Psychology to Psychiatry

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Anasazi23

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Jon Snow said:
I think it is inaccurate to lump clinical psychologists in with nurse practitioners and PAs. We are not midlevels and physicians are not considered the "highest level of care" providers in the field. It is more complicated than that and is driven by area of expertise. Compensation for psychiatrists is directly tied to their ability to prescribe drugs. That's why it is higher than the average clinical psychologist. I believe that is the motivation of psychologists in pushing for prescribing priv. I disagree with prescription rights for psychologists because it places us in a "midlevel" status with respect to pharmacotherapy and blurs the lines relative to areas of expertise. I believe that many clinical psychologists have the requisite physio backgrounds (with some additional pharm training) to be excellent prescribers, but until/if the psychology boards become more powerful I think it is dangerous to pursue prescription rights.

The real enemies are the government (medicaid and medicare) and managed healthcare.

I'm not sure if a psychiatrist's salary is so much larger than a psychologist's simply because they prescribe medications. Indeed, there doesn't seem to be a correlation (thinking off the top of my head) to amount of medications prescribed, or the frequency of medications prescribed and salary within the medical field itself. (Radiology comes to mind) Likewise, (although psychologists may resent the comparison), nurse anesthetists make substantially less than anesthesiologists. Why should they? They perform essentially the same duties most of the time. The truth is that the anesthesiologist can provide a higher level of medical care than a nurse. The same would be true for psychologists and psychiatrists. A higher overall level of medical care is potentially provided by a psychiatrist - post-doc masters/neuropsychology or not. That's just the nature of the training and education.

It's an interesting idea you bring up...the thought that prescribing psychologists will be considered more like mid-levels if they DO prescribe. I think this is accurate and I can understand your trepidation. Psychologists, after all, must confer with a physician, and ultimately defer to their decision when it comes to prescribing. Psychologists, however, will be pleased to find out that most physicians are too busy to welcome the extra unpaid time spent in face-to-face supervision/conferencing and phone calls. I can't say I blame them. This cannot be compared to psychiatry, since the psychiatrist theoretically does not have to confer with a primary care doc, and fully understand the medical complexities of the patient as they are listed. The result of this will be psychologists doing what many PAs do now. Saying hello over the phone for 10 minutes every 6 months, or some such nonsense. This will give them an increased sense of autonomy, but will be bad for the patient. This, incidentally, is a direct violation of the prescribing mandates put forth in LA, and should be prosecuted as such. Given the fact that the disciplinary board, (who refuses to even release a standard passing score for their prescribing test) consists primarily of psychologists. No repercussions will be had. This is in addition to the complete lack of entrance requirements to post-doc psychopharm programs, (and often taught by psychologists, which makes absolutely no sense at all). It reminds me of a sort of pathological inbreeding that results in a genetically mutated offspring.

This again is unfortunate. Peer reviewed physician disciplinary teams appear to be much more objective, and have a reputation for erring on the side of patient care and rights. Given the political clout that psychologists feel that rxp has for them, similar values regarding these scenarios are highly unlikely.

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mdblue

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Anasazi23 said:
I'm not sure if a psychiatrist's salary is so much larger than a psychologist's simply because they prescribe medications. Indeed, there doesn't seem to be a correlation (thinking off the top of my head) to amount of medications prescribed, or the frequency of medications prescribed and salary within the medical field itself. (Radiology comes to mind) Likewise, (although psychologists may resent the comparison), nurse anesthetists make substantially less than anesthesiologists. Why should they? They perform essentially the same duties most of the time. The truth is that the anesthesiologist can provide a higher level of medical care than a nurse. The same would be true for psychologists and psychiatrists. A higher overall level of medical care is potentially provided by a psychiatrist - post-doc masters/neuropsychology or not. That's just the nature of the training and education.

