Monday, January 07, 2008

Groups Wants Psychologists To Write Scripts

The aptly named Missouri Families For Access to Comprehensive Treatment is asking state lawmakers to pass legislation that would allow some psychologists to prescribe certain medications for the treatment of mental health disorders.

Supporters say "progressive legislation" is needed to improve patient access to treat emotional and behavioral disorders.

At a press conference in Jefferson City Wednesday, Rep. Danielle Moore is expected to announce a bill to give prescription privileges to licensed, doctoral psychologists who meet certain criteria.

Spokesperson Connie Farrow tells the KY3 Political Notebook many of the speakers Wednesday will have Ozarks connections.

14 comments:

john doe said...

"Missouri Families For Access to Comprehensive Treatment" is a front organization for the Missouri branch of the American Psychological Association. It is a group formed by psychologists to advance their agenda. It is another shameful attempt to mislead legislators and laypersons. The underhanded tricks that some psychologists are using to trick people into supporting their agenda really disgusts me. It is all about money. The PhD programs are suffering from a lack of income-generating applicants. Third-party payers are increasingly paying social workers to do psychotherapy thus eliminating the need for PhD psychologists. As a result, PhD's are finding them over-qualified for psychotherapy, what they do best! These self-interested entities along with drug companies are trying to allow psychologists to practice MEDICINE! This, in light of the fact that any psychologist already have the option to go to medical school, become a nurse practicioner or physician's assistant and thus be able to prescribe medicine. This bill would have non-prescribing psychologists as the regulators for prescribing psychologists! Talk about the blind leading the vision-impaired! Lastly, this bill would do nothing but harm the most vulnerable of our population, the mentally ill. It would allow psychologists who have no significant record of practicing medicine to literally experiment on Missouri's citizens as they find out as a profession how to practice medicine. THis is ridiculous and should not be allowed to happen. Let other states allow psychologists to experiment on their citizens. I am truly concerned and shocked that psychologists would propose such bill as this with so many obvious flaws. If they are truly concerned about access to mental health care, they should promote Medicaid funding, rural health clinics, the national health service corps an other such programs that provide scholarships to psychiatrists to practice in under-served areas. Or maybe they should just go to an already existing medical training program?

Tom said...

Well, it seems it only took the disorganized few only a few hours to come up with a marionette,.....but why hide behind a blog post name such as John Doe? First, a fair and honorable bit of full disclosure. My name is Thomas Parquette and I represent NO ONE but myself as a private and very concerned citizen of the State of Missouri. I am not a member of the medical or mental health profession nor any ancillary industries or professions.

It is imperative that it be made abundantly clear to the public, the medical profession and our Missouri legislators that the missive "John Doe" renders to this forum is patently false and baseless in all forms.

The issue of "prescriptive authority" which Missouri Families for Access to Comprehensive Treatment, or MOFACT, supports is a critical necessity which can and will further improve our mental health system in Missouri.

Rather than "waste" space and effort attempting to respond in a point by point fashion to the diatribe of "John Doe" which would reduce myself and more importantly the integrity and efficacy of this issue to the gutter low of an ambush writer (John Doe), some clarity is called for. This person is clearly a frightened, knee jerk mouth piece for that ever small portion of the existing community of medicos and psychiatrists who feel their "turf" is threatened in some way.

Having said that, the public needs to understand that our present medical system cannot handle the load presented by the mental health demands, responsibly. They cannot, either by design, disinterest, lack of capacity or professional training meet the needs of the public.

A recent survey conducted by the US Center for Disease Control and available through the Missouri Department of Mental Health, the American Medical Association and the Missouri Medical Association finds that 32.2% of the adult population of the state of Missouri reports having a "serious", "diagnosable" mental health condition. Further data which are readily available to all clearly indicates that suicide exceeds homicide as a cause of death in Missouri and that the hospital admissions generated by attempted suicides exceeds the suicide rate by ten fold. We have a problem.

