.

In Florida only a Licensed SCHOOL Psychologist just needs a Masters degree.

In Florida someone with an MS or MA in psychology CANNOT be licensed as a psychologist AT ALL; though some do register as Mental Health Counseling Interns in order to provide prof counseling services while they continue to pursue the PhD/PsyD and become a Licensed Psychologist which will afford them the privilege to provide psychotherapy/psychodiagnostic evaluations/psychometric testing.

Peace.

Thank you for the accurate description and not allowing this misconception to go on. It is insulting to describe a B.A. or MA as a psychologist. For you medical doctors or to be, It’s like calling a PA/NP an MD, pretty inaccurate huh?

 

[sasevan]

Thank you for the accurate description and not allowing this misconception to go on. It is insulting to describe a B.A. or MA as a psychologist. For you medical doctors or to be, It’s like calling a PA/NP an MD, pretty inaccurate huh?

You're welcomed.
I agree with your point as well; though maybe, people (referring here to not just medical but also to mental health prof and students as well as lay persons) who make that description are not intending so much to insult as are simply misinformed, e.g., I got a call yesterday from a person initially describing themself as a psychologist and inquiring about any work opportunity in my practice who later on explained that they were expecting to be finished with their BA in psychology in 1/06

 

[PsychEval]

You're welcomed.
I agree with your point as well; though maybe, people (referring here to not just medical but also to mental health prof and students as well as lay persons) who make that description are not intending so much to insult as are simply misinformed, e.g., I got a call yesterday from a person initially describing themself as a psychologist and inquiring about any work opportunity in my practice who later on explained that they were expecting to be finished with their BA in psychology in 1/06

As you guys know, it is not unique to mental health. I have met several “radiologists” who never went to medical school.

 

[Milo]

As you guys know, it is not unique to mental health. I have met several “radiologists” who never went to medical school.

Well sure, people devoting their lives to understanding, diagnosing, and yes, even fixing radios should have that title.

 

[mastamark]

Some of you people are arseholes! I can't believe someone can't ask a question without people getting all critical and stuff. I would hate to have you as a therapist, that's for sure.

Oh by the way Deuist this statement is not correctly expressed.

"In some states such as Florida, people with master's degrees can get licensed."

It should read:

"In some states, such as Florida, individuals with masters degrees may gain liscensure."

HAHAHA Im just kidding...lighten up though people. It's not the "lets flex our intellectual muscle" forum, It's a "Let's help each other reach a common goal" Forum.

 

[Anasazi23]

"In some states, such as Florida, individuals with masters degrees may gain liscensure."

HAHAHA Im just kidding...lighten up though people. It's not the "lets flex our intellectual muscle" forum, It's a "Let's help each other reach a common goal" Forum.

Yes, but the term "individual," which I hate, is actually improper English in its original form. It's a PC term meant to make us all feel warm and fuzzy. Not unlike other words, it has been beaten into the English lexicon and incorporated as improper but ultimately acceptable English.


HAHA...Call again tomorrow! I'm delirous from the joy!

 

[Nikki2002]

Seth be nice, we all knew what he/she meant

Poety...look at the wee lil baby in your avatar.....how cute!!

 

[mastamark]

Yes, but the term "individual," which I hate, is actually improper English in its original form. It's a PC term meant to make us all feel warm and fuzzy. Not unlike other words, it has been beaten into the English lexicon and incorporated as improper but ultimately acceptable English.


HAHA...Call again tomorrow! I'm delirous from the joy!

Haha. I hear ya....I was just being funny. Just trying to get everyone to lighten up.

 

[mosche]

Well sure, people devoting their lives to understanding, diagnosing, and yes, even fixing radios should have that title.

 

[mosche]

Haha. I hear ya....I was just being funny. Just trying to get everyone to lighten up.

Why does everyone get soooo bent out of shape when I make smart a$$ remarks? I don't want to sound petty, but it hurts!

 

[Poety]

Poety...look at the wee lil baby in your avatar.....how cute!!

THANK YOU! <beaming>

and Mosche; you were DRUNK, you didn't even post in this thread so no one was even talking to you <rollin eyes at the drunkard>

 

[Anasazi23]

Haha. I hear ya....I was just being funny. Just trying to get everyone to lighten up.

