MINDOFMYOWN

Junior Member
10+ Year Member
5+ Year Member
Feb 14, 2005
17
0
Status
What effect do u ppl think will this latest 'turf war' about Psychologists being able to prescribe drugs will have on Psychiatrists???
 

OldPsychDoc

Senior Curmudgeon
Moderator Emeritus
10+ Year Member
Dec 2, 2004
6,254
3,905
57
Left of Center
Status
Attending Physician
MINDOFMYOWN said:
What effect do u ppl think will this latest 'turf war' about Psychologists being able to prescribe drugs will have on Psychiatrists???
CNS's and primary care docs can already prescibe psychotropics, but their activity in our groups hasn't reduced the number of med evals I'm getting.

I think it will end up looking like it does now--the PCP starts prozac, tries Zoloft, maybe bumps up the ante with some Effexor, or writes for "a little Xanax"--but when the patient doesn't get better, or switches into mania, or gets psychotic, or starts demanding higher doses of benzos, it's off to psychiatry for a detailed evaluation and intensive management. I think it's probably a minority of psychologists who will want to take on the risk of med management.
 

OldPsychDoc

Senior Curmudgeon
Moderator Emeritus
10+ Year Member
Dec 2, 2004
6,254
3,905
57
Left of Center
Status
Attending Physician
Anasazi23 said:
Please just let this thread die....it's been discussed ad nauseam. Do a search....
Agreed. "MINDOFMYOWN" appears to be trying to restart an old conversation about a subject which I think produces far more panic among those who aren't actually working in the Real World than among those who are.
 
OP
M

MINDOFMYOWN

Junior Member
10+ Year Member
5+ Year Member
Feb 14, 2005
17
0
Status
OldPsychDoc said:
Agreed. "MINDOFMYOWN" appears to be trying to restart an old conversation about a subject which I think produces far more panic among those who aren't actually working in the Real World than among those who are.
I am not trying to restart anything... i actually stumbled upon a couple of more threads after i had posted this one.....and it certainly did add new info, as evidenced by "OldPsychDoc"'s previous post....and precisely what he said in the second part of his present post is true....the main concern would be to ppl who are about to get in the field...the ppl already in the field would have a first hand experience, which would help starters like me a lot....
 

OldPsychDoc

Senior Curmudgeon
Moderator Emeritus
10+ Year Member
Dec 2, 2004
6,254
3,905
57
Left of Center
Status
Attending Physician
MINDOFMYOWN said:
I am not trying to restart anything... i actually stumbled upon a couple of more threads after i had posted this one.....and it certainly did add new info, as evidenced by "OldPsychDoc"'s previous post....and precisely what he said in the second part of his present post is true....the main concern would be to ppl who are about to get in the field...the ppl already in the field would have a first hand experience, which would help starters like me a lot....
Fine--but please lay off characterizing this as a "turf war".
Psychologists, masters level therapists (MSWs, MAs, etc.,) and midlevel prescribers are our friends, teammates, and colleagues.

Thank you.
 
OP
M

MINDOFMYOWN

Junior Member
10+ Year Member
5+ Year Member
Feb 14, 2005
17
0
Status
OldPsychDoc said:
Fine--but please lay off characterizing this as a "turf war".
Psychologists, masters level therapists (MSWs, MAs, etc.,) and midlevel prescribers are our friends, teammates, and colleagues.

Thank you.
Thanks for ur 'advice' .... I hope you really mean it..... and please 'lay off' being rude and haughty........its a discussion forum, not a 'put down' pedestal....
 

almost done

Junior Member
10+ Year Member
5+ Year Member
Jan 28, 2005
12
0
Status
For what it's worth, there are constantly new people reading and contributing to this discussion board. Who's to say that there aren't any new opinions out there?