Well meaning and caring primary care physicians simply cannot spend the necessary amount of time with a patient to properly assess a mental health condition.Their patient care "system" just does not allow for it. Thus, we have a condition of mis-diagnosis, no diagnosis, no care at all or greatly delayed application of care even when working in concert with a clinical psychologist.

This legislation has and is being mis-characterized as a push by the American Psychological Association, the Missouri Psychological Association or simply PhD psychologists to obtain the "power" of prescription. And, yes, they support these efforts.

But, let this be completely clear now, the APA, MOPA and the concerned psychologists are responding to and helping to carry and implement the DEMANDS of the citizens of this state. This issue and the demands for corrective legislation have their genesis with the many thousands, nay, tens of thousands of patient citizens who have experienced the ineffective, special interest-protective "system" we currently have. The very citizens represented in the aforementioned CDC survey above.This issue is about the people who are NOT receiving the timely and efficient care and most importantly, they are not receiving it because of the lobbying efforts of the dissident faction of the medical community and the arrogant members of the psychiatric community who DO finance their efforts to protect their turf and they think, income.

John Doe strives to involve every "villain" possible including the drug companies. This issue isn't about "if" psychotropic drugs are prescribed it is about "who" prescribes them. Many will be taken off of these currently improperly prescribed medications.

Unlike many if not most who experience mental health issues, I am not intimidated by the alleged "stigma" of this issue. I am also not intimidated by any individual or organization who wishes to debate or challenge my platform on this issue and I do in fact willingly make myself available to appear anywhere in the state to defend this position.

I do have the time, the resources and the knowledge to carry this issue throughout our state and I will fully intend to make this an election issue, if need be.

If that faction, small though it be, of dissident psychiatrists and/or medical professionals who choose to hide behind false identities wish to further degrade a patient driven grass roots issue (NOT driven by the psychologists), I am at the ready. But I fairly caution you that you do so at your own professional peril.

john doe said...

IN response to "Tom", who also does not provide his full name, I offer this. You explicitly state that you will not directly debate the points that I raised in my post. Why not?

Missouri Families For Access to Comprehensive Treatment is obviously an arm of the missouri psychological association. Look it up.

There is no doubt that there are a lot of people suffering from mental illness in MO. Yes, there are gaps in coverage. The ultimate question is what is the best solution to the problem? Is creating an entirely new medical profession from the ground up the most efficient way to address the issue? Surely not.

I have no problems with psychologists prescribing. But to go about it in an illogical and haphazard way is very dangerous, especially when considering we are trying to help the most disadvantaged and under-priveledged in our society.

In order to come to a sound solution to our mental health shortage we DO need to discuss and debate the individual points that I raised in my original post as well as others. Avoiding a legitimate discussion does nothing but obscure what is a public health issue.

Be a part of the solution, not of the problem.

john doe said...

By the way "Tom". I dont appreciate being threatened. "But I fairly caution you that you do so at your own professional peril."

It is innappropriate in what should be a civil discussion on a serious and important issue.

john doe said...

Thomas Parquette, I apologize. You did include your name. However, I will not provide you with my personal information due to your threat against me.

By the way, your article that you submitted through Missouri Families For Access to Comprehensive Treatment states that there are only 400 liscensed psychiatrists in MO. That is incorrect. There are about that many in the Eastern MO alone! I dont know where you get your facts, but clearly they need to be checked.

I share your sincere concern about the gaps in mental health care. However, I dont believe that arguments based purely on emotion, intimidation and tactics such as "snowing" the opposition to obscure the real issues does anything to further the cause of expanding mental health treatment.


Using such tactics may get your bill passed, but the end result may not be the best thing for Missouri's citizens.

Tom said...

Mr. Doe,
Let us approach this at a level you will understand. It is satisfying to see that at least you were able to reread the post to learn that my name is fully and accurately included in my post.

It is amusing at best and completely astounding at the very least that you find anything in my post a threat or of a threatening nature. My closing statement in cautioning that you continue this foolish rhetoric at "your professional peril", only serves to caution you that the public in general finds your continued sofhistry totally lacking in credibility and thus, you place your professionalism at peril. A statement of fact (?), clearly, a threat (?) definitely not.

