trouble in the southwest for psychiatric patients

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mswphysician

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Has anyone heard of the troubling news coming out of New Mexico and Louisiana? In New Mexico, psychologists (who are not medical doctor nor do they have medical training of any sort) are being allowed prescription rights comparable to trained, board certified psychiatrists and other physicians. In order to procure this right, the psychologist (Ph.D. or Psy.D.) must take several courses (not at the medical school level), be supervised by a physician for a short period of time, and take a licensure exam. The only bright side to this catastrophe is the state medical board is to design and implement the courses, supervision, and develop the licensure exam.

Even more troubling, in Louisiana (where the measure has passed the house and the senate) the state board of psychologists has proposed it has the authority and knowledge to train, set standard, develop licensure requirements, etc. for psychologists to practice what is essentially psychiatric medicine. Additionally, the psychologist would only need 100 hours of "supervised" time before they could prescribe. Psychologist would also be required to attend classes that, to paraphrase Dr. Marcia Goin (president of the APA), falls woefully short of medical school.

After reading several articles and reports on this subject, I looked at both the AMA and AOA websites for a response and hopeful advocacy from the groups. There was nothing that I could find addressing this issue. When I went to the APA website, there is a letter written to Louisiana governor urging the veto of the bill if it passes.

Now, why should we care? You may not be interested in psychiatry as a profession. After being a social worker for six years I certainly am not. This to me is not the point. Adequate medical care is. As medical doctors, no matter what the specialty, we will treat the mentally ill. By going into medicine we are required to advocate for all patients by keeping the standards of care high for all, including the mentally ill. If these psychoactive drugs (including clozaril, haldol, Thorazine, as well as the atypicals, SSRI's and controlled substances) are so benign, why not make them over the counter? If training medical doctors to deal with people who have psychiatric conditions is so pedestrian, why have residency? Why not hold physicians to the same standard as proposed by the psychologists? for that matter, why not allow MSW's, PA's, NP's, RN's the ability to take the same course work and have unsupervised prescriptive powers?

To me, the disregard for proper training in medical mental health further reinforces the notion that psychiatry and those with psychiatric conditions do not suffer from biological diseases and therefore do not need trained medical doctor treating them.

I end my rant with a call for all MD's and DO's to put aside bickering over who has the better degree and focus on the real and tangible threats to our patients. Get active. Wright both the AMA and AOA and encourage more advocacy for patients and their safety.

Please reference the American Psychiatric Association: www.psych.org and the American Psychological Association www.apa.org


Here is a letter from the APA, please note all the dates:
DATE: May 3, 2004

TO: LPMA Members

FR: Patrick O?Neill, M.D.
Dudley M. Stewart, M.D.

RE: YOUR CALLS OPPOSING PSYCHOLOGIST PRESCRIBING BILL ARE STILL NEEDED

ACTION REQUESTED:
USE THE TOLL-FREE NUMBER TO CALL GOVERNOR BLANCO; ASK HER TO VETO HB 1426

Louisiana Governor Kathleen Blanco has until May 6 to veto House Bill 1426, legislation to allow psychologists to prescribe psychotropic medications. If Governor Blanco does not veto the bill by that date, HB 1426 will become law, even without her signature.

LPMA, in partnership with LSMS, APA, and AMA, with strong support from patient groups, has worked tirelessly to persuade Governor Blanco to veto this threat to the health and safety of Louisiana patients.

PLEASE HELP US PERSUADE GOVERNOR BLANCO TO VETO THIS BILL. Your calls are needed NOW so that she knows that there is strong opposition to HB 1426. Use the toll-free number below to call Governor Blanco and let her know that Louisiana physicians and their patients don?t want this dangerous bill to become law.

Call the governor?s constituent services line toll-free at 800-317-5918.

Your suggested message:

?As a psychiatric physician, I ask you to veto House Bill 1426, the psychologist prescribing bill. Our patients deserve the very best health care. This bill is a prescription for disaster. Please veto HB 1426.?

Thank you for your continued personal support of LPMA?s efforts on your behalf. Please contact LPMA at 504-891-1030 for additional information.

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yea, that is troubling....
 
Lots of posts/responses on this in the "Psychiatry Residency" forum if anyone's interested....and you all should be as current/future physicians.
 
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Anasazi23 said:
Lots of posts/responses on this in the "Psychiatry Residency" forum if anyone's interested....and you all should be as current/future physicians.

can you post a link please? thanks
 
Kudos MSWphysician, for paying attention and keeping us informed!

Thanks for the information!
 
thanks bluesunlilly- also check out the allopathic site for more discussion. i have no idea as to how to put the link in this page. sorry!

robert g.
 
I think giving psychologists prescribing rights is a dumb idea, and I know many psychologists feel the same way.

That said, it's kind of irritating to listen to psychiatrists whine about their "systemic knowledge" and the "complexity" of prescibing effectively. Anyone who has utilized this profession's services knows that few psychiatrists do anything beyond passing out whatever random pill the drug rep brought in that day.
 
I actually believe clinical psychologists should be able to treat patients with drugs. Most clinical psychologists are not going to use drugs as a primary method of treatment but I think they should be able to use them as they feel necessary. I agree that it will take some time to find suitable methods for licensing psychologists to dispense medications but as a student who majored in both biology and psychology in undergrad and shadowed with several clinical psychlogists I think it would in fact be a good idea to give them the right to prescribe certain mediciations. Honestly physicians only have a semester of pharmacology and they can prescribe drugs. My parents who are doctors of pharmacy cannot prescribe drugs but studied around eight years in the clinical and proper uses of the medications. honestly i think the right to prescribe is arbitrary and should be worked out. I don't agree that only DO's and MDs should have the right to dispense I think others should be able to also.
 
jmarra03 said:
I actually believe clinical psychologists should be able to treat patients with drugs. ... Honestly physicians only have a semester of pharmacology and they can prescribe drugs...

jmarra03, I give you props for posting a message that I'm sure you know will take some heat. Obviously, most people do not agree with your position so thanks for keeping things interesting here. I do have to take issue with your assertion that physicians only have one semester of pharmacology. I don't know which physicians you are talking about, but as an almost physician (only three more weeks!!! yea!!! :clap: ), I have to tell you that I had an entire YEAR of pharm - fall, winter, and spring quarters. This also does not take into account all of the on-the-job pharmacology that we learn in our clinical third and fourth years. To my knowledge, most clinical psychologists don't have this exposure in their training. I just had to take issue with the statement that we only have one semester of pharm 'cuz it just ain't true... :)
 
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