Psychology vs Psychiatry and my thoughts on it

[beBrave]

Like many I've spent years in school. Others have PM'd me about this so I feel like sharing, I dropped out of my PhD program in Clinical Psychology because I felt like I was missing something. What I have found really surprises me. After spending time evaluating both Psychologist and Psychiatrist, I have to admit that surprisingly, Psychiatrist are better assessors. They assess better, and jump to conclusions far less. They may prescribe meds but they do so cautiously and they are hesitant to make a quick diagnosis. They use common sense a lot better. I find psychologist are more concerned about the number of sessions they can charge you for rather than actually achieving anything. As a Psych student, there is so much you simply don't learn and I think that is one of the more troubling aspects of the field.

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[cliquesh]

Like many I've spent years in school. Others have PM'd me about this so I feel like sharing, I dropped out of my PhD program in Clinical Psychology because I felt like I missing something. What I have found really surprises me. After spending time evaluating both Psychologist and Psychiatrist, I have to admit that surprisingly, Psychiatrist are better assessors. They assess better, and jump to conclusions far less. They may prescribe meds but they do so cautiously and they are hesitant to make a quick diagnosis. They use common sense a lot better. I find psychologist are more concerned about the number of sessions they can charge you for rather than actually achieving anything. As a Psych student, there is so much you simply don't learn and I think that is one of the more troubling aspects of the field.

I liked your PRE-edited version better, hah.

This is a totally tangential statement. My buddy failed comlex level 1 once and he still matched a decent university program for pyschiatry. As long as you get into a medical school somewhere you can be a psychiatrist with minimal effort.

 

[costales]

Well, this kind of stuff beats head and neck anatomy any day of the week:

 

[MrChance2]

You are basing your sample on too small of a sample size. I dated a clinical psych PhD and got to know most of the people in her program (one of the better programs in the country). Most of them would do quite well in medical school if that is what they wanted to do. Honestly, I spent 6 years in the real world before med school and the academic road you take to your job is less important than who you are. I don't think med school is going to make you any better of a mental illness diagnostician than a good clinical psych PhD program. If I was interested in psychology/psychiatry I would do clinical psych as I think it serves the same utility (more and more states even allow you to prescribe as you probably know) with less debt.

 

[Drrrrrr. Celty]

You are basing your sample on too small of a sample size. I dated a clinical psych PhD and got to know most of the people in her program (one of the better programs in the country). Most of them would do quite well in medical school if that is what they wanted to do. Honestly, I spent 6 years in the real world before med school and the academic road you take to your job is less important than who you are. I don't think med school is going to make you any better of a mental illness diagnostician than a good clinical psych PhD program. If I was interested in psychology/psychiatry I would do clinical psych as I think it serves the same utility (more and more states even allow you to prescribe as you probably know) with less debt.

Psychology is a research field, you go into it because you want to study something.
Psychiatry is a medical field, go into it if you want to practice and know a whole perspective on the body and the mind.

Psychiatry may be more debt if you're in a PhD or more if your in a Psy.D.

Either way, psychiatry and psychology are different fields with in many cases. But generally a psychiatrist will be a team leader and have options to go up the ranks as opposed to psychologists.

 

[Drrrrrr. Celty]

I liked your PRE-edited version better, hah.

This is a totally tangential statement. My buddy failed comlex level 1 once and he still matched a decent university program for pyschiatry. As long as you get into a medical school somewhere you can be a psychiatrist with minimal effort.

I always wondered if psychiatry was a field that you needed to take the usmle for?

 

[NontradCA]

I liked your PRE-edited version better, hah.

This is a totally tangential statement. My buddy failed comlex level 1 once and he still matched a decent university program for pyschiatry. As long as you get into a medical school somewhere you can be a psychiatrist with minimal effort.

Why do you think that is? Why does no one want to be involved with psych cliquesh?

 

[beBrave]

You are basing your sample on too small of a sample size. I dated a clinical psych PhD and got to know most of the people in her program (one of the better programs in the country). Most of them would do quite well in medical school if that is what they wanted to do. Honestly, I spent 6 years in the real world before med school and the academic road you take to your job is less important than who you are. I don't think med school is going to make you any better of a mental illness diagnostician than a good clinical psych PhD program. If I was interested in psychology/psychiatry I would do clinical psych as I think it serves the same utility (more and more states even allow you to prescribe as you probably know) with less debt.