Now, to attempt to "debate" or address your blather would be to add an undeserving element or aura of credibility to your babble. You see, I did not in any way submit an "article" of any kind through Missouri Families for Access to Comprehensive Treatment nor did I participate in the crafting of any "article". Though you accuse me of such.

Your original post indicated to me through its alarmist, knee jerk, protective tone that you are probably a psychiatrist in Missouri who is pulling the old defeat by destruction card out of his/her "hat" again.

The fact is there ARE only something just over 400 licensed practicing psychiatrists in the state of Missouri-----period. Your profession is now losing and has lost attraction to our finest candidates for potential careers in mental health in favor of psychology.

The fact is, as clearly represented by your exhibited arrogance here, from behind anonymity no less, that the psychiatric community is delusional as to its' importance in the entire scheme of mental health care in this state. Thus, you reduce yourself to this foolish practice of spreading untruth and distorted propaganda to defeat a well thought out benefit to our mental health crisis.

You see, the true fact of this entire post or thread that you so ineffectively "began" is this: your profession (psychiatrists) ARE part of the existing problem, NOT part of the solution. Certainly there are exceptions to this and I am sure there are many fine, committed and dedicated psychiatrists who have avoided becoming there own best patients but I fear they are in somewhat the minority.

I am reminded of a statement by one of our esteemed military leaders of history. General George Patton is quoted quite effectively, I think, with "lead, follow or get the hell out of the way".

It is time for disorganized psychiatry in Missouri to follow that stellar advice. The citizens of Missouri and the country WILL see to it. (oh, and thats NOT a threat either). Be advised, for the record, that I represent myself in my opinions and support of this issue and have been asked by scores of other Missourians at the layman level who are less vocal than I to speak to this issue.

Marci said...

Hi John Doe,
My name is Marci Manna and I am the founder of MOFACT. I am a psychologist in Branson. While it is true that MOFACT does support the RxP legislation. It is NOT TRUE that it is a front organization. The group of 500 people are citizens not psychologists. We have a petition for psychologists to fill out if they support rxp. They are citizens most of which whom I went to personally like my groomer, people I know at the gym - i spoke to them about the legislation and asked them if they wanted to join. Their contact information and signatures are kept at my office.

It seems as though you might be from out of town. In 2007, according to Professional Registration and Licensure, there are approximately 400 psychiatrists in MO. This number does not indicate how many of these 400 that are parttime, or retired and keeping their license active. So your information is incorrect according to the state of MO. This number of psychiatrists makes the waiting time to get into see a psychiatrist pretty lengthly. As a psychologist in Branson, getting a patient in to see someone at the burrell center now is an 8 month wait. If the patient has medicaid it can be even a longer wait. There are many psychiatrists that don't take medicaid. So, patients see primary care doctors. A lot of these docs in my area don't want to deal with psych meds and don't feel well versed.

I want to mention that medically trained psychologists would only prescribed psych meds. not pain killers. We would also have the ability to take patients off of medications. I spoke to a representative last week who is also a physician - who indicated that he saw a woman recently on 8 different antidepressants. This type of situation is fairly common (lots of duplicated meds).

I could go on and on. I don't know about the financial part or the economically driven part, but I do know that a lot of people are suffering and need help. This bill will help to solve some of Missouri's access problems. Sincerely, Marci Manna

john doe said...

There is no debating that we have an access problem. However, your statistics are misleading. There are many PA's and Nurse practitioners who also provide psychiatric medicines to patients. Additionally, most psych meds are prescribed by family practice physicians, pain medicine doctors etc.

What about the professional and board supervision proposed under the current legislation. In it, non-prescribing psychologists would be overseeing the work of newly trained psychologists. Dont you see this as dangerous?

Why dont psychologists go to an already established physicians assistant or nurse practitioner program? Why set up a completely new training and regulatory system when it is entirely redundant?