As was I.

Humorous sarcasm doesn't convey well through this digital media.

Seriously though, I can't stand when people use the term "individual." It makes my skin crawl.

"Excerpt from the 10:00 news: A woman was found raped and murdered today in her Brooklyn apartment. Investigators are on the lookout for the perpetrator. Neighbors report a suspicious looking individual, about 6' tall, wearing a grey sweatshirt and jeans."

Awww...isn't it so sweet that we're all individual people? Every last one of us is unique and special! Not like anyone else. Awwwwwwww....Let me go hug a tree.

 

[Heath82371]

Just thought I would clarify a few things that were incorrectly stated on this website. Individuals with Masters degrees in certain fields may obtain licensure as therapists by the state they reside in (I live in Florida). These individuals must have a masters in psychology, counseling, or mental health and after 2 years of supervised experience and passing boards they will be licensed as LMHC (Licensed Mental Health Counselor). If they did graduate work in the field social work they will be a LCSW (Licensed Clinical Social Worker), or if they studied marriage and family therapy, they will be licensed as a LMFT (Licensed Marriage and Family Therapist). I have a graduate degree in clinical psychology and I am a LMHC. I am in nursing school. Though, I personally will not do this, I could become a ARNP (Advanced Registered Nurse Practitioner) and I could effective prescribe meds to the oh-so-fun mental health clients I have left behind. I am actually leaning towards nurse anesthesia at this point. If you entering the field of psychiatry for the money...RUN....or change your specialization ASAP. Listening to people complain is not all that it is cracked up to be.

Oh, only during the two years after that we are being supervised are we registered interns. Once we complete our supervision and pass boards we are independently licensed, can accept third party reimbursement, and can "hang a shingle."

 

[Anasazi23]

I'm not sure what you're lazily copied post from the psychology forum with the word "psychology" changed to "psychiatry" is supposed to accomplish, but the discussions there are quite different from the ones in this forum. The professions, while serving the same population, are completely different, involve completely different levels of training, and entail much different work, as you know.

There are plenty of people here that know what psychiatrists make, and no psychiatrist that I know is losing sleep over nurse practitioners seeing psychiatry patients.

Incidentally, psychiatrists make substantially over 100k on average, with many making upwards of 200k and much more.

Sounds like you're burnt on the mental health field. This is understandable. But easy on trying to rain on other people's parades.

 

[Poety]

Sazi, I hate to say it, but it seems a lot of people seem to forget one very important fact: PSYCHIATRISTS ARE PHYSICIANS. Why is it so hard for people to remember this? why?

 

[Heath82371]

Obviously I know the difference between a psychologist, psychiatrist and a psychotherapist. I most worked at the state hospital and as a member of an interdisciplinary treatment team and I think I know more than say an individual who works in private practice (been there done that) or in an acute care hospital about the work that many indiviudals (MDs, Phds, etc) do. I am sure salary you have quoted are fairly accurate but in the places I have worked (state hospital, crisis units, community mental health agencies) psychiatrists make low 100s. Not that this isn't a great salary, but it isn't the same salary that a cardiovascular surgeon earns. Managed care has changed the face of healthcare regardless of the speciality. My intention here was to clarify that licensed psychotherapists (like myself) do have graduate degrees and do work as post graduate interns for 2 years before sitting for boards. We can "hange a shingle" and we receive third-party reimbursement like anyone else. None of us think we are psychologists and we all know the extensive training psychiatrists must undergo. That is what my post what intended to accomplish. I have hit a nerve and I am sorry to offend you.

QUOTE=Anasazi23]I'm not sure what you're lazily copied post from the psychology forum with the word "psychology" changed to "psychiatry" is supposed to accomplish, but the discussions there are quite different from the ones in this forum. The professions, while serving the same population, are completely different, involve completely different levels of training, and entail much different work, as you know.

There are plenty of people here that know what psychiatrists make, and no psychiatrist that I know is losing sleep over nurse practitioners seeing psychiatry patients.

Incidentally, psychiatrists make substantially over 100k on average, with many making upwards of 200k and much more.

Sounds like you're burnt on the mental health field. This is understandable. But easy on trying to rain on other people's parades.[/QUOTE]

 

[Poety]

Heath, I must be lost - whats going on this thread?