I think you are missing my point. Clinical Psychologist focus way too much on simply the Psychological aspect, they have a limited understanding of Physiology and science (that varies). A Psychologist just doesn't take the whole person into account. No Psychologist should be prescribing medication, I stand firmly against it.

There are enough Physicians with class action lawsuits against them for simple mistakes and you want to give prescription privileges to someone that does not have a comprehensive understanding of Physiology, doesn't understand the differences of how drugs may affect children compared to adults. Physicians are often scared to death to prescribe Benzo's and you are going to hand this kind of power to a Psychologist? I think an experienced internist has a better understanding of behavior just through observation than many Psychologist.

 

[NontradCA]

I think you are missing my point. Clinical Psychologist focus way too much on simply the Psychological aspect, they have a limited understanding of Physiology and science (that varies). A Psychologist just doesn't take the whole person into account. No Psychologist should be prescribing medication, I stand firmly against it.

There are enough Physicians with class action lawsuits against them for simple mistakes and you want to give prescription privileges to someone that does not have a comprehensive understanding of Physiology, doesn't understand the differences of how drugs may affect children compared to adults. Physicians are often scared to death to prescribe Benzo's and you are going to hand this kind of power to a Psychologist? I think an experienced internist has a better understanding of behavior just through observation than many Psychologist.

 

[beBrave]

The story never gets old.

 

[Drrrrrr. Celty]

I think you are missing my point. Clinical Psychologist focus way too much on simply the Psychological aspect, they have a limited understanding of Physiology and science (that varies). A Psychologist just doesn't take the whole person into account. No Psychologist should be prescribing medication, I stand firmly against it.

There are enough Physicians with class action lawsuits against them for simple mistakes and you want to give prescription privileges to someone that does not have a comprehensive understanding of Physiology, doesn't understand the differences of how drugs may affect children compared to adults. Physicians are often scared to death to prescribe Benzo's and you are going to hand this kind of power to a Psychologist? I think an experienced internist has a better understanding of behavior just through observation than many Psychologist.

I personally believe that psych should should be adding in more physiology and neurophysiology into their basic curriculum. Psychology is strongly moving towards becoming more and more a biological and etiology based area of study.

But regarding prescription rights it is complicated. I think that if a person finishes a post-graduate masters in clinical pharm and understands the biology then they shouldn't have much problem prescribing basic ssris, xanax, and other drugs for non-serious depression and anxiety. But obviously they should and likely do stay far away from serious psychiatric illness and more severe forms of mental illness which can be drug resistant.

Regarding clinical psychologists focusing on the psychology aspect, what the hell does that even mean? They're there usually to train you to deal with mental issues, of course they will use psychology, but likewise most psychiatrists probably do the same, though paradigm wise psychiatrists are usually more psychodynamic as opposed to behaviorists like psychologists.

And I think we're all psychologists in our lives either way. So an internist has a good idea of what to expect or deal with in his life of working with his patients. However a psychologist is far likely more prepared to properly treat them if they have a significant problem than the internist who likely may be going off of gut feeling and not specific methodology.

 

[beBrave]

And I think we're all psychologists in our lives either way. So an internist has a good idea of what to expect or deal with in his life of working with his patients. However a psychologist is far likely more prepared to properly treat them if they have a significant problem than the internist who likely may be going off of gut feeling and not specific methodology.

I regret shortening my original post. Needless to say, Psychologist are trained in psychology and that's all they really have to work with. Psychologist assess > treatment vs Psychiatrist treatment > assessment. Psychologist, waste critical time with never ending assessments and hesitate to to refer patients to a Psychiatrist. Here is an issue, a Psychologist reviews symptoms using the DSM and comes to the conclusion that someone is bi-polar, a psychiatrist reviews symptoms, reviews the patients medical history and or orders a series of medical test because behaviors can be triggered by things other than mental illness. Your point on Neuro-Psychiatry takes center stage here. We will simply have to agree to disagree on prescription rights, if a Psychologist wants to prescribe medication they should go to Medical school. Allowing them to take a shortcut creates a distortion of how people view Psychologist and Psychiatrist. They aren't the same but you can be sure that Psychologist with prescription powers will begin to act this way.