One way to reduce or eliminate the resistance to this RxP push is to copy the requirements for PA's. So far, the proposed legislation does not meet the requirements even for PAs. This gap needs to be closed. One of the main differences is the supervision element. Under the current bills, there would be no direct supervision by medically trained professionals. The requirement for a "referral mechanism" is entirely inadequate.

MOFACT is obviously tied closely to psychologists. You yourself showed that being both the founder and a psychologist. To present MOFACT as a grass-roots organization made up of people with mental illness and their family and friends is dishonest. Might I remind you that to manipulate ones patients in any way to support a political purpose violates many professional codes of ethics. I think that walking that line is dangerous and may poison the therapeutic relationship. I am in no way implying that you or your colleagues do this but I am just bringing it up as a potential conflict of interest.


I have spoken with other, very prominent psychologists who are afraid of signing a petition stating their opposition to this legislative push. They feel that the MO branch of the American Psychological Association is currently controlled by RxP backers and that they would be "black-listed" by the political factions currently in control. As you can see from the previous exchange, some of the RxP backers can be quite fervent in their enthusiasm perhaps sacrificing rationality in the process.

THhre are many psychologists and other mental health professionals who oppose this bill who are afraid to identify themselves due to the rabidity of the RxP supporters. There is something wrong with the current tone of the RxP debate that does not tolerate dissension and is not helpful to the process.

This phenomenon is similar to the Psychoanalysts domination of American psychiatry from which the mental health field is only recently beginning to recover. The psychoanalytic period did very little to help patients and may have delayed advances in treatment and advocacy.

If only the energy that RxP backers put into their self-serving legislation would be put into truly addressing access issues, we might actually accomplish something.

THere are many much more effective ways to increase access to mental health treatment such as increased funding for Medicaid, community mental health clinics, and rural health initiatives etc. Dont you think to start an entirely new profession is a bit inefficient if we really want to increase access? Besides, cant a psychologist just go to a physician assistant (PA) or Nurse practitioner (NP) program and obtain prescribing priveledges?

Tom said...

Mr. Doe,

Your latest post on this subject is just another verse in your playbook.

You have made every effort on this blog to assail the APA, MOPA and the grassroot MOFACT organization, to no avail. Attempting to create an impression of, I think your words were, rabidity, intimidation and fear of the efforts by all persons attempting to make a true and valued humane contribution to the advancement of mental health care in Missouri. You should examine your ethics, integrity and behavior relative to patient well being.

I am presently at the forefront as an activist for patient rights and advancements in mental health care in Missouri and nationally. I am in contact and aware of virtually dozens of Missourians who support this legislative effort and are striving for its passage. I have made it my point to inquire of virtually every supporter as to their connection or interest in mental health in Missouri and how they became aware of the issue at hand and how they became aware of MOFACT. Virtually every person, whether a patient, medical practitioner, or relative or spouse of a patient learned of this effort and/or of MOFACT through the media coverage in Missouri or through word of mouth. Not one person has referenced, reported, or alluded to being told by or informed by a psychologist at any level.

For you to attempt to imply, through your veiled "warning" or through innuendo that any type of unethical dealings or conduct may be taking place or may have taken place in this effort is clearly reprehensible.

Fine, dedicated professionals are taking their time and expending their collective efforts to institute a measure that will greatly improve mental health care in Missouri and elsewhere.

The most you have offered here is more self serving, protective, ineffective "solutions" that do or would do nothing more than exacerbate the already monumental problems which have been largely created and fostered by the psychiatric community as opposed to the creative and positive efforts of the psychology community.

Shame on you, Mr. Doe!

Thomas Parquette

john doe said...

More food for thought:

1) This is a way to save psychology as a profession at the cost of taxpayers’ money and physical safety.

This bill is simply a way for professional schools of psychology to increase the number of tuition-paying students. The number of applicants has decreased dramatically over the past 20 years. Managed care companies are no longer willing to pay over-priced PhD’s to do psychotherapy that a master’s degree level therapist can do just as well. The professional schools are threatened and the livelihoods of psychologists as well. So, psychologists need to make a new niche for themselves or they will die out as a profession. RxPhD is nothing more than a desperate attempt by the psychologists to save their shrinking profession.

