RxP for masters level providers

[50960]

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For those of you in favor of RxP or neutral, how would you feel about LCSW/MFT/LPC types getting RxP if they had to do the same training psychologists are getting in order to prescribe?
I doubt this will happen soon, but it is interesting to consider.

 

[vesper9]

with LCSW/MFT practicing therapy in the same environment and on the same level as psychologists (for example in managed care like Kaiser)...it would be hard to find a reason not to allow it, wouldn't it?

 

[Forensic M.S.]

i think master's level should have the privledges as long as they are somewhat supervised and take psych.pharm classes.

 

[JatPenn]

i think master's level should have the privledges as long as they are somewhat supervised and take psych.pharm classes.

So this is what we've come to: 'as long as they are "somewhat" supervised and take some classes.' What's the next step? Reducing the requirements to a weekend workshop? Granting prescription privileges to college graduates who complete a short training course a la an EMT?


Look, I have been largely neutral towards RxP, and once I finish my doctorate will probably look into whatever requirements, licensure issues, etc, exist at that time (a couple years from now), but comments on this board push me more and more towards being against the whole thing. It just seems largely money-driven, people don't want rxp to expand their treatment offerings, rather to command MD-level salaries. Taking a couple of pharmacology classes doesn't equip me with the skills to administer meds any more than sitting in a driver's ed class teaches me to drive.

I'll quote Richard McFall's view on the matter: "if psychologists want prescription privileges, there is nothing stopping them from obtaining them via the customary routes (med school)."

Focus on what your degree has equipped you to accomplish and ditch the inferiority complex. If you are insecure with the degree you obtained, get a different one.

 

[Forensic M.S.]

So this is what we've come to: 'as long as they are "somewhat" supervised and take some classes.' What's the next step? Reducing the requirements to a weekend workshop? Granting prescription privileges to college graduates who complete a short training course a la an EMT?


Look, I have been largely neutral towards RxP, and once I finish my doctorate will probably look into whatever requirements, licensure issues, etc, exist at that time (a couple years from now), but comments on this board push me more and more towards being against the whole thing. It just seems largely money-driven, people don't want rxp to expand their treatment offerings, rather to command MD-level salaries. Taking a couple of pharmacology classes doesn't equip me with the skills to administer meds any more than sitting in a driver's ed class teaches me to drive.

I'll quote Richard McFall's view on the matter: "if psychologists want prescription privileges, there is nothing stopping them from obtaining them via the customary routes (med school)."

Focus on what your degree has equipped you to accomplish and ditch the inferiority complex. If you are insecure with the degree you obtained, get a different one.

actually it would lower future MD's salaries, not increase those who have the training. perhaps you should actually read into people's intentions and not assume people are doing it for the money (because of a message board most of all). it allows for efficiency in the real world, which will happen whether you like it or not. if you want to limit what you can do then fine, that's great. don't enforce it on others. and obviously the training isn't over a weekend and they already offer it anyways as a master's. i can make the same argument about education in general: does four years of undergrad really do anything to prepare you for a job in psychology? according to you probably not.

 

[50960]

Well said forensic-psyd. The real world is something that most who post here have no knowledge of..it bears no resemblance to internship or postdoc! The question I asked begs the question; does a doctorate in psych in any way prepare one better than a MA to eventually prescribe when they get trained to do so (NP, PA, MSCP etc..). I find it funny so many who are against RxP have no idea that most of the MSCP training is biological science and clinical medicine..........

 

[50960]

I don't consider myself dumb, and the MDs I work with agree. I agree that managed care is forcing the so called dumbing down of healthcare, but has quality really changed?? Show me the numbers snow!! Get off your soapbox for a second and consider my question...FYI this thread was for those in favor of RxP, and we know you are not.

 

[JatPenn]

actually it would lower future MD's salaries, not increase those who have the training.

show me some evidence of this, please?

perhaps you should actually read into people's intentions and not assume people are doing it for the money (because of a message board most of all).

there are many threads on this board inquiring about Psychologist salaries, I can adopt your "real world" viewpoint and see that the bottom line is that much in life is driven by money

it allows for efficiency in the real world, which will happen whether you like it or not.

I'm not sure I understand this sentence

if you want to limit what you can do then fine, that's great.

I don't feel as though my degree will be limiting, whatsoever. I can research, teach, and practice with it and each of those endeavors is practically boundless in itself.

don't enforce it on others. and obviously the training isn't over a weekend and they already offer it anyways as a master's.

again, your writing isn't clear. My exaggerations above were to prove a point, when do we stop the "EZ-Healthcare" dumb-down?

i can make the same argument about education in general: does four years of undergrad really do anything to prepare you for a job in psychology? according to you probably not.

So what do you propose? What should the minumum requirements be for prescription privileges, regardless of degree?

 

[Forensic M.S.]

show me some evidence of this, please?



there are many threads on this board inquiring about Psychologist salaries, I can adopt your "real world" viewpoint and see that the bottom line is that much in life is driven by money



I'm not sure I understand this sentence




I don't feel as though my degree will be limiting, whatsoever. I can research, teach, and practice with it and each of those endeavors is practically boundless in itself.




again, your writing isn't clear. My exaggerations above were to prove a point, when do we stop the "EZ-Healthcare" dumb-down?