 

[Drrrrrr. Celty]

Well no doubt there needs to be a lot more referring and frankly a psychiatrist should be the guy you go to first to diagnose you and then proceed to going to a psychologist for behavioral or psychodynamic treatment.

 

[beBrave]

Well no doubt there needs to be a lot more referring and frankly a psychiatrist should be the guy you go to first to diagnose you and then proceed to going to a psychologist for behavioral or psychodynamic treatment.

Exactly, the problem is it often goes the opposite way. In most patient intakes, people meet with a Psychologist or LCSW (licensed clinical social worker) before they can see a Psychiatrist. I think Psychologist can do more harm than good when they are the first line of defense. Psycho-dynamics is very interpretive and a Psychiatrist can do assessments. Research has shown that shorter visits with a Psychiatrist produce significantly better long term benefits for patients versus visits with a Psychologist.

Others on SDN have pointed this out for years. Psychology is slowly moving more into integrated care. Basically a one stop shop for all. A good skill that Physicians develop is that they learn how to get to the point quickly. Psychologist will hold your hand as they eye your wallet. Some people spend 10 years in therapy and achieve nothing. They spend a solid session with a Psychiatrist and the Psychiatrist decides that you should have your thyroxine levels checked. The earth shatters when fluctuating thyroxine levels were causing fluctuating behavior as "Low thyroid hormones, and the common occurrence of sluggish, poorly functioning adrenals, can play a role in a variety of emotional and behavioral symptoms ". I don't recall any of this in the DSM.

@NontradCA, the story is true but its not really cool.

 

[Balantidiumcoli]

We will simply have to agree to disagree on prescription rights, if a Psychologist wants to prescribe medication they should go to Medical school. Allowing them to take a shortcut creates a distortion of how people view Psychologist and Psychiatrist.

People don't seem to have too much difficulty distinguishing between PA's and Family physicians in spite of the former sharing Rx rights.

 

[Balantidiumcoli]

Exactly, the problem is it often goes the opposite way. In most patient intakes, people meet with a Psychologist or LCSW (licensed clinical social worker) before they can see a Psychiatrist. I think Psychologist can do more harm than good when they are the first line of defense.

Serious? If so ... wow.

Please tell me you have some experience actually working in mental health, and I don't mean volunteering I mean actually working in a position where you are responsible for a person's treatment and recovery. That is one of the most ridiculous and arrogant posts I've seen yet.

 

[beBrave]

People don't seem to have too much difficulty distinguishing between PA's and Family physicians in spite of the former sharing Rx rights.

A PA works under a Physician.

 

[Balantidiumcoli]

A PA works under a Physician.

And still write scripts. NP's do too and even practice independently in several states.

All of that aside, your main objection to psychologists having Rx power on a dynamic that is akin to a mid level practitioner would be what exactly?

 

[Temperature101]

OP concerns might be legit if OP is working with psychologists and psychiatrists at a mental health institution. But I have a feeling that OP has no first hand knowledge of what psychologists do and resort in bashing them because he/she has some interest in becoming a psychiatrist... That is just a hunch! I might be wrong however.

 

[beBrave]

OP concerns might be legit if OP is working with psychologists and psychiatrists at a mental health institution. But I have a feeling that OP has no first hand knowledge of what psychologists do and resort in bashing them because he/she has some interest in becoming a psychiatrist... That is just a hunch! I might be wrong however.

My firsthand experience comes mainly from Psychologist. My experiences with Psychiatrist has been much more limited but I've been blown away with their level of professionalism and ability to make unbiased assessments. While we are on the subject, you are a health student, what's your level of experience?

Psychiatrist amaze me at how quickly they cut through the BS, while Psychologist just seem to layer it on. I've spoken with Psychologist who have been in the business for 20 years and they urged me strongly not to enter the field (I've spent time working with clinical counselors and to be honest I didn't like what I saw; nothing really ever changed for those involved in treatment). When I was an analyst working on my PhD some of my clients who I got to know were Psychologist and would ask me if this was the life I really wanted as we reviewed their dramatically low financial earnings. It is not a good lifestyle. Neuro-Psychology is an entirely different field, however Clinical psychology is a field in transition, a transition where I see Psychiatrist and advanced Psychiatric practitioners completely servicing patient needs and care more efficiently and effectively.

