No, my point is that if there needs to be a reasonable amount of medical training involved - not just simplified this-for-this applied pharmacology - what is that? Who is that helpful to other than get-rich-quick psychologists? The "downside" is it would be neither quick nor easy and much fewer psychologists would be able to do it simply because people with affinity for biological/medical approach tend not to self-select into psychology. And the right amount of medical training is almost definitely going to be difficult anyway- far from the "no competition" admissions policy of RxP. Further, they shouldn't be afraid to come under the jurisdiction of the AMA and the related scrutiny.
Not surprisingly, I agree. Education and training are key issues, but still not the only ones. I would also suggest considering some others:
1. These would be the only part-time medical providers I know of. We as professionals know that you get better at something when you do a lot of it. Therefore, that would further reduce the potential quality of service. Considering that prescribing drugs is a complex business with the potential for real harm (one study found that 23 percent of the adverse drug events in nursing homes was from psychoactives) I wonder how many people with a choice would send their loved ones to a part-timer.
2. These would very possibly be medical professionals who practice medicine detached from the rest of the medical system. As persons with substandard education and who are practicing part-time, it would be even more dangerous for them to be prescribing drugs outside a medical setting where consultation and cross checking acts as a safety net. Instead, APA model bills call for completely independent prescribers. As a case in point, in Illinois APN's don't have to have a collaborative agreement with a physician if they are working in a hospital, under the assumption that the context and the natural cross-checking of their work by various medical professional colleagues would help ensure safety.
3. As you touched on, the APA model calls for these persons to be licensed and supervised by psychology boards populated by people with no medical education or training. That of course makes no sense. The primary responsibility of a psychology board is to protect the public ... but they clearly are not qualified to do so in the area of medical practice.
4. Practicum experience called for by these bills is allowed to be supervised by other psychologists, ones with the same low-quality training. Also, as a practical matter, psychologists who are RxP trained mostly tend to be highly partisan and thus may be less likely to provide true quality control and filter out or require remediation of less-competent prescribers. In addition, training systems are designed for cross-checks, so that it would be preferred if aspiring psychologist-prescribers were supervised by medical professionals who are also specialists in prescribing psychoactive medications.
5. The "national exam" that RxP advocates refer to is actually one written by APA for its RxP campaign. The number of conflicts of interest in the RxP campaign is significant, and this is yet another one. APA wrote the exam and decided what the cutoff score is. I for one would be very impressed if RxPers were required to pass the psychiatric board exam.
As a result, following the APA model for RxP, it is possible that a person with no education or training in bio-medical sciences or practice, could be prescribing the same psychoactive medications as a board-certified psychiatrist after:
a. Taking 8.8 semester internet courses from a psychology school
b. Passing an exam written by the organization that spends millions politically lobbying for RxP
c. Being supervised in practicum by yet another psychologist with the same insufficient training
d. Being licensed by psychologists with no medical training on the psychology board
Therefore, they could be prescribing powerful drugs without ever having met or spoken to a physician, nurse or pharmacist, and without ever having stepped foot inside a hospital, clinic or even a classroom. That is how bizarre this campaign is. I mean ... really?
Therefore, while the grossly insufficient internet education called for by the APA model - which is what virtually all RxP bills are based on - is a major reason to oppose these bills, that is only one part of the mess that is the RxP campaign.
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