Im becoming a psychiatrist because I didn't want to become a psychologist, lsw, or np - I was a nurse for a long time and I have 13+ years of working in the health care profession, I chose MD because none of those other professions ARE physicians.

I thought you were referring to why a psychiatrist would become a psychiatrist instead of a psychologist or NP - is that not where this has gone? I admit, I get lost in these threads sometimes.

Are you disputing something here? I would never want the job of an LSW or LCMH - I just wouldn't. And I also think these are very different job descriptions from psychiatry although they're in the same field.

And as for the money aspect - if you're going into psych for money you will be sorely mistaken to find that the patient pop. itself is too grueling if you don't love it, money aside.

But I know plenty of psychs (like Sazi has said) that make 175,000+ (which I just found out about recently) so I don't think money is actually an "issue" once you're established.

 

[PublicHealth]

But I know plenty of psychs (like Sazi has said) that make 175,000+ (which I just found out about recently) so I don't think money is actually an "issue" once you're established.

Will this change once psychologists secure RxP in your state? Simple economics.

 

[OldPsychDoc]

Will this change once psychologists secure RxP in your state? Simple economics.

PH--this has been done to death. Health care in this country just ISN'T governed by "simple economics". People don't wake up in the morning say, "I need prozac", then look for the least expensive prescriber. Providers don't set their own fees to some "market-driven rate", but are reimbursed based on mazes of third-party payor contracts. We have all kinds of mid-levels and non-psych MDs prescribing already, yet access for patients trying to get into the mental health system still sucks. We will all be making a reasonable living doing this for a long, long time--or at least until the Canadians invade...

 

[Poety]

I don't think psychologists should be prescribing ANYTHING. And I think if enough psychiatrists dispute this, then something can be done to prevent/stop it for the safety of the patients.

One must understand the mechanism of drugs, what pathways they use, and have more than a fundamental knowledge of human physiology which requires an enormous amount of study to prescribe medications. Letting a psychologist prescribe is just ridiculous (although I know some states allow it - we'll see how long this lasts when they deal with the law suits that ensue from missed drug interactions, missed side effects and the like)

As a nurse I would never have wanted to diagnose and prescribe meds, that should be reserved for physicians. Here again, it goes back to the argument that psychiatrists are doctors first.

With all of the lawsuits currently going on, if I was a psychologist I would stay the heck away from prescribing ANYTHING for fear of losing more than just my license. I know of FP's that won't even prescribe anti-psychotics because healthcare is just too specialized to understand the mechanism of every drug out there - hence we have specialties.

But this is just my .02 cents- I'm sure others disagree.

 

[Poety]

PH--this has been done to death. Health care in this country just ISN'T governed by "simple economics". People don't wake up in the morning say, "I need prozac", then look for the least expensive prescriber. Providers don't set their own fees to some "market-driven rate", but are reimbursed based on mazes of third-party payor contracts. We have all kinds of mid-levels and non-psych MDs prescribing already, yet access for patients trying to get into the mental health system still sucks. We will all be making a reasonable living doing this for a long, long time--or at least until the Canadians invade...

OPD, do you think that non-physicians should be prescribing? You know, with all the mismanagement of patients as it is - it makes me nervous to know that so many other professions have the ability to prescribe. Especially when so many of them aren't even trained in human a & P and biochemistry. I was just wondering how you felt about this, although I agree with you that the money factor is just a non-issue.

 

[OldPsychDoc]

OPD, do you think that non-physicians should be prescribing? You know, with all the mismanagement of patients as it is - it makes me nervous to know that so many other professions have the ability to prescribe. Especially when so many of them aren't even trained in human a & P and biochemistry. I was just wondering how you felt about this, although I agree with you that the money factor is just a non-issue.

I think that access makes it imperative that some nonMDs prescribe. My experience is mixed, though. I supervise an EXCELLENT, cautious NP and work with several PAs. OTOH, I've expressed in other threads a disdain for transfers I've gotten from another mid-level where I thought that prescribing was very inappropriate. And there's WAY too much handing out of Adderall like it's candy, or something....