 

[cliquesh]

I always wondered if psychiatry was a field that you needed to take the usmle for?

You don't, but I still would. Some really good places will take DOs for psych, but they want to see a usmle score.

Why do you think that is? Why does no one want to be involved with psych cliquesh?

Psych isn't very "prestigious" and it is not like normal medicine, which is a turn off for most people. Moreover, the medications, in general, are not much more effective than placebos. I did inpatient psych for a month and none of the patients improved in any significant way. I still thought it was pretty cool and it's definitely a good life style career...if you don't mind the patient population.

 

[Balantidiumcoli]

Psych isn't very "prestigious" and it is not like normal medicine, which is a turn off for most people. Moreover, the medications, in general, are not much more effective than placebos. I still thought it was pretty cool and it's definitely a good life style career...if you don't mind the patient population.

No... There are studies that find that to be the case for many anti-depressants but that's definitely not the case for anti-psychotics, anti-parkisonians and mood stabilizers.

 

[Drrrrrr. Celty]

No... There are studies that find that to be the case for many anti-depressants but that's definitely not the case for anti-psychotics, anti-parkisonians and mood stabilizers.

Right, and even then there are classes of anti-depressants that are pretty effective. But again, anti-depressants probably are a really individualistic drug, sometimes one class will work better than another.

 

[Balantidiumcoli]

Right, and even then there are classes of anti-depressants that are pretty effective. But again, anti-depressants probably are a really individualistic drug, sometimes one class will work better than another.

Pretty much. From what I understand, the current Tx protocol is to essentially write a script, get the patient proper psychosocial supports and wait for neuroplasticity to help the person adjust and ultimately kick their depression with med adjustments being made as applicable.

I remember being at one seminar where a psychiatrist was discussing psychopharm and he said that the most potent anti-depressants actually belong to a class called monoamine oxidase inhibitors (the name is a bit of a giveaway, they essentially inhibit neurotransmitter degradation). The only problem is that mixing these things with wrong drug or food intake has some very nasty side effects (can even be lethal).

 

[MrDocMD]

And still write scripts. NP's do too and even practice independently in several states.

All of that aside, your main objection to psychologists having Rx power on a dynamic that is akin to a mid level practitioner would be what exactly?

A PA isn't allowed to call him/herself a doctor. I don't know, for me, I think if you call yourself a doctor and prescribe medications, it confuses patients. They think they're seeing a medical doctor as opposed to a clinical psychologist.

 

[beBrave]

A PA isn't allowed to call him/herself a doctor. I don't know, for me, I think if you call yourself a doctor and prescribe medications, it confuses patients. They think they're seeing a medical doctor as opposed to a clinical psychologist.

NP's and PA's aren't Doctors but they often get referred to as Doctors. The attending nurse will usually say "the Doctor will be right in", no matter who comes walking in. I remember joking with this one 'Doctor' who turned out to be a Medical school student stitching me up (I had fun teasing her about prescribing drugs, and her attending physician seriously asked me if I thought she would stand by and let me corrupt her lol), in another case a Physicians Assistant told me that she didn't have to do much to get into PA school; didn't even have to take Physics to get in where she went and prescribed me drugs without any issues.

It's one thing having trained individuals filling in for Physicians (while working under their guidance) or learning alongside them, its another thing misrepresenting yourself as one. Insurance companies are so greedy that if it saves them money and proves to be low risk enough, then they would go along with referring patients to Clinical Psychs for medication management. Unfortunately, when a patient begins experiencing mild symptoms (that can become serious) due to a medication that a first year Med student would recognize as the cause versus a trained Clinical Psychologist, that's another story.

 

[GUH]

NP's and PA's aren't Doctors but they often get referred to as Doctors. The attending nurse will usually say "the Doctor will be right in", no matter who comes walking in. I remember joking with this one 'Doctor' who turned out to be a Medical school student stitching me up (I had fun teasing her about prescribing drugs, and her attending physician seriously asked me if I thought she would stand by and let me corrupt her lol), in another case a Nurse Practitioner told me that she didn't have to do much to get into PA school; didn't even have to take Physics to get in where she went and prescribed me drugs without any issues.