My 2 cents:

I don't think you can say that because PMDs prescribe psychotropic meds, and that hasn't affected psychiatrist, it won't matter if psychologists are granted that privelege as well.
First of all, how can you say that it hasn't affected psychiatrists? There are plenty of PMD's out there who are treating their patients' psychiatric disorders (some do it well, some not so well) without ever referring them to a psychiatrist. Sure, you may get the referral when things get out of control, but that's just the tip of the iceberg. I don't the exact figures, but it wouldn't surprise me if internists write as many prescriptions for SSRIs as psychiatrists prescribe.
Secondly, for the sake of argument, let's say you're right, and PMDs prescribing psych meds doesn't significantly affect the psychiatrist at the present time. That still doesn't make it a logical assumption that the field can therefore absorb the addition of psychlogists without being affected. There are a TON of psychologists out there.
Lastly, to get away from speaking totally out of self interest, I'm not convinced that psychologists prescribing medications in the best thing for the patients, either.
 

OldPsychDoc

Senior Curmudgeon
Moderator Emeritus
10+ Year Member
Dec 2, 2004
6,254
3,905
57
Left of Center
Status
Attending Physician
almost done said:
For what it's worth, there are constantly new people reading and contributing to this discussion board. Who's to say that there aren't any new opinions out there?

My 2 cents:

I don't think you can say that because PMDs prescribe psychotropic meds, and that hasn't affected psychiatrist, it won't matter if psychologists are granted that privelege as well.
First of all, how can you say that it hasn't affected psychiatrists? There are plenty of PMD's out there who are treating their patients' psychiatric disorders (some do it well, some not so well) without ever referring them to a psychiatrist. Sure, you may get the referral when things get out of control, but that's just the tip of the iceberg. I don't the exact figures, but it wouldn't surprise me if internists write as many prescriptions for SSRIs as psychiatrists prescribe.
Secondly, for the sake of argument, let's say you're right, and PMDs prescribing psych meds doesn't significantly affect the psychiatrist at the present time. That still doesn't make it a logical assumption that the field can therefore absorb the addition of psychlogists without being affected. There are a TON of psychologists out there.
Lastly, to get away from speaking totally out of self interest, I'm not convinced that psychologists prescribing medications in the best thing for the patients, either.
At the risk of being "rude and haughty"...

1) PMDs *do* prescibe more (FAR more) SSRIs than psychiatrists already. Again--it hasn't cut into my business any. Frankly, I'm not all that interested in filling my day pushing Zoloft for mild depression. I'd rather use my training dealing with patients who've already "been there, done that" and really need a closer evaluation. PMDs don't have time to do this. They are the front lines for depression (as with everything else) and they get mere minutes to eval and manage this. There is more than enough complicated psychopathology to go around. Most hypertension and diabetes gets managed by PMDs, too--but no one is predicting the death of cardiology or endocrinology.

2) There are a "ton" of psychologists, but not all of them are going to jump at the chance to get certified for prescribing privileges. There are also a "ton" of nurses, but only a minority put in the extra effort to become a CNS or NP. I also think that the current climate will discourage psychols from doing too much of this. Look at last week's Adderal recall in Canada for example--say you're a psychologist thinking about setting up an ADHD prescription mill, do you want the liability for a sudden cardiac death in a kid? Or for prescribing the Zoloft that some defense attorney will blame a murder on? Those prescribing privileges will come with a price--in documentation, call coverage, and professional liability premiums!

None of the psychols I know are exactly rushing to demand this privilege--they seem to like doing therapy, and knowing they can turf their med referrals to me. I happen to like this practice model--teammates, not competitors.
 

LM02

Senior Member
10+ Year Member
Nov 8, 2004
660
27
Status
OldPsychDoc said:
None of the psychols I know are exactly rushing to demand this privilege--they seem to like doing therapy, and knowing they can turf their med referrals to me. I happen to like this practice model--teammates, not competitors.
Yes!

I am a clinical psycholgist and have no interest in obtaining Rx privileges. In fact, there is a huge rift within our field concerning this matter. In case you were unaware, there is a very large group of psychologists who believe that this is a poor direction to move in, and are actively fighting against Rx privileges for psychologists. More recently, however, there is emerging helplessness toward the strong lobby within APA.

So to answer the original question, it is unclear just how many psychologists will actually pursue this privilege.

And as the above poster stated, I much prefer to work in tandem with a psychiatrist on these matters. Moreover, I have often been approached by psychiatrists with requests for testing or consultation regarding behavioral management. From my own experiences, the multidisciplinary approach is quite effective. To further promote this way of practice, I would strongly urge against the future use of provocative titles such as the one utilized for this thread. We're your friends, not your enemies. :)