It's an interesting idea you bring up...the thought that prescribing psychologists will be considered more like mid-levels if they DO prescribe. I think this is accurate and I can understand your trepidation. Psychologists, after all, must confer with a physician, and ultimately defer to their decision when it comes to prescribing. Psychologists, however, will be pleased to find out that most physicians are too busy to welcome the extra unpaid time spent in face-to-face supervision/conferencing and phone calls. I can't say I blame them. This cannot be compared to psychiatry, since the psychiatrist theoretically does not have to confer with a primary care doc, and fully understand the medical complexities of the patient as they are listed. The result of this will be psychologists doing what many PAs do now. Saying hello over the phone for 10 minutes every 6 months, or some such nonsense. This will give them an increased sense of autonomy, but will be bad for the patient. This, incidentally, is a direct violation of the prescribing mandates put forth in LA, and should be prosecuted as such. Given the fact that the disciplinary board, (who refuses to even release a standard passing score for their prescribing test) consists primarily of psychologists. No repercussions will be had. This is in addition to the complete lack of entrance requirements to post-doc psychopharm programs, (and often taught by psychologists, which makes absolutely no sense at all). It reminds me of a sort of pathological inbreeding that results in a genetically mutated offspring.

This again is unfortunate. Peer reviewed physician disciplinary teams appear to be much more objective, and have a reputation for erring on the side of patient care and rights. Given the political clout that psychologists feel that rxp has for them, similar values regarding these scenarios are highly unlikely.
anecdotes don't count but I couldn't resist. ;)
Last PM Man(a frequent flier) came to PES w/ shakes, flu sx, raised BP/tachycardic/headache-apparently PCP stopped Clorazepate and Catapres cold turkey because she was trying to help him for his addiction. Called back because it was not too believable. The PCP is a NP and didn't realize the man had a Axis III for HTN and you can prescribe Catapres for that.
I am afraid the 'med psychologists will be providing similar level of care or lack of it.
 

mosche

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Jon Snow said:
That may the case (your conclusion), but that's just stupid (the NP and her d/c of clonidine).

I think we can throw anecdotes to and fro ad infinitum. Obviously, there are lots of stupid MDs around as well given the ever profitable medical malpractice lawyer career.

Now it gets ugly! :scared: :scared:
 
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mosche

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The Great Moderator Mauling of 2005 :clap: :clap: :clap:
 

Anasazi23

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Jon Snow said:
Perhaps, perhaps not. It's a billing code issue for the most part. It is possible to generate more dollars prescribing than it is doing therapy. Specialties narrow this gap somewhat (e.g., neuropsychology), but there is an establishment issue (i.e., billing for professional time in neuropsychology). There has been some progress on that front for psychology. ...No, but, again, it is a billing issue. Psychiatry's most lucrative average daily endeavor is med management. ...That isn't true. Expertise is the issue. A psychiatrist provides a higher level of care for med management. This is no slam on psychiatry and I understand the desire to draw parallels. However, I don't think their is another situation in medicine quite like psychiatry and psychology. ....That's not reality for psychiatry in my opinion. Psychiatrists refer out, or confer with the primary care doc for areas outside of the psychiatry discipline. Psychiatrists are no more independent of an operator than a psychologist or any other specialist.

Or professional schools of psychology. :)

A large part of professional psychiatry that you consistently leave out are hospital-based and university psychiatrists...salaried psychiatrists. They don't care how much they bill for. They are in salaried positions. These positions are much higher paying than the comparable psychologist salary. One must also remember that many psychiatrists are fee for service, and do not even accept medicare or medicaid. Because of the comprehensive service they can and do provide, they can charge a LOT.

Yes, psychiatrists refer out medical problems, as they primarily should. However, they are not required to confer with a physician prior to doing anything.

Again, I know the comparison is resentful, but the closest comparison of this scenario is other disciplines competing with NPs, nurse anesthetists, ODs, PAs and the like. While I respect that the psychologist carries a doctoral degree (in most cases, I know), the medical field's food chain operates this way. After all, it is psychology that is trying consistently to become more like medicine. As you know, the field originally was not very clinically oriented at all. There is a price to pay in this regard, and that is dealing with the medical heirarchy and (decades-long) slow to change medical field billing, heirarchy, and the like.
 

