This likely needed to happen bc side effects with psych meds are so common. The injection thing is interesting. I don't really think it will make much of a difference because psych injectables are still pretty rare (as compared to pill/capsule), and cost-wise most Pharma companies don't give a break on pricing for them, so I've only really seen them used in community MH and patients who struggle with compliance. Some in the VA too.
Same way a practicum student writes a report without being licensed. Under someone else’s license, under direct supervision.
1) Medical students do it all the time. I can’t imagine a state that doesn’t have this practice worked into their laws and case law.
People applying to med school aren't doing the clinical work and just having the physicians sign off on it like we're discussing here. They're shadowing physicians during their regular patient care.
The difference is that there are legal pathways and established standards for NPs, med students, and others to do this supervised work while there isn't one for RxP in the vast majority of states.
1) I don't think that your characterization of the supervised experience is accurate. I believe the expectation is that the psychologist shadows a physician. That is how I did it.
1) The law is based upon similarity. The prongs of malpractice are the exact same for psychologists, physicians, PAs, NPs, etc. I don't know how that would work. "Hey, we accept supervision as X criteria. That is codified into federal law too. But our state is going to completely alter the definition of supervision for a very small profession, opening the door to different interpretations of established case law." That would create appeals for every case mentioning supervision in any profession. Mostly with medical labs and radiology.
That seems like a strange reason to resign, at least on the surface.
Yeah, it was on the health psych one. I was surprised. I believe two folks gave a more thorough explanation later, but did seem to boil down to disagreeing with ABPP supporting that.
That's interesting. How would an assessment-heavy neuropsychologist incorporate prescription privileges into their practice? Seems pretty far removed from the testing they do, at least on the surface.
Of the folks I know who pursued it, I'd say it's about a 50/50 split between neuropsychologists and non.
As a person who semi-fits this description ( I am consulting pediatric psychologist in a neuro department of an AMC that does some mixed assessment and intervention), it makes a lot of sense, at least in the pediatric sense. A number of pediatric assessments include evaluation of psychiatric comorbidities and a number of identifiable conditions respond well to medication management (i.e.; ADHD, anxiety, behavioral concerns associated with neurodevelopmental concerns, etc.) alongside EBP psychotherapy interventions. Also, strong agree with WisNeuro that my previous education made this very easy to transition over to, as I had already attended neuroanatomy and neurophysiology coursework with medical students during my doctorate. I also have a strong background in biological and chemistry sciences, which is what drew me a bit towards health and neuro. Having said that, there is a number of students in my program who also hail from all sorts of background, including strong psychoanalytic and Rogerian therapy models. So, you kinda get the whole perspective during class discussions.
I'm a neuropsychologist who sees adults with severe TBI across the rehabilitation continuum (i.e., inpatient to outpatient). I often evaluate patients first at bedside, then (sometimes serially) post-discharge, then (for some people) I'll follow-up every two-to-three months, or so, for reinforcement of feedback, brain injury education, and problem solving around persistent challenges.
I did mine partially because my AMC required it. But I've since moved to a new setting, and my new colleagues don't even know what this specialty board is. It's been fun explaining that over and over.
I imagine so. I always find the duality of academia placing so many hoops in front of us while most people can not even find a decent general mental health provider interesting.
Along with, “I’m stressed out about work. I only get 2 weeks of PTO, that is dedicated to seeing my family of origin once per year. My work had increased my duties by 400%, and disciplines me if my productivity isn’t 400% of my maximum abilities. They won’t pay for someone whose cognitive abilities are commiserate with that level of productivity. Anyway, I need appointments after 6pm.”
Indeed, and probably depends on what's meant by "small."
The APA negotiated with the trust for a maximum premium increase of 10% for individuals granted rxp.
That's actually pretty great.
Unfortunately, this is part of the oral history rather than a part of the scientific literature. I doubt there are official resources for this negotiation, especially since APA and the trust parted ways. The best way to independently verify the cost is to call the Trust and ask.
Noted on the lack of resources.
Idaho just updated their RxP laws (Senate Bill 1088) you seemed pretty well versed in breaking down each states rules so I wanted to ask you how this changes things, particularly with regards to collaboration requirements and working with certain populations (geriatric and pediatric). Kinda a big deal imo since Idaho was one of the more laxed states in terms of the rules.
I honestly have no idea how the process works. I know that it becomes effective in a few months.
legislature.idaho.gov
Idaho- "We are bad, but at least our state constitution didn't ban black people like Oregon!"Hey now, the Idaho legislature is doing very important and serious work! Like trying to figure out a way to prosecute Dr. Fauci for state crimes, for.....reasons! You can't expect them to have time to try and seriously solve their physician shortage problem.
HOUSE CONCURRENT RESOLUTION 5 – Idaho State Legislature
I am a prescribing psychologist and just wanted to comment on this: Malpractice for prescribing psychologists is only around 100$ more than for standard psychologists, so you could have a small caseload of patients who need medication management, and it would still be worth it.
Given my current trajectory and direct interest, is it possible to directly message you related to this topic to "pick your brain some more?"
Good to know. Sent you a DM.