It's one thing having trained individuals filling in for Physicians (while working under their guidance) or learning alongside them, its another thing misrepresenting yourself as one. Insurance companies are so greedy that if it saves them money and proves to be low risk enough, then they would go along with referring patients to Clinical Psychs for medication management. Unfortunately, when a patient begins experiencing mild symptoms (that can become serious) due to a medication that a first year Med student would recognize as the cause versus a trained Clinical Psychologist, that's another story.

Just you wait. All new NP's are getting DNP's (the NP's have banned non-doctoral NP programs in spite of there being no evidence that DNP's provide better care than master's-trained NP's). Many DNP's will call themselves "doctors" and have the legal ability to diagnose, prescribe, and treat without physician collaboration in many states. The best part is that a DNP program can be completed in a year and half with no required residency program.

 

[beBrave]

Just you wait. All new NP's are getting DNP's (the NP's have banned non-doctoral NP programs in spite of there being no evidence that DNP's provide better care than master's-trained NP's). Many DNP's will call themselves "doctors" and have the legal ability to diagnose, prescribe, and treat without physician collaboration in many states. The best part is that a DNP program can be completed in a year and half with no required residency program.

And when the quality of health care suffers they will blame the Physicians.

 

[Temperature101]

And when the quality of health care suffers they will blame the Physicians.

The public always blame the physicians, but administration always blame the nurses. Just venting my frustration.

 

[Balantidiumcoli]

A PA isn't allowed to call him/herself a doctor. I don't know, for me, I think if you call yourself a doctor and prescribe medications, it confuses patients. They think they're seeing a medical doctor as opposed to a clinical psychologist.

Psychologists can't legally refer to themselves as 'medical doctors' either. Considering that psychologists have to maintain a license (which requires a strict adherence to set guidelines) that seems like a very trivial obstacle.

I wonder what happens to the poor patients who meet PA's or NP's with PhDs... Nothing bad I hope.

 

[Balantidiumcoli]

It's one thing having trained individuals filling in for Physicians (while working under their guidance) or learning alongside them, its another thing misrepresenting yourself as one. Insurance companies are so greedy that if it saves them money and proves to be low risk enough, then they would go along with referring patients to Clinical Psychs for medication management. Unfortunately, when a patient begins experiencing mild symptoms (that can become serious) due to a medication that a first year Med student would recognize as the cause versus a trained Clinical Psychologist, that's another story.

*faceplam*

Just go out and get some experience working in the mental health field man. Seriously.

While you're at it perhaps you'd care to cease being so condescending to the practicing psychologists who have been safely prescribing medications to their patients and giving them proper physician referrals for more than a decade now in certain jurisdictions?

 

[geh926]

The story never gets old.

You were waiting on that opportunity weren't you

 

[MrDocMD]

NP's and PA's aren't Doctors but they often get referred to as Doctors.

The point is, they don't call themselves doctor. A PhD in psych can legally walk into a patient's room, say I'm dr. so and so and I'll be prescribing your meds and the patient has no idea who they're seeing isn't a medical doctor.

I remember joking with this one 'Doctor' who turned out to be a Medical school student stitching me up (I had fun teasing her about prescribing drugs, and her attending physician seriously asked me if I thought she would stand by and let me corrupt her lol)

I don't get it. What's the problem with a med student stitching you up?

in another case a Physicians Assistant told me that she didn't have to do much to get into PA school; didn't even have to take Physics to get in where she went and prescribed me drugs without any issues

As a 4th year MD student, I don't see the relevance of physics to practice general medicine. I don't get your point.

Psychologists can't legally refer to themselves as 'medical doctors' either

No one said they could legally refer to themselves as "medical doctors." What I said was that they could legally refer to themselves as "doctors". Therefore, the misunderstanding would be on the patient's part, assuming the "doctor" is a medical doctor when he or she is not.

 

[Isha2018]

You don't, but I still would. Some really good places will take DOs for psych, but they want to see a usmle score.

Psych isn't very "prestigious" and it is not like normal medicine, which is a turn off for most people. Moreover, the medications, in general, are not much more effective than placebos. I did inpatient psych for a month and none of the patients improved in any significant way. I still thought it was pretty cool and it's definitely a good life style career...if you don't mind the patient population.