PsychEval

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Since you brought up medical hierarchy, I just read that in 1997, Dr. Sexton, a prescribing psychologist trained in the DOD, was the head of the mental health department at the Naval Hospital in Camp Pendleton, Calif., where he managed psychiatrists and psychologists. Sounds like Dr. Sexton was the Captain of the ship. I know several Ph.D. Medical Directors, I suspect RxP will produce even more.

http://www.apa.org/monitor/feb03/prescribers.html

Furthermore, MDBlue raises concerns about the NP not being aware of the pt’s Axis III, I agree, that’s stupid. Although, psychiatrists seem to be the worst at failing to list axes II and III. Most psychiatrists don’t know how to diagnose and treat Axis II, and most are not interested in Axis III (maybe that is why some go into psychiatry). However, psychologists are good at integrated and collaborative care, and will continue to work effectively with primary care to avoid such problems.
 

Poety

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PsychEval said:
Furthermore, MDBlue raises concerns about the NP not being aware of the pt’s Axis III, I agree, that’s stupid. Although, psychiatrists seem to be the worst at failing to list axes II and III. Most psychiatrists don’t know how to diagnose and treat Axis II, and most are not interested in Axis III (maybe that is why some go into psychiatry). However, psychologists are good at integrated and collaborative care, and will continue to work effectively with primary care to avoid such problems.


I completely and utterly disagree with that statement and I'm actually a bit resentful over it - that is why we TRAIN AS PHYSICIANS - now you may be referring to some really old school psychs or something, but this is NOT what I have encountered at all. In fact, I've found so many psychs diagnosing medical problems when other specialties just want to get rid of the patient and they're frustrated- its mind boggling that some people would even think that the training psychs endure today is anything remotely to what it used to be.

Most institutions are very focused on balancing psychotherapy (CBT, DBT, insight, psychodynamic, etc) with biological treament.

I've always appreciated your opinions psycheval but I'm really insulted by your last post - I did NOT enter psych to leave behind "medicine" and I think you'll find most people that go into psych now haven't either. In fact, many of the programs have psychs doing all the medical duties during intern/2nd year so as not to lose these skills and be trained thoroughly.

This is where psychologists will always falter and not be able to match the education of MD's. We are trained in disease identification, differential and the like from a medical standpoint. Psychologist RxP simply are not - they are taught minimal psychopharm and zilch as far as pathophys goes for all the drugs they want to prescribe.

Here again, if a psychologist wants to prescribe - be my guest, but they are not going to get my approval vote nor are they going to ride on my license when I'm a practicing doc.
 

Poety

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Jon Snow said:
Wait a few years. It may not be fair or always true, but it is an oft repeated stereotype and not one that orginated in psychology land.

Well, sort of. We are not MDs. Toe fungus is not our area of expertise :)


I don't think psychology generated this stereotype at all - I just think the whole thing is ridiculous - I've said this in a previous post though.

My brother is psychology trained and even he has said "there is no way I would ever prescribe meds" now his friend has chosen to do it and as my brother, and half his class said "I wouldn't go to him to get meds, he's not a doctor"

I think that psychologist are going to find that they're not going to have many cash for service patients - its going to be the poor VA people/medicaid/welfare recipients and those without a choice. Sad... but true.

I'm done posting here too - I've said my peace and I think this thread is degenerating into another us vs. them which all in all is just stupid.
 

PsychEval

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And none of this is insulting?

Completely dismantling their own profession,

Dramatic.

Thank God I got out of that field. The prescribing is going to be horrible.
It has not been so far, and we have 10 years of data.

The psychologists have lied.

Psychopathic deviants, that’s us.

Predoctoral pharm courses are simply pitiful, and take into account absolutely no assumption of patient or medical knowledge whatsoever.

Not true.

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.

In LA, something like 15,000 prescriptions have been written by psychologists. Where are all the nasty ramifications and sick patients. Not one complaint to date.

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.

No mess thus far.

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

We now have 10 years of data, no shoddy healthcare thus far from prescribing psychologists. In NM, there is a 6 month waiting list to see a psychiatrist. In LA, there is 1 psychiatrist for every 8,000 people. These issues should have been addressed 20 years ago.

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.

Do you think that prescribing psychologists in private practice have a roster full of people with poor medical insurance or no money? If patients were satisfied with their healthcare and healthcare providers, they would not spend billions on alternative health care crap.

