The current paths for prescribing: medical school, PA, NP, dentists et al., and post-doc psych RxP'ers in certain states/areas. Ok, so of those MD/DO and some NPs have independent Rx. Then the limited formularies and/or collaborative setup is PA, NP, and psych RxPer's. How does this "change the rules" to want additional states have a collaborative setup? How are the LA or NM models a "change" in the rules from what is current existing? It's not. These are all paths that current exist, so there is no "new" path or "change".The rules are very clear- they are the specifics of medical school or midlevel school (if you want to practice as a midlevel). A more apt analogy is you're trying to change the rules by arguing that something that's much less might be good enough. (Also its not a "game." I wouldn't use that in my analogy.)
Let's consult the mounds of data showing that MD Rx'ing is the ONLY safe way to train and RxP safely. Oh wait, that data doesn't exist. The best I've seen are some studies that look at outcomes of MD/DOs and NPs…and from what I recall it was a wash. Okay, so what other data are out there? Well…DoD was one source, albeit not a great fit for what is "typical". Okay, what else is out there. Let's look at LA and NM. There isn't much there either that looks specifically at prescribing. So do we look at anecdotal data or are there other options?
One way medical systems evaluate the safety of a procedure/program/intervention in their system is to measure how many adverse outcomes per 100 (or 1000) cases. If someone were to believe the (unsubstantiated) claims of anti-psych RxP you'd think that there would be piles of dead bodies everywhere or at least lawsuits for adverse outcomes from all of the medication mismanagement. So….where are they? Tens (hundreds?) of thousands of prescriptions written and….? You'd think that if the training were so inadequate that there would be reports of problem, no?