So what do you propose? What should the minumum requirements be for prescription privileges, regardless of degree?

yes, the world is driven by money, but i have to disagree with you in regards to rxp, people sure as hell wouldn't get psy.d's if it was all about the money. as for evidence, it's quite impossible to become a psychic and predict the future and provide stats (see also psy.d v. ph.d debate in regards to employment).

that is fine you don't think your degree is limiting. personally if i get a master's or doctorate, i think that wouldn't be enough, i'd like to expand my knowledge for years to come, and that doesn't just mean within psychology.

i am not a public adminstration major so it's not my place. i understand your position but unfortunately there is little than can be done except advocacy. there's a reason there are mph and mpa degrees.

 

[Forensic M.S.]

To me, this is all about the dumbing down of healthcare.

Professional schools, social workers, nurse practitioners, optometrists performing surgeries, prescription rights for psychologists, weekend neuropsychological courses, etc. . .

Who does this benefit? Mostly, it benefits managed healthcare, government, and big pharma. The dollars support dumbing down healthcare. It's a shame.

i totally agree, unfortunately there are two options: adapt or become obsolete.
actally a third would be to "fight the man".

the only part i disagree with is "dumbing down", becoming more efficient does not mean "dumbing down" it means (to me anyways) ensuring efficency in the workforce.

 

[sasevan]

I am very much on record here, and in the psychiatry forum on this site as well as in other domains (including my state psychological association), in support of psychologists having RxP.
I did not think there was a valid argument against this development but now i'm having second thoughts.
I've always favored this development given the DoD original experiment and continued experience of psych PhD/PsyD being competent and efficient psychopharmacologists.
While current post-doc MS psychopharm programs are not exactly a replica of the DoD training model at least they are post-doc programs supposedly open only to those doctors that have already had years of academic and clinical education, including a 2-3 year residency (internship/fellowship).
From what I understand doctoral-level psychology programs have much more exposure to neuroscience, psychopathology, and psychopharmacology than MSW/MHC/MFT masters-level programs.
Presumably, the post-doc MS in psychopharm is building on all of that higher level training and its corresponding development of higher level diagnostic and interventional skills.
Maybe the psychopharm curricula-even better if expanded-should be part of the doctoral cl psych program or at least for those who will be specializing in med psych.

 

[Logic Prevails]

Question:

Lets say that you're doing renovations to your house. Do you:

1) Hire the contractor to replace your windows?

or

2) Hire a 'window' installer to do the job?

Although the contractor (jack of all trades) is qualified to do the work, I would probably get the window installer to do the job, because that's what they work with on a daily basis - nothing else.

Maybe psychologists are looking to spread themselves a little thin with all the things they hope to be competent at.

 

[PublicHealth]

Maybe psychologists are looking to spread themselves a little thin with all the things they hope to be competent at.

EVERY psychologist will not pursue RxP. Those who want to expand their scope of practice by specializing in medical psychology (much like specializing in neuropsychology, forensic psychology, etc) will have to pursue additional training that culminates in a postdoctoral master's degree in clinical psychopharmacology, complete a clinical practicum, pass a national exam in psychopharmacology, complete a 2-year conditional prescribing term, and only then could they prescribe a limited formulary in collaboration with their patients' primary care physician.

Graduates of PhD/PsyD programs in clinical psychology will not simply waltz out of their programs with one biologic basis of psychology course under their belt, be handed a prescription pad, and be expected to know what to do.

Please educate yourselves before posting here! 🙄

 

[Logic Prevails]

Graduates of PhD/PsyD programs in clinical psychology will not simply waltz out of their programs with one biologic basis of psychology course under their belt, be handed a prescription pad, and be expected to know what to do.

I don't think you get my analogy. I'm saying that even if people have the proper training, they may be taking on too much to be considered an "expert" in all of these different areas. People gain expertise not only through training, but through experience.

Please educate yourselves before posting here! 🙄

Please refrain from pissing people off by posting stupid comments such as this 😀

 

[soaringheights]

Hi everyone
I'm doing M.A. (Clinical Psychology) from Bombay, India.
I'm curious to know which subjects u guys are u guys required to take to obtain prescription privileges. I'd heard that it was allowed only in some states. Is such training allowed everywhere in U.S. or only with selected universities? Can u enroll for it while doing PhD?
And another burning hypothetical situation: if such a licensed psychologist with prescription privilege practices in a hospital or any other large setup, where does it leave the psychiatrist?

 

[50960]

I am a medical psychologist. Every day I manage patient's psych care including meds, labs, therapy etc. in an outpatient family practice clinic. We have a psychiatrist who is fine with me doing this, and we use him for the more complicated patients (medically, psychiatrically). I feel very competent in doing what I do, and I have the support of the 20 clinic docs, and 15 midlevels. In the years I have been doing this I have yet to kill or harm anyone, and in no way feel that my knowledge of medicine and pharmacology has spread me too thin. Actually the opposite is how I feel; psychologists who do not have adequate medical and pharm training are taking a big risk in treating something with therapy that has a good chance of being physical in nature. I see this every day. People are anaemic, have diabetes, thyroid problems, heart problems, are on meds that cause these sx etc..... I always ask myself "what else could this be", and refer to the proper medical provider...do you?