The danger grows. When all you have is a hammer, everything looks like a nail.

Were not the one trick pony.

That statement helps illustrate precisely why MDs laugh at psychologists.

You think MD’s/DO's don’t laugh at psychiatrists? We are all fighting a mental health stigma.

I wrote “most” when I should have put “some.” In reviewing this thread, I particularly appreciate Public Health and Mosche, they seem more open minded about the issues. Psychologists are not a threat to psychiatrists or patient safety.

BTW, regarding the money concerns, a psychiatrist can knock out $200,000 of school loans in 6 years with several loan repayment programs, even in NM and LA. I just checked. You guys also have the new doctor home loan option through Bank of America. After residency, your hard work will pay off.
 
M

Miklos

PsychEval said:
That statement helps illustrate precisely why MDs laugh at psychologists.

You think MD’s/DO's don’t laugh at psychiatrists? We are all fighting a mental health stigma.

The problem is how we define mental illness. My experience has been that many psychologists (along with some psychiatrists) tend to have a very liberal (and self-serving) definition of mental illness.
 
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PsychEval

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Miklos said:
The problem is how we define mental illness. My experience has been that many psychologists (along with some psychiatrists) tend to have a very liberal (and self-serving) definition of mental illness.

Could you please elaborate?
 
M

Miklos

PsychEval said:
Could you please elaborate?

From the other thread:

psisci said:
My 2 cents is that psychiatrists are the best trained to treat serious mental illness, and mental illness with medical comorbidities. Psychologists are best trained to treat medium-minor (the majority) severity mental illnesses, but do not have the proper tools, and will not until some level of limited RxP is available.
 

PsychEval

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That is a great example of the limits of the medical model, considering every condition of living is not a disease/disorder. Managed care has trained psychiatrists to over prescribe and psychologists to over pathologize.
There are plenty of self serving psychiatrists (and psychologists) out there. MDD, single episode, mild, and on fluoxetine for the last 13 years. Perhaps the provider has a kid in college.
 

Poety

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PsychEval said:
That is a great example of the limits of the medical model, considering every condition of living is not a disease/disorder. Managed care has trained psychiatrists to over prescribe and psychologists to over pathologize.
There are plenty of self serving psychiatrists (and psychologists) out there. MDD, single episode, mild, and on fluoxetine for the last 13 years. Perhaps the provider has a kid in college.


Thats the most intelligent comment I've seen on this thread all day.
 
M

Miklos

PsychEval said:
There are plenty of self serving psychiatrists (and psychologists) out there. MDD, single episode, mild, and on fluoxetine for the last 13 years. Perhaps the provider has a kid in college.

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O Lord, Kum ba yah

(In all seriousness, I think that we've got some common ground.)
 

Poety

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I concur, now can this thread just die please? :laugh: :laugh:
 

Poety

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I concur, now can this thread just die please? :laugh: :laugh:

don't steal my song Miklos! :p
 

mosche

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Miklos said:
Kum ba yah, my lord, Kum ba yah!
Kum ba yah, my lord, Kum ba yah!
Kum ba yah, my lord, Kum ba yah.
O Lord, Kum ba yah

Someone's crying, Lord, Kum ba yah!
Someone's crying, Lord, Kum ba yah!
Someone's crying, Lord, Kum ba yah!
O Lord, Kum ba yah

Someone's singing, Lord, Kum ba yah!
Someone's singing, Lord, Kum ba yah!
Someone's singing, Lord, Kum ba yah!
O Lord, Kum ba yah

Someone's praying, Lord, Kum ba yah!
Someone's praying, Lord, Kum ba yah!
Someone's praying, Lord, Kum ba yah!
O Lord, Kum ba yah

(In all seriousness, I think that we've got some common ground.)

:laugh: :laugh: :laugh:
 

Poety

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Miklos said:
Sorry. But, as you didn't rise to mosche's request... I figured that the opportunity was perfect.


touche! ;)
 

PublicHealth

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From this month's APA Monitor:

Prescriptive authority

In recent years, New Mexico and Louisiana made history as the first two states to pass legislation allowing qualified psychologists to write prescriptions. This year, they made history by implementing the legislation.