DO students can pursue AOA residencies in psychiatry. However, it never hurts to take the USMLE, especially if you want to pursue an allopathic fellowship after residency.

I don't care about prestige. I care about having lots of time with my wife and kids and a comfortable living doing something I love.

As a psych nurse for the first 3 years of my nursing career, I can attest that antidepressants do work on many patients. Working in a state hospital, I saw many people change for the better. This was very rewarding, and had a lot to do with the miracle of 'better living through chemistry!' This 'placebo' argument is NOT based in fact or evidenced-based clinical outcomes (that's my nice response ). In addition, antipsychotropics and benzodiazepines are awesome when a patient has become a danger to him/herself or others.

 

[Balantidiumcoli]

No one said they could legally refer to themselves as "medical doctors." What I said was that they could legally refer to themselves as "doctors". Therefore, the misunderstanding would be on the patient's part, assuming the "doctor" is a medical doctor when he or she is not.

We could always tattoo "I am a clinical psychologist. I do not have an MD, I have a PsyD degree. I am legally allowed to prescribe medications to people suffering mental illness as defined in the Diagnostic and Statistical Manual 5. There are certain medical complications that are beyond my scope of practice and I will refer you to proper professionals as appropriate. But I can and will treat psychological maladies with your informed consent and can prescribe medications for only such maladies in accordance with therapeutic guidelines." to the forehead of each practicing clinical psychologist with prescription rights.

But in all seriousness, you're making a mountain out of a mole hill. Psychologists that overstep their scope of practice don't remain practicing psychologists.

 

[beBrave]

The point is, they don't call themselves doctor. A PhD in psych can legally walk into a patient's room, say I'm dr. so and so and I'll be prescribing your meds and the patient has no idea who they're seeing isn't a medical doctor.



I don't get it. What's the problem with a med student stitching you up?



As a 4th year MD student, I don't see the relevance of physics to practice general medicine. I don't get your point.

My point is that it's fine if a PA prescribes medication under the guidance of Physician or a Medical student provides care alongside the guidance of a trained Physician. What I do find problematic is when a PA is described as a Doctor but does not even have close to same training. The physics reference is pointing out the difference in experience and requirements when choosing a PA path vs Physician path. There are many things that must be learned that don't appear relevant to practice general medicine but guess what, you are still required to learn them.

*faceplam*

.

While you're at it perhaps you'd care to cease being so condescending to the practicing psychologists who have been safely prescribing medications to their patients and giving them proper physician referrals for more than a decade now in certain jurisdictions?

I remember an interesting article where a Psychologist with prescribing powers discussed the ability to not only prescribe medication, but also take a patient off medication. It becomes very tempting to simply cut out the "Physician" middle man.

We could always tattoo "I am a clinical psychologist. I do not have an MD, I have a PsyD degree. I am legally allowed to prescribe medications to people suffering mental illness as defined in the Diagnostic and Statistical Manual 5. There are certain medical complications that are beyond my scope of practice and I will refer you to proper professionals as appropriate. But I can and will treat psychological maladies with your informed consent and can prescribe medications for only such maladies in accordance with therapeutic guidelines." to the forehead of each practicing clinical psychologist with prescription rights.

But in all seriousness, you're making a mountain out of a mole hill. Psychologists that overstep their scope of practice don't remain practicing psychologists.

The general public are just as likely to accept medication and medical advice from someone with a Psy.D referred to as a Doctor of Psychology vs a DO that they have never heard of. If the Clinical Psychologist does not explain the differences between a Psy.D with prescription rights and a Physician, then how does the patient know the difference? Lets be serious, people hear Dr. see a prescription pad and think Physician.

 

[costales]

Just you wait. All new NP's are getting DNP's (the NP's have banned non-doctoral NP programs in spite of there being no evidence that DNP's provide better care than master's-trained NP's). Many DNP's will call themselves "doctors" and have the legal ability to diagnose, prescribe, and treat without physician collaboration in many states. The best part is that a DNP program can be completed in a year and half with no required residency program.

Not to mention many, if not most, DNP programs can be done online in your pajamas.