 

[50960]

I know YOU do, and this is one topic we agree on. The rhetorical question was mainly do most clinical psychologists? The answer is no.

 

[PublicHealth]

I wonder what effect, if any, all the news about stimulant medications killing 26 children will have on psychology RxP this legislative cycle.

http://www.psycport.com/showArticle...ews_ap_org.anpa.xml&provider=Associated Press

 

[sasevan]

I know YOU do, and this is one topic we agree on. The rhetorical question was mainly do most clinical psychologists? The answer is no.

I know I most definitely do and I know that some colleagues (the ones who are more neuro or health inclined) tend to as well. I also know some who don't.
I'm not sure at all about what most cl psychologists in fact do but given cl psychology's developing appreciation for the interaction between biology and behavior I believe that doctoral programs will begin to emphasize the connection more and more.
I mean it is fundamentally a question about not doing any harm to our patients; isn't it?
If we're going to be diagnosing in order to treat then we must know the nature and range of medical conditions manifesting as psychiatric symptoms so that we can better determine when treatment is within our scope and when referral to another specialist is warranted.
But this brings me to the original post.
If cl psych is still developing this appreciation, and if this development is necessary in order to acquire RxP, should mid-level psychotherapists (i.e., social workers, counselors, etc),whose training may not approximate even cl psych current levels in terms of neuroscience, psychopath, psychopharm, etc., be supported in becoming prescribers?

 

[Pterion]

For those of you in favor of RxP or neutral, how would you feel about LCSW/MFT/LPC types getting RxP if they had to do the same training psychologists are getting in order to prescribe?
I doubt this will happen soon, but it is interesting to consider.

Psisci: although I have disagreed with you at almost every point along this debate, I have respected your opinion. Since it seems difficult to get your question answered on this topic - I am disqualified from participating 😉 - I would like to know your view. How would you feel about such a move?

Thanks,
Pterion

 

[50960]

I am not sure.....really. If it happened today I would be against it. Not because I have a good argument against it, but most of the MA level providers I know I would not trust with that kind of authority. That is my honest non scientific answer for now.

 

[PublicHealth]

Psychologist RxP is progressing VERY slowly. I do not even think that RxP is on the radar screen for Master's-level providers.

 

[50960]

No it is not, and probably will not be. This was a hypothetical topic.

 

[pingouin]

I am not sure.....really. If it happened today I would be against it. Not because I have a good argument against it, but most of the MA level providers I know I would not trust with that kind of authority. That is my honest non scientific answer for now.

Truer words have never been spoken.

A friend and I recently got into a debate about this. He supports LCSWs prescribing, I was against it. Too many blurred lines across what are pretty distinct professions, too many masters programs becoming diploma mills. The overall quality of the clinicians and the training just aren't at the level of what would be needed to even consider prescribing.

 

[edieb]

Although this thread was probably posted with good intentions, I think posts with statements like "RxP for master's levels providers" may make other discipliines, with which we share these boards, frown upon clinical psychology.
We have the dubious distinction of being the most highly trained specialty (5+ years post undergraduate) with the fewest # of privileges in the healthcare arena. MDs are using the argument that giving psychologists prescrptive authority is a harbinger to the dumbing down of health care. Then we have someone from our own ranks write "RxP for Master's...." for all these professions to see.... It may make these other professions think this is our hidden agenda or give them evidence that RxP for psychologists is leading to this trend/this is our hidden agenda.. Remember social psychology's theory of confirmation bias!! As other professions are viewing these boards, we may want to be a bit more careful with what we write!!!

 

[PublicHealth]

Precisely!

Psisci and everyone else,

How about we stop posting in this thread, kill it altogether, and resume posting in the Psychopharmacology/Advanced Practice Psychology thread that was initiated for the purpose of this discussion!

 

[50960]

PA and NP's are masters level at best, so medical providers are more used to this concept than we are. I think limiting our talk over paranoia on a msg board is silly because in no way does SDN= real worl thought...most people here are students. I am happy to continue this conversation elsewhere but I am not closing the thread or any thread unless TOS/ SDN rules are broken. Aside from PH, there were no responses from anyone on any other forum, so I do not think I caused a stir...and I generally like to on Fridays!!!

 

[PublicHealth]

PA and NP's are masters level at best, so medical providers are more used to this concept than we are. I think limiting our talk over paranoia on a msg board is silly because in no way does SDN= real worl thought...most people here are students. I am happy to continue this conversation elsewhere but I am not closing the thread or any thread unless TOS/ SDN rules are broken. Aside from PH, there were no responses from anyone on any other forum, so I do not think I caused a stir...and I generally like to on Fridays!!!

Oh, I'm still stirring, my friend! 😛

 

[50960]

Stir it up...... 😉