The training requirements are different in each state. In New Mexico, after psychologists have completed all coursework and other training requirements, they are eligible for a two-year conditional prescription certificate, which allows them to prescribe under the supervision of a physician. If they successfully complete the two-year supervision process, psychologists will then be allowed to independently prescribe, but will still work closely with the patient's physician.

In Louisiana, after psychologists have completed their training, they may independently prescribe medication, but are required to consult the patient's physician. According to James Quillin, PhD, president of the Louisiana Academy of Medical Psychologists, 25 psychologists are currently prescribing in Louisiana, with more on the way. Quillin says the system is working well for all parties.

"It's well accepted by patients," he says. "It's quite a benefit to them because it's based on a collaborative-care model that ensures optimal treatment," he says.

Other states are working on prescriptive authority bills. Hawaii, which has been working on this issue since 1984, pushed a bill all the way to the Senate floor this year–the farthest such legislation has ever advanced. The bill died on a tie vote, but a task force has been set up to study the need for prescriptive authority in the state. Tennessee has also been making progress in moving a bill through the legislature, and several other states have held hearings.

"More prescriptive-authority bills got hearings this year than any other year–it's an indication of the growth of the movement," says Michael Sullivan, PhD, assistant executive director for state advocacy in APA's Practice Directorate.

APA's Committee for the Advancement of Professional Practice (CAPP) provided funding for most of the state prescriptive initiatives.

Source: http://www.apa.org/monitor/dec05/access.html
 

sasevan

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Hi all,
As a current psychologist and future psychiatrist I have enjoyed (for the most part) the unfolding debate on RxP.
I am especially appreciative of OldPsychDoc and mosche's perspective on this issue.
Personally, I believe that medical psychologists acquiring RxP will be good for patients and clinical psychology as well as psychiatry. Below is a link to a very informative article as to why.
Peace.

http://www.nationalregister.org/TRR_online_fall2005_Norcross.htm
:thumbup:
 

PublicHealth

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sasevan said:
Hi all,
As a current psychologist and future psychiatrist I have enjoyed (for the most part) the unfolding debate on RxP.
I am especially appreciative of OldPsychDoc and mosche's perspective on this issue.
Personally, I believe that medical psychologists acquiring RxP will be good for patients and clinical psychology as well as psychiatry. Below is a link to a very informative article as to why.
Peace.
http://www.nationalregister.org/TRR_online_fall2005_Norcross8.htm
:thumbup:

Here it comes... :eek:
 

mosche

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I read the artcle with some interest, and it was what I expected -- not that that's a bad thing by any means, it was just what I expected.

I do have one question, and I AM NOT trying to stir a hornet's nest, if you want to answer it via PM I will understand.

The article stresses that psychologists have to train under the guidance of a physician.What happens if M.D.s or D.O.s refuse to supervise those psychologists who want prescribing privilages? This seems, to me, to be a very real possibility based on the venom that I see spewed everytime this topic arises. Has this issue been dealt with in the past? if so, how was it resolved?
 

sasevan

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mosche said:
I read the artcle with some interest, and it was what I expected -- not that that's a bad thing by any means, it was just what I expected.

I do have one question, and I AM NOT trying to stir a hornet's nest, if you want to answer it via PM I will understand.

The article stresses that psychologists have to train under the guidance of a physician.What happens if M.D.s or D.O.s refuse to supervise those psychologists who want prescribing privilages? This seems, to me, to be a very real possibility based on the venom that I see spewed everytime this topic arises. Has this issue been dealt with in the past? if so, how was it resolved?