 

[9675flamingo]

As someone who has been a practicing clinician in MH for over 18 years, this is what I know:

1. Only insurance reimbursable psychologists are Ph.D. or Psy.D., Overall, in the field, we use them for testing.

2. Primary practitioners of one hour psychotherapy sessions - reimbursable - in the field - Masters level Social Workers with credentialing.

3. Psychiatrists - 2-4 patients per hour evaluation and prescribing of medications. The only acceptable signature for disability evaluations.

All three credentials do diagnosing. All three can "hang out their shingle". It just depends on your focus. Do you want to do primarily testing? Primarily therapy? Primarily prescribing??

 

[beBrave]

Not to mention many, if not most, DNP programs can be done online in your pajamas.

The D in DNP isn't for Doctor. It's for Disgrace.

 

[Isha2018]

The D in DNP isn't for Doctor. It's for Disgrace.

That's a troll comment! There's nothing wrong with nurses obtaining a doctorate. The question lies in what sort of privileges a doctorate in nursing practice should provide.

 

[beBrave]

That's a troll comment! There's nothing wrong with nurses obtaining a doctorate. The question lies in what sort of privileges a doctorate in nursing practice should provide.

The statement is meant as a metaphor. I apologize if it came across misconstrued. It has nothing to do with the respectable field of Nursing but rather the misconception that a DNP is equivalent to a DO or MD and will be treated as such.

When you look at the current state of healthcare, with an aging population that is living longer but not necessarily healthier lives and the need for long term care rising as resources and healthcare providers become more scarce, with DNP's stepping up to fill this gap, I find it unsettling that future generations of patients will not receive the same quality of care that they have received in the past. That's what I find a disgrace.

 

[Isha2018]

.

 

[Drrrrrr. Celty]

I agree that DNP's and PA's should not have the same privileges as physicians. As an accepted medical student for 2014, I am happy to be leaving nursing so that I may broaden my skill set.

DNPs no, PAs they can pretty decently preform exams and what not, they need only a little bit of supervision as opposed to nurses.

 

[postbacpremed87]

Anyone thinking of going into psych?

 

[Drrrrrr. Celty]

Anyone thinking of going into psych?

I am.

 

[NontradCA]

You don't, but I still would. Some really good places will take DOs for psych, but they want to see a usmle score.



Psych isn't very "prestigious" and it is not like normal medicine, which is a turn off for most people. Moreover, the medications, in general, are not much more effective than placebos. I did inpatient psych for a month and none of the patients improved in any significant way. I still thought it was pretty cool and it's definitely a good life style career...if you don't mind the patient population.

What's wrong with the population?

 

[NontradCA]

I am.

You wanna know dem feels?

 

[Drrrrrr. Celty]

You wanna know dem feels?

U wanna know dat drug dose?

 

[NontradCA]

U wanna know dat drug dose?

Is that all there is to it? Dosing patients?

 

[Cmaj7th]

My point is that it's fine if a PA prescribes medication under the guidance of Physician or a Medical student provides care alongside the guidance of a trained Physician. What I do find problematic is when a PA is described as a Doctor but does not even have close to same training. The physics reference is pointing out the difference in experience and requirements when choosing a PA path vs Physician path. There are many things that must be learned that don't appear relevant to practice general medicine but guess what, you are still required to learn them.



/QUOTE]

I hate to break it to you but PA's are not always prescribing medicine under the guidance of their supervising physician. The graduates a few years out of school? Yes. The ones who have been in primary care for a long time? No.

It is not uncommon for their SP to only have to review 10% of their charts and those patients don't spontaneously combust. The hiring physicians pick experienced and strong candidates for these positions.

I also think it's incredible insulting to say DNPs are a disgrace. They are providing a necessary service. Obviously they are not equivalent to physicians in breadth and depth of medical training, but there are not enough physicians to go around. And shortage of physicians isn't going anywhere anytime soon.

Now I do have an issue with DNPs with truly independent practice; that is merely the product of successful lobbying. But these practices are uncommon and I think the traditional collaborative arrangement that mid-levels and physicians have works well. It's a logical fallacy to assume that MLP provide shoddy care. They know when a patient has a condition out of their scope and they do what physicians in these instances do: consult and refer out. The hospitalists at the facility I have rotated at complain that the MLP in the ED admit too much BS because they are afraid of missing something.

To quote an attending from this board "If you think you can be replaced by a nurse you should be."