 

[PublicHealth]

I think that access makes it imperative that some nonMDs prescribe. My experience is mixed, though. I supervise an EXCELLENT, cautious NP and work with several PAs. OTOH, I've expressed in other threads a disdain for transfers I've gotten from another mid-level where I thought that prescribing was very inappropriate. And there's WAY too much handing out of Adderall like it's candy, or something....

Is this training sufficient to practice psychopharmacotherapy? http://www.rxpsychology.com/crsstudy.htm

 

[OldPsychDoc]

Is this training sufficient to practice psychopharmacotherapy? http://www.rxpsychology.com/crsstudy.htm

I think that the key to success is down at end of the course description:
a clinical practicum with medical supervision. That's really how I learned my psychopharmacology in residency, and I think it is what makes the difference between good and abysmal mid-level prescribing.

 

[Anasazi23]

I just can't take them anymore. They are completely dismantling their own profession, and my only fear (not money, not prestige) is that this nonsense will be associated with what care of the psychiatric patient entails.

I'll quote the paragraph from Fairleigh Dickinson's rxp program:
"Course 5: Clinical Pharmacology (7.5 weeks)

This course presents major classes of drugs (excluding psychotropics) and their uses in clinical settings. It includes an examination of the social, cultural, and behavioral aspects of prescribing medications. Approved for 48 CE Credits plus 3 academic credits."

What in the hell does that mean? So in the (arguably) most important prescribing course, the focus sits on cultural and social aspects of prescribing Zyvox, finasteride, and complicated cultural aspects of third generation cephalosporins? What in God's name is their obsession with this stuff?

Thank God I got out of that field. The prescribing is going to be horrible. Just like it is from the PAs and NPs that I see weekly.

I just took a 70 year old lady with IHSS, HTN, and a slew of other problems, who was seeing an NP off 50 of Lexapro (titrated it down). She's miraculously better. Who would have known? And, I can still keep her BP under control. It's no longer 180/100.

How anybody can take these pharmacology classes without actually laying hands on an actual medical patient in a medical setting just blows my mind. That's the difference between NP/PAs and psychologists. The former knows what medical patient care entails to some degree. Residency is 3-4 years of hands-on patient care for a reason...

And to address this push now for predoctoral rxp classes. As if the former design wasn't skimpy enough. Again, the psychologists have lied. They begged for the postdoctoral masters and got it. Now the inch is yet again turning into the mile. Predoctoral pharm courses are simply pitiful, and take into account absolutely no assumption of patient or medical knowledge whatsoever. The point, I believe, of the post-doc masters was to (I assume) have some semblance of knowledge of the mental health field, have some familiarity of at least names of a few of the drugs, and so on. I thought it was to be akin to admission to an MBA program - they much prefer business experience prior to admission so that you have a base of knowledge.

 

[Poety]

Sazi, I personally agree with your post 100%

 

[PublicHealth]

How anybody can take these pharmacology classes without actually laying hands on an actual medical patient in a medical setting just blows my mind. That's the difference between NP/PAs and psychologists.

Here's what NM prescribing psychologists are doing for a practicum: http://www.zianet.com/jamesthomp/practicumManual.doc

And their curriculum: http://www.zianet.com/jamesthomp/handbook05.doc

 

[Poety]

So in essence, a psychologist with no formal medical training shadows a PRIMARY CARE PHYSICIAN for TWO WEEKS and they can then prescribe?!

Like I said before - ridiculous. There are going to be some nasty ramifications and SICK PATIENTS from the institution of this new "law" or whatever it is. Oy! I'm not moving to New Mexico because I really don't want to have to deal with cleaning up the mess this is going to make.

OPD is in practice, and I'm sure he knows there is some really crappy prescribing that goes on - as a nurse I can still remember an NP that prescribed Mellaril with Thorazine at the VA - can you say malignant hypertension? 240/180 in a matter of 30 minutes - FRIGHTENING

 

[mosche]

Two weeks!????? Good grief, I studied longer than that for tests in Pharm.! This topic has reared its ugly head several times, and I've always said that as long as someone has ADEQUATE trining, I have no problem; however if they put this crap up as so-called "adequate training", they lose any shred of hope that they may have of garnering even my support (not that they care).