Hi mosche,

I'm not sure but I guess the experience in NM, LA, and in those States where psychopharm programs are located suggest that there are sufficient number of MD/DOs (most probably PCPs) who are willing to provide this guidance as they have possibly already been successfully collaborating with psychologists.
I for one, though, would much more prefer for psychiatrists to be providing this guidance. Unfortunately, IMO, psychiatry's refusal to consider this has led psychology to turn to other medical branches to provide the supervision that I believe we can all agree would be best provided by psychiatry. Its sad really, especially for the future of patient care and collaboration between the two doctoral level mental health disciplines. :(
Peace.
 

mosche

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sasevan said:
Hi mosche,

I'm not sure but I guess the experience in NM, LA, and in those States where psychopharm programs are located suggest that there are sufficient number of MD/DOs (most probably PCPs) who are willing to provide this guidance as they have possibly already been successfully collaborating with psychologists.
I for one, though, would much more prefer for psychiatrists to be providing this guidance. Unfortunately, IMO, psychiatry's refusal to consider this has led psychology to turn to other medical branches to provide the supervision that I believe we can all agree would be best provided by psychiatry. Its sad really, especially for the future of patient care and collaboration between the two doctoral level mental health disciplines. :(
Peace.

That was what I had assumed, but I would really like to know if it was met with hostility in LA and NM. Either way, it doesn't really matter since it's working in those two states. However, I imagine that in more saturated markets there would be some sort of reprisal by the AMA. Again, I'm NOT passing judgment it's just what I see as an inherent obstacle.
 

PublicHealth

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mosche said:
Again, I'm NOT passing judgment it's just what I see as an inherent obstacle.

I think it was Frederick Douglas who said, "Without a struggle, there can be no progress."
 

mosche

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PublicHealth said:
I think it was Frederick Douglas who said, "Without a struggle, there can be no progress."

He also said: "It is easier to build strong children than to repair broken men"!
 

Poety

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sasevan said:
Hi mosche,

I'm not sure but I guess the experience in NM, LA, and in those States where psychopharm programs are located suggest that there are sufficient number of MD/DOs (most probably PCPs) who are willing to provide this guidance as they have possibly already been successfully collaborating with psychologists.
I for one, though, would much more prefer for psychiatrists to be providing this guidance. Unfortunately, IMO, psychiatry's refusal to consider this has led psychology to turn to other medical branches to provide the supervision that I believe we can all agree would be best provided by psychiatry. Its sad really, especially for the future of patient care and collaboration between the two doctoral level mental health disciplines. :(
Peace.

I agree with that above statement but I think a lot of psychs aren't going to let that ride on their license, especially with all the lawsuits emerging re:oops:ver prescribing, SI, and physiological SE of certain meds. I mean, why would any psych let someone else prescribe zyprexa for instance, knowing darn well they can't order the appropriate tests to monitor for untoward effects?
 
5

50960

With Rxp comes ordering labs. I order labs already in a non RxP state...nobody cares as long as someone gets paid.
 

PublicHealth

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mosche said:
He also said: "It is easier to build strong children than to repair broken men"!

But "broken men" are BOTH psychiatrists and psychologists in this case! Accessibility and comprehensive behavioral healthcare are lacking in many regions of the US. The entire system is "a broken man." The real challenge is how to best build "strong children" to promote the public's mental health.

While we're on a Frederick Douglas bent,

"Man's greatness consists in his ability to do and the proper application of his powers to things needed to be done."
 

mosche

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PublicHealth said:
But "broken men" are BOTH psychiatrists and psychologists in this case! Accessibility and comprehensive behavioral healthcare are lacking in many regions of the US. The entire system is "a broken man." The real challenge is how to best build "strong children" to promote the public's mental health.

While we're on a Frederick Douglas bent,

"Man's greatness consists in his ability to do and the proper application of his powers to things needed to be done."

I'm not totally convinced that Mr. Douglas would agree with your interpretation of his diatribe; however, I'm not convinced that most authors would agree with the various interpretations proffered by countless English Lit. teachers as to the meanings of their works! ;)

Either way, it still begs the question: what if physicians refuse to serve as attendings? I think that it's unfortunate that -iatrists and -ologists can't reach a common ground; but it's reality -- at least on SDN (where the average USMLE score would serve as a PBA dream score :laugh: ).

Now, as Frederick Douglas undoubtedly said, "I have to go to the potty"! :D

BTW PublicHealth, I really do appreciate your civility and your opinions! Ya'll too Sasevan and Psisci.
 