2) Psychologists are not in rural areas.

Like other health professionals, psychologists are not in the areas where they are needed. Prescribing psychologist legislation will not in any way improve access to mental health professionals.

3) Prescribing psychologist’ education is far less than for any other prescribing health profession.

The APA would require 400 hours of biomedical education for prescribing psychologists. This is less than half that of a physician assistant! Compare this to over 4000 hours for a medical school graduate. This is before internship and residency which would add at least another 4000 hours!

4) There is no data to show that psychologists can prescribe safely.

Psychologists have not studied their own safety. Why would they? It would show that inferior education leads to poor outcomes. It would not be in their interest to study their own outcomes. Besides, it’s like the fox guarding the henhouse.

5) The National Alliance on Mental Illness does NOT support this bill.

6) All medical societies are opposed to this bill.

7) There is no required regulation of prescribing psychologists by medically trained persons.

This type of legislation would set up regulation of prescribing psychologists by a counsel made up of seven psychologists, and one layperson. They would not be required to know anything about prescribing medications or have any medical expertise.

8) There is no ongoing medical supervision of prescribing psychologists.

There is a vague requirement for a “referring relationship” with a physician. This is not a supervisory or oversight position. The PhD psychologist could just send them to the emergency room.

9) PhD psychologists would be impersonating real physicians.

A person with mental illness would not be able to tell the difference between a person wearing a white coat, calling themselves “doctor” and holding a PhD in psychology from a person wearing a white coat, calling themselves “doctor” and having gone to medical school and actually being a physician with a medical degree.

10) The prescribing psychologist 1-year “fellowship” has no educational component.

There is only a vague requirement for “supervision” on a weekly basis. This “supervision” could consist of a weekly phone call.

11) The Department of Defense pilot program that trained 10 psychologists to prescribe medications was shut down due to the massive cost associated.

This pilot program was a flop but is used as proof that allowing psychologists to prescribe is a good idea. The cost was enormous, so they shut it down. The psychologists only treated the healthy and young in an outpatient setting. There were no adverse outcomes because they didn’t look for any! Also, the program required 800 hours of medical education compared to the APA's 400 proposed hours. In addition, there was ongoing supervision by a physician.

12) Prescription drug abuse is a growing problem and will only get worse if RxPhD legislation is passed. With under-qualified psychologists prescribing drugs like amphetamines, methylphenidate, Xanax, Valium and others, there will be more drug addicts. This is especially true if the person giving the drugs doesn’t know what they are doing.

13) The quality control of psychologists is much lower than for other prescribing professions, especially psychiatrists. Psychiatrists score highly on the MCAT( medical college admission test), pass 3 levels of national boards, a general practical exam, specialty boards with another practical exam and pass the specialty boards every 7 years in addition to 30 Continuing Medical Education credits each year to maintain their liscense. Psychologists have to pass only the PEP.

14) RxPhD legislation is redundant. Psychologists can already go to a Physician Assistant (PA), Nurse Practitioner (NP), or Medical Degree (MD) program and obtain prescribing authority. We dont need to start an entirely new medical profession from scratch.

Jonathan Rich, Ph.D. said...

Dear Mr. Doe,

Let me introduce myself and address some of your incorrect statements. My name is Jonathan Rich. I'm a clinical psychologist, practicing in Southern California. My website is at PsychologicalTesting.com.

Here are your statements and my responses. Your anonymity has apparently embolded you to spread misinformation.

"This is a way to save psychology as a profession at the cost of taxpayers’ money and physical safety."

There is no evidence of safety problems; quite the opposite, as I point out below. Taxpayers are likely to save money. There is a shortage of psychiatrists, resulting in long waits for patients, exhorbinant fees, and prescriptions for psychotropics written by practioners with minimal mental health training. Public facilities (and thus taxpayers), including community clinics, jail, prisons, and state hospitals bear these costs. As far as saving the profession, I assure you that there is no shortage of well-paying work for psychologists. Psychologists' broad training in the behavior sciences has many applications in addition to mental health treatment. I earn a living doing psychological testing, quality improvement, research consultation, teaching, and writing. Prescribing is not needed to save psychologists' livelihood.