I shadowed an MD prior to med. school for three years, and am a CNA -- I think that I ought to be able to prescribe drugs. Screw moonlighting. I want a pad, and I want it NOW!!!

 

[PublicHealth]

http://www.psychiatrictimes.com/p010720.html

From a psychiatrist:

"I find it more than a little amusing when I hear all kinds of high-minded arguments being bandied about over what is obviously an economic issue. To quote from the above-mentioned article by Jan Leard-Hansson, M.D., "To prescribe medication properly the physician must know the patient from head to toeýWe, as psychiatric physicians, must maintain a steadfast commitment to protecting and providing high-quality patient care."

Admirable sentiments indeed, but when was the last time Leard-Hansson, or any of us, did a rectal examination on a patient? Or auscultated their chest? Or palpated their lymph nodes or liver? Even my colleagues who work in hospital settings routinely defer physical examination to their internal medicine or family practice consultants. The simple truth of the matter is that sub-specialization, by definition, means that most of us lose some of the skills that we learned in medical school, primarily those that we do not use on a regular basis. I know that I would have a tough time picking up a murmur on a chest exam or appreciating a subtle physical finding. It is, therefore, more than a little disingenuous to claim that we, as psychiatrists, know our patients from head to toe. The day-to-day practice of our art demands, in fact, that we concentrate on certain areas and de-emphasize others, referring patients to others with more expertise when necessary. Surely, I find it easier to examine a routine blood report and pick up obvious abnormalities or interpret the results of a computed tomography or magnetic resonance imaging scan, but those are skills that can be learned with time.

I think prescribing privileges for non-physician personnel are inevitable at some point. If such practitioners would cost less than psychiatrists, you can be sure managed care will be the first to jump on the bandwagon. As psychiatrists, our choice is not between having or not having non-physicians prescribe psychotropics. Our challenge is to engage in this process in a way that is productive and non-confrontational. In the long term, as with managed care, we will gain more by being active and shaping the debate rather than being isolated behind the ramparts of our self-righteousness, firing off shots in the dark."

 

[mosche]

http://www.psychiatrictimes.com/p010720.html

From a psychiatrist:

"I find it more than a little amusing when I hear all kinds of high-minded arguments being bandied about over what is obviously an economic issue. To quote from the above-mentioned article by Jan Leard-Hansson, M.D., "To prescribe medication properly the physician must know the patient from head to toeýWe, as psychiatric physicians, must maintain a steadfast commitment to protecting and providing high-quality patient care."

Admirable sentiments indeed, but when was the last time Leard-Hansson, or any of us, did a rectal examination on a patient? Or auscultated their chest? Or palpated their lymph nodes or liver? Even my colleagues who work in hospital settings routinely defer physical examination to their internal medicine or family practice consultants. The simple truth of the matter is that sub-specialization, by definition, means that most of us lose some of the skills that we learned in medical school, primarily those that we do not use on a regular basis. I know that I would have a tough time picking up a murmur on a chest exam or appreciating a subtle physical finding. It is, therefore, more than a little disingenuous to claim that we, as psychiatrists, know our patients from head to toe. The day-to-day practice of our art demands, in fact, that we concentrate on certain areas and de-emphasize others, referring patients to others with more expertise when necessary. Surely, I find it easier to examine a routine blood report and pick up obvious abnormalities or interpret the results of a computed tomography or magnetic resonance imaging scan, but those are skills that can be learned with time.

I think prescribing privileges for non-physician personnel are inevitable at some point. If such practitioners would cost less than psychiatrists, you can be sure managed care will be the first to jump on the bandwagon. As psychiatrists, our choice is not between having or not having non-physicians prescribe psychotropics. Our challenge is to engage in this process in a way that is productive and non-confrontational. In the long term, as with managed care, we will gain more by being active and shaping the debate rather than being isolated behind the ramparts of our self-righteousness, firing off shots in the dark."

I agree with your sentiments, and with your prediction that it's "inevitable".
However, I do not believe that setting a high bar is indicative of "our self-righteousness". Ultimately, as far as the managed care providers are concerned, physicians ought to take a strategic approach. For example, if we would begin to pressure managed care providers to accept responsibility for their poor coverage or their forced diagnostics, then they would begin to take a more hands off approach. One way to do that would be to force them to accept co-defendant status in the resulting lawsuits should they push for psychologists being able to prescribe.