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mosche said:
I'm not totally convinced that Mr. Douglas would agree with your interpretation of his diatribe; however, I'm not convinced that most authors would agree with the various interpretations proffered by countless English Lit. teachers as to the meanings of their works! ;)

Either way, it still begs the question: what if physicians refuse to serve as attendings? I think that it's unfortunate that -iatrists and -ologists can't reach a common ground; but it's reality -- at least on SDN (where the average USMLE score would serve as a PBA dream score :laugh: ).

Now, as Frederick Douglas undoubtedly said, "I have to go to the potty"! :D

BTW PublicHealth, I really do appreciate your civility and your opinions! Ya'll too Sasevan and Psisci.


Mosche why were you up at 2:47am?
 

PublicHealth

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Poety said:
Mosche why were you up at 2:47am?

Unlike those of us who refresh the SDN page every two minutes, mosche actually has a life!
 

Poety

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PublicHealth said:
Unlike those of us who refresh the SDN page every two minutes, mosche actually has a life!


was this question directed to you? was there a need for you to respond to it? do I sense sarcasm in your voice?......... looking at ignore button........ :smuggrin:
 

mosche

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Poety said:
Mosche why were you up at 2:47am?

Unfortunately, I don't have a life -- I have a job (but I hear-tell that "life"s are over rated) :D ! I teach for Kaplan, and there is an LSAT test Saturday; so I was working with some students who were wanting some "last minute" logic games practice. Anyway, Thursday just happens to be my "must see TV" night; therefore when I got home, I had to watch last night's ER (I've been addicted for 12+ years).

BTW PublicHealth, I really thought that I was the only person who was obsessed with the refresh button and SDN. We should start a group therapy session..."Hi! My name's Mosche and I'm addicted to SDN"! :scared: :scared: :scared:
 

Poety

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PublicHealth said:
Nope.


Nope.


A little.

Officially ignored :D

I am loving this button!

Now back to the mature/relevant threads - Mosche I'll see you over there~!
 

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mosche said:
That was what I had assumed, but I would really like to know if it was met with hostility in LA and NM. Either way, it doesn't really matter since it's working in those two states. However, I imagine that in more saturated markets there would be some sort of reprisal by the AMA. Again, I'm NOT passing judgment it's just what I see as an inherent obstacle.

Hi mosche,

I'm not sure if the AMA would take reprisals against the collaborating PCPs but I think in "saturated" (more urbanized?) markets its State affiliates as well as those of the Am Psychiatric Assoc will be very successful in preventing the passing of RxP legislation as one of the big arguments of the Am Psychological Assoc for RxP is increasing patient access to psychopharmacotherapy by doctoral level mental health clinicians.
This is the reason why I chose to pursue psychiatry. I don't believe that psychology will attain RxP in States like FL any time soon.

Peace.
 

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sasevan said:
Hi mosche,

I'm not sure if the AMA would take reprisals against the collaborating PCPs but I think in "saturated" (more urbanized?) markets its State affiliates as well as those of the Am Psychiatric Assoc will be very successful in preventing the passing of RxP legislation as one of the big arguments of the Am Psychological Assoc for RxP is increasing patient access to psychopharmacotherapy by doctoral level mental health clinicians.
This is the reason why I chose to pursue psychiatry. I don't believe that psychology will attain RxP in States like FL any time soon.

Peace.

Good morning/afternoon sasevan,

I really enjoyed discussing this topic with you. I think that your reasoning is very cogent. I really had assumed, obviously incorrectly, that you were a psychologist, since you had given the "other side" a fair analysis. I agree that the state affiliates will be their biggest hurdle (as it ought to be) -- which goes back to what I had argued earlier in the "states' rights" posts.

Good luck, and post more often! I think that you will be an asset to your field!

mosche
 

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mosche said:
Good morning/afternoon sasevan,

I really enjoyed discussing this topic with you. I think that your reasoning is very cogent. I really had assumed, obviously incorrectly, that you were a psychologist, since you had given the "other side" a fair analysis. I agree that the state affiliates will be their biggest hurdle (as it ought to be) -- which goes back to what I had argued earlier in the "states' rights" posts.