"Prescribing psychologists’ education is far less than for any other prescribing health profession."

After undergraduate training, psychologists complete a Ph.D., requiring an average of 7 years. They complete an additional two years of internship. This training includes coursework in biological bases of behavior and psychopharmacology. After these nine years of professional training, psychologists are fully qualified to diagnose and treat mental health conditions. To become a prescribing psychologist requires an additional two years of training. The 11 years of post-Bachelor's training exceeds psychiatrists' 8 years of training.

"There is no data to show that psychologists can prescribe safely."

At last count, psychologists have written well over 50,000 prescriptions with NO adverse events. The evidence that psychologists prescribe safely is monumental.

"The National Alliance on Mental Illness does NOT support this bill."

They also are not opposing it. At this point they remain neutral on the issue.

"PhD psychologists would be impersonating real physicians."

This is as silly as saying that psychiatrists impersonate psychologists without the benefit of a Ph.D. in psychology. Or that dentists, podiatrists, optometrists, or other prescribing professionals are "impersonating" physicians. Psychologists are ethically bound to identify themselves as psychologists. Psychologists are not trying to become physicians -- they are seeking to practice comprehensive psychology.

"The Department of Defense pilot program that trained 10 psychologists to prescribe medications was shut down due to the massive cost associated."

The start-up costs were considerable, as with many government-initiated programs. Psychologists would absorb the costs of their own training. Here is a quote from the GAO report on the DOD project: "Overwhelmingly, the officials with whom we spoke, including each of the graduates' clinical supervisors, and an outside panel of
psychiatrists and psychologists who evaluated each of the graduates rated the graduates' quality of care as good to excellent." The project has been reinstituted.

"Prescription drug abuse is a growing problem and will only get worse if RxPhD legislation is passed."

Psychologists often state a significant benefit of prescription privileges would be the power to UNprescribe. Because psychologists receive extensive training in non-pharmaceutical treatments, they are often able to reduce symptoms while also reducing medication. Their use of psychological testing and generally longer treatment sessions enable them to make more accurate diagnoses, resulting in a reduction in inappropriate or unneeded medication.

"RxPhD legislation is redundant. Psychologists can already go to a Physician Assistant (PA), Nurse Practitioner (NP), or Medical Degree (MD) program and obtain prescribing authority. We don't need to start an entirely new medical profession from scratch."

Psychologists reasonably want training which is integrated with their other training and appropriate for a doctoral-level practitioner. Sitting through the extremely basic mental health information that would be provided in a PA or NP program is not efficient or useful.

john doe said...

"I assure you that there is no shortage of well-paying work for psychologists."

-This is the opposite of what national and state psychological associations, Political action committees, professional journals and others are saying.

"After undergraduate training, psychologists complete a Ph.D., requiring an average of 7 years."

-Why would it take a psychologist 7 years to comlete a 4-year program? That doesnt make any sense. If anything, that is a misleading number intended to inflate the education of psychologists. IT is inappropriate.


"The 11 years of post-Bachelor's training exceeds psychiatrists' 8 years of training."

-A physician needs a minimum of 4 years for a pre-medicine undergrad degree, 4 years for a medical degree, 4 years of residency to become a psychiatrist. That is 12 years. The average would be longer.

"At last count, psychologists have written well over 50,000 prescriptions with NO adverse events. The evidence that psychologists prescribe safely is monumental."

- There have been no adverse events because noone has studied them! You cant see if your eyes are closed. There is NO objective data. Show me references. Besides, anyone who prescribes medications knows that 50,000 scripts without any adverse events is ridiculous and doesnt know what they are talking about. The DOD report concluded that there were no adverse outcomes because they were not even studied or monitored!


