The June issue of the APA Monitor had a piece on the legislation in Hawaii trying to get prescription privileges for psychologists. In some states there are shortages of psychiatrists creating a deficit of services. One of the proposed solutions is to allow psychologists to receive extensive training to prescribe a limited amount of medication for mental disorders. However, groups representing psychiatrists have consistently advocated against these types of bills, and like in Hawaii, have been quite successful. Their arguments have been that the risk of mistakes is too great, but essentially this is a turf war, and if psychologists begin to prescribe medication it cuts into their piece of the pie.
My take is that the years it would take to receive the additional training and certification is something I would not personally be interested in doing at this point. However, since there is an unmet need for services in some states and there are psychologists willing to do that work, I support the effort (I’ve written more on this topic here and here). So far only Louisiana and New Mexico have passed legislation, but there are quite a few states at different levels in terms of getting things passed. Regardless of the Hawaii outcome, the trend is toward allowing these priviledges, and I wouldn’t be surprised to see and handful of other states pass bills in the coming years.
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7 Comments to
“Psychologist Prescription Privileges”
Yes I agree with your take on it. Fascinating stuff -
I wonder whether Australia will move this way.
I live in Alaska and we have a hard time getting qualified psychiatrists to the bush communities to help them with their medication needs. If our Psychologists living in those areas could have script privileges, many could be helped that currently have limited resources.
I am currently a psychology major at the University of Alaska and would be very interested in receiving training to help these isolated communities.
The problem with psychologists prescribing is that their training is totally inadequate to do it competently…even with the additional training that the APa requires. They can work collaboratively with current prescribers very successfully, and don’t need to prescribe themselves.
How much training in pharmacology do medical students get? One course? Take a look at the medical school curriculum at the University of New Mexico, for example, and you will see that there is not even ONE formal course in pharmacology. Everything is arranged by systems, and/or cases, and is geared towards passing the USME step I. I looked at a couple of other medical schools and the arrangement was the same. It seems to me that the in-depth training that psychologists are required to get on pharmacology SPECIFIC to their area of expertise is by far superior to what an M.D. gets. M.D.’s are generalists until they do their three years of residency. A general practicioner has far less training in pharmacology and little training in psychiatry/psychology. Why should s/he be privileged to write prescriptions and a psychologist who is more expert in this area not?
I think this will start a dangerous trend in the watering down of Psychopharmacology
I am sorry to say this, but only an idiot could write the above per MWT: “…there is not even ONE formal course in pharmacology.” If that was even remotely true, then the school is running a fraudulant program and should be sanctioned. But, I doubt that is true.
It is just not about didactile training, folks, but internship and on site learning about meds that is not mastered in a classroom. And that is why psychologists only add to the detriment of mental health failings, by using such false accusations as justifications for attaining prescribing habits. Hey, when your malpractice rates quadruple, call me to complain. The click you will hear is my sympathy.
By the way, Dr Ghesquierre, the trend started with the overmedicating by psychiatrists, so we are part of the problem too!
Skillsnotpills, board cert psychMD
I actually have more faith in nurse practitioners prescribing medicines. As an RN myself, we had to take a class in pharmacology. I then applied for my first job at NY-Hospital, in NYC, a teaching Hospital. We were trained extensively for six months straight, and tested in all matters, including pharmacology. I learned never, ever to give a drug to a patient unless I was absolutely familiar with it and had read it up in the PDR as well, including dosages.
Even if the MD wrote an incorrect order, if we gave it, we were equally responsible. We always had to double check on Doctor’s orders. But this was in the eighties!
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Last reviewed: By John M. Grohol, Psy.D. on 20 Jun 2006