Good luck, and post more often! I think that you will be an asset to your field!

mosche

Hey mosche,

Thanks. Same here; I think you have a very balanced perspective.
I believe we'll both be good for the field of psychiatry and most importantly for our patients.
Best of luck in all your pursuits. :luck:

P.S. I am a psychologist (since Fall 2004) but I started pre-med reqs in Spring of 2004 and hopefully will be starting med school in Fall 2007. I decided to pursue psychiatry because I want to provide integrated mental health treatment (psychological and pharmacological). As I was completing my psychology residency I met a number of colleagues, at the med ctr where I was, that had made the transition from psych PhD/PsyD to psych MD/DO and they assured me that the pursuit was well worth making. I totally agreed and here I am. :)
 

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sasevan said:
Hey mosche,

Thanks. Same here; I think you have a very balanced perspective.
I believe we'll both be good for the field of psychiatry and most importantly for our patients.
Best of luck in all your pursuits. :luck:

P.S. I am a psychologist (since Fall 2004) but I started pre-med reqs in Spring of 2004 and hopefully will be starting med school in Fall 2007. I decided to pursue psychiatry because I want to provide integrated mental health treatment (psychological and pharmacological). As I was completing my psychology residency I met a number of colleagues, at the med ctr where I was, that had made the transition from psych PhD/PsyD to psych MD/DO and they assured me that the pursuit was well worth making. I totally agreed and here I am. :)


Congrats Sas and welcome to the psych forum! :)
 

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Poety said:
Congrats Sas and welcome to the psych forum! :)

Hi Poety,
Thanks. I still have a long way to go but I'm happy to be on my way.
Peace. :)

P.S. Good luck on the residency match. Did you apply to UM/JMH?
 

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I think you made the right decision, Sase. If you were like I was, and mulled over the differences, and even agonized about your future and "how it would have been," you'll be much more satisfied through this route.

How are pre-meds going?
 

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Anasazi23 said:
I think you made the right decision, Sase. If you were like I was, and mulled over the differences, and even agonized about your future and "how it would have been," you'll be much more satisfied through this route.

How are pre-meds going?

...and sazi's speaking from the "trenches!" Says a lot for his dedication to the field. Go sazi! :thumbup:
 

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Anasazi23 said:
I think you made the right decision, Sase. If you were like I was, and mulled over the differences, and even agonized about your future and "how it would have been," you'll be much more satisfied through this route.

How are pre-meds going?

Hey Anasazi23,
No doubt; its a better fit for me. I didn't want to go through my professional career possibly frustrated due to a limited scope of practice. But "yeah," I did agonized about having to go back to school for 10+ years to become a psychiatrist after just completing 6 to become a psychologist. :eek:
Yet once I committed to it I was fine and have never looked back; even now that I'm taking physics :mad: :laugh: And I still have organic to do :scared:
as well as the MCAT :eek: :scared:
Congrats on being a PGY2 and thanks for providing so much info, as PH would say, about and from the trenches. I have really enjoyed your posts about residency, especially about the integration of medicine and psychiatry services. I'm very interested in C-L (psychosomatics). Thanks again. :thumbup:

Peace.
 

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sasevan said:
Hey Anasazi23,
No doubt; its a better fit for me. I didn't want to go through my professional career possibly frustrated due to a limited scope of practice. But "yeah," I did agonized about having to go back to school for 10+ years to become a psychiatrist after just completing 6 to become a psychologist. :eek:
Yet once I committed to it I was fine and have never looked back; even now that I'm taking physics :mad: :laugh: And I still have organic to do :scared:
as well as the MCAT :eek: :scared:
Congrats on being a PGY2 and thanks for providing so much info, as PH would say, about and from the trenches. I have really enjoyed your posts about residency, especially about the integration of medicine and psychiatry services. I'm very interested in C-L (psychosomatics). Thanks again. :thumbup:

Peace.

Wow Sas, you are one devoted person, and you'll be a great asset to the field I'm sure! I did apply to Miami, however due to family, I had to cancel my interview there since I don't think living in Miami would be suitable for my needs - I heard its a great program though!

Unfortunately with the wee one in toe, I have to think of geography as a huge factor.

And thank you for the luck on the match! I wish you all the luck in your premed studies :) You'll do great I'm sure! :)
 
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