"Sitting through the extremely basic mental health information that would be provided in a PA or NP program is not efficient or useful."

Noone has stated that psychologists arent well educated in mental health. It isnt their mental health education that I am concerned about. It is their BIOMEDICAL education, or lack thereof that concerns me. Mentally ill patients are more medically sick than most people. If psychologists want to practice medicine, they need medical supervision, regulation by the Board of Healing Arts, not by non-medically trained psychologists. THey need to step up and go to at least a PA program or ideally medical school.

WHy do you think that 2 of the DOD trainee psychologists went to medical school even after going through the prescribing psychologist training program? Because they realized that they needed much more education than they had in order to practice good medicine.

If psychologists want to practice medicine they must be willing to step up to the plate and raise their BIOMEDICAL education to the level necessary to do so safely and effectively.

Jonathan Rich, Ph.D. said...

"Why would it take a psychologist 7 years to comlete a 4-year program?"

Because it's not a four year program. It's four years of coursework plus internships and a dissertation. The dissertation, an extensive original contribution to the scientific literature, is an important part of a Ph.D.'s training.

"A physician needs a minimum of 4 years for a pre-medicine undergrad degree, 4 years for a medical degree, 4 years of residency to become a psychiatrist. That is 12 years. The average would be longer."

That number agrees with mine -- I said that a psychiatrist has 8 years of post-Bachelor's training, a prescribing psychologist 11. It's 12 vs. 15 if you include undergraduate education.

"There have been no adverse events because no one has studied them!"

To be fair, I believe you are right, that this hasn't been studied closely enough. I believe there are plans underway to do so and I expect that this will reflect well on psychologists. Let me point of that psychiatrists predicted that prescribing psychologists would regularly produce catastrophic events. If there have been adverse events, they have been minor and manageable.

"WHy do you think that 2 of the DOD trainee psychologists went to medical school even after going through the prescribing psychologist training program?"

Because they wanted to continue to practice after they left the military.

"If psychologists want to practice medicine they must be willing to step up to the plate and raise their BIOMEDICAL education to the level necessary to do so safely and effectively."

In general, I don't disagree. The specifics of an appropriate curriculum, one that integrates well with a psychologist's prior training, is still evolving.

john doe said...

Thanks for the clarifications. However, the Missouri laws which we are discussing include school psychologists with a doctorate in educational psychology. Correct me if I am wrong, but there is only a 3 year program plus a 1 year internship requirement. This is according to the US dept of Labor Bureau of Labor Statistics.

Besides, the so-called "2-year master's degree" consisting of 400 course hours as required in these bills is the educational equivalent of a single full-time semester spread over two years. Just because it’s spread over 2 years doesn’t make it a master's degree.


I’m not sure I understand your math. Even with a 7 year Phd/PsyD and a 2 year "master's degree" that only equals 9 years. The 7 years includes internship. Perhaps the requirements are different in California, where you are, versus Missouri, where these laws are being considered.


"The specifics of an appropriate curriculum, one that integrates well with a psychologist's prior training, is still evolving."

Psychologists who want prescribing rights should evolve their curriculum before practicing medicine. Let’s not put the cart before the horse! Only fools rush in.

When comparing years of education we should not compare apples with oranges. 12 years of physical, biomedical education as required of psychiatrists does not equate to the training of psychologists. To be truly comparative, one should compare BIOMEDICAL education since prescribing psychologists are no longer only mental health professionals but HEALTH professionals. They must compare like education with like.

If the biomedical education of prescribing psychologists is to consist of less than a third of that required of a physician assistant, they should be supervised by physicians at all times.

Prescribing psychologists MUST be regulated by the same Board of Healing Arts that regulates all other health professionals, not the Board of Psychology which has no experience or expertise in regulating medical practice.

I have seen colleagues and friends in the practice of doctorate level psychology suffer financially from lost income to master's level psychotherapists. I sincerely believe that the pursuit of prescribing rights is motivated solely by territorial and financial ambitions rather than an altruistic drive to solve the "access crisis" or any other such issue.