 

[Poety]

PH: My argument is that non-physicians should not prescribe for the safety of patients. (I am not making this whole economic argument because in all honesty, I think that only the poorest of patients are going to end up having to go to a psychologist for their scripts or would for that matter, and here again, you'd end up with shoddy healthcare for the underserved - I don't think its going to take a penny outta the psychs pockets) I'm not saying psychologists don't have their place and aren't necessary because they ARE -I think we start getting into shoddy medicine when non-medically trained people start prescribing drugs. I know I "think" differently now then I ever have when considering what meds to put a patient on - I don't just throw them on this or that like cookbook medicine.

I've seen this time and again when working before medical school. When one doesn't have the proper training - they become dangerous with what little prescribing power they have. But I'm also of the mindset that I'm not going to let an NP treat my pulm. HTN or arrythmia either - these meds can be very dangerous in the wrong hands and I think without the practice/supervision and understanding of how these medications work, how the body responds to them and the reasons WHY these things occur - they can be catastrophic not only physically to a patient, but mentally as well.

My argument is strictly patient safety - and I admit - because of my poor experiences with non-docs prescribing, I am definitely on the unconvinced side that psychologists should be prescribing anything.

 

[Poety]

I agree with your sentiments, and with your prediction that it's "inevitable".
However, I do not believe that setting a high bar is indicative of "our self-righteousness". Ultimately, as far as the managed care providers are concerned, physicians ought to take a strategic approach. For example, if we would begin to pressure managed care providers to accept responsibility for their poor coverage or their forced diagnostics, then they would begin to take a more hands off approach. One way to do that would be to force them to accept co-defendant status in the resulting lawsuits should they push for psychologists being able to prescribe.

AMEN brothah!

 

[PublicHealth]

My argument is strictly patient safety - and I admit - because of my poor experiences with non-docs prescribing, I am definitely on the unconvinced side that psychologists should be prescribing anything.

But this is simply your (n=1) perspective on the issue. Are you aware of any systematic studies showing that nonphysician providers are less safe than physician providers on objective measures of healthcare provision? Given managed care's mission of cost reduction, one can readily assume that they will be in favor of psychologist RxP, provided that it's cheaper and equally safe and effective.

For the record, I a second-year medical student interested in pursuing psychiatry. I am interested in fostering discussion of psychologist RxP insofar as this is an issue that will continue to affect our chosen profession and the patients we serve.

 

[Poety]

PH: No I'm not aware of any studies that you asked about, my thoughts and ideas are founded in experience alone, but I also think that sometimes experience goes a lot further than some of these bunked out studies do. (my n=1 is also additive of 13+ years in healthcare) The things I've seen aren't controlled and they're backed by observations I've made in healthcare in a multitude of different settings.

And yes I think that managed care would approve of this to cut costs - I think managed care providers would do ANYTHING to cut costs. I'm not too sure what you're asking me here - do I know its probably inevitable? Yes. Do I accept it none-the-less? No. I am fundamentally against prescribing meds without the proper training - the reason here again is patient safety and to reiterate, these are NOT going to be the patients with multiple options or that have the best healthcare to begin with (or even the best capacity to make medical decisions in general). These are going to be the VA patients, or the patients that are so mentally ill that they won't know the difference anyway.

Ask any patient with decent medical insurance or plenty of money in their pocket if they would let a psychologist prescribe drugs and I'd bet a dollar the answer would be an unequivocable no.

Why? because we seem to think its ok for the poor to get crappy health care while the upperclass or wealthier are the only ones to reap the benefits of good health care. AGain, this is from experience and 13 years of it can go head to head with any study you show me.

If you're thinking of psychiatry as a specialty - you need to be able to think about these things objectively and make your own decisions about them which is exactly what you're doing now. You'll definitely develop your own ideas about healthcare as time goes by. Some people think that secondary adn tertiary prescribers are great, I just don't happen to be one of them. I think you taking all this into consideration at this point is a great idea -whether you're an MD or a psychologist in training, these are things one should seriously ponder especially since you'll be running into a whole slew of it when out in practice. (which at that point will be yet another new learning experience for me)