It always pains me to read the latest news about how psychologists are making a new push to gain prescription privileges, state by state. Last year, psychologists attempts to gain prescription privileges was shot down in nine different states and approved in none.
Despite the multiple avenues open to allow professionals to prescribe (with appropriate experience and training), the professional field of clinical psychology believes its graduate school training in behavior and psychology somehow makes it special. It believes it should be given the unique right to prescribe after taking what amounts to a crash course in human physiology and biology. After only 300 or so “contact hours” of coursework (which roughly translates into the equivalent of 27 hours of traditional course credit) and supervised prescriptions with 100 patients, psychologists believe they will have the necessary knowledge to adequately prescribe powerful psychiatric medications — the same medications which can interact badly with a wide variety of physical conditions, diseases and other non-psychiatric medications. It would take most psychologists approximately 1 to 2 years to complete this additional training if they are already out of school.
The latest attempt to gain some momentum is in Missouri. House Bill 1739 has over 85 sponsors, according to The National Psychologist, but is still a far cry from passage. Florida’s legislature also authorized a study to see whether there was an actual need, as prescription-privilege advocates claim, to extend prescription authority to properly trained psychologists within the state. That study could either provide the psychologists with additional ammunition to support their claims, or help sink them. (I just hope the study isn’t conducted by psychologists.)
But the most interesting news tidbit this month was from a Maine-based behavioral and mental health care provider organization called Sweetser. It announced that it was canning two psychiatrists and instead replacing them with cheaper nurse practitioners in order to save money (practicing under the supervision of a still-employed psychiatrist). So let’s look at the median incomes for these practitioners in Portland, Maine:
Psychologist with prescription privileges: $95,000 – $105,000 (est.)
Nurse practitioner: $78,100
Gee, I wonder which professional health and insurance companies are going to increasingly turn to in order to cut health care costs?
By the time psychologists actually get their vaunted prescription privileges, I suspect they’ll not find the huge marketplace they claim is just awaiting their services. Especially when one of their claims (lack of psychiatrists) goes away as psychiatrists get more quickly replaced by specialty nurse practitioners.