Opinions @ Prescribing Psychologists & Prescription Privledges

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Prescribing rights for clinical psychologists is a hot topic in the psychology and psychiatry worlds, though I haven't heard much from NPs. I'm curious to hear people's opinions about the topic.

Currently New Mexico, Louisiana, the US Military, and I think Gaum/Puerto Rico all have prescribing rights, with another dozen or so states with active bills in support of clinical RxP'ing.

I'm a big supporter of clinical RxP'ing, though I'm still a bit concerned about consistency in training and standards of other programs that are popping up.

I guess in a slight tangent, I'm also curious how the training varies for NPs, and if this has caused any 'real world' problems, or if it is something that people just nitpick (my school is better than your school, etc). I'm asking because I'm a bit worried that some of the training for clinical RxP training varies too much in quality.

So....

1. What do you think about clinical psychologists (with proper training) prescribing?

2. How (if at all) does NP training vary, and does this have real world implications, or is it mostly a 'my school is better than your school' argument?

-t

ps. For full disclosure, I'm in clinical psych, and I am halfway through my RxP training at a university/classroom based program.

Drat!!!

The others will have to trust that we had a great conversation, and we bother offered some strong points and whatnot.

:rotfl:

-t

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Specializes in Acute Care Psych, DNP Student.
Drat!!!

The others will have to trust that we had a great conversation, and we bother offered some strong points and whatnot.

:rotfl:

-t

:roll

Yes!

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Specializes in Psych..

I don't think psychlogists have the right educatinor experience-sorry. I think APRN's do as do Psychiatrists. This is not a turf issue for me. There are plenty of pts. to go around. Frankly, I have seen bad outcomes when even medical MD's prescribe. I respect Psychologist' areas of experise and I consult with them often. I think they should consult with me about meds or a Psychiatrist-only.

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I don't think psychlogists have the right educatinor experience-sorry. I think APRN's do as do Psychiatrists. This is not a turf issue for me. There are plenty of pts. to go around. Frankly, I have seen bad outcomes when even medical MD's prescribe. I respect Psychologist' areas of experise and I consult with them often. I think they should consult with me about meds or a Psychiatrist-only.

That is why they are going for additional postgraduate training to have advanced practice. If a RN can be trained in a MSN program to safely rx psych meds or other meds why can't a PSYD be trained in a masters program to do this?I think with proper training this is a great idea.

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That is why they are going for additional postgraduate training to have advanced practice. If a RN can be trained in a MSN program to safely rx psych meds or other meds why can't a PSYD be trained in a masters program to do this?I think with proper training this is a great idea.

Very true. My program is 2 years w/2 practica, and then 1-2 year residency. More pharma classes then med school, nursing, PAs, etc. I think it is the best combination of two areas. This is after 4 + 1 + 1-2 for a clinical program, internship, and post-doc.

I view the training to be aimed at adjunct use (as an ADDITION to therapy)

-t

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Specializes in Psych..

Yes but that can't replace years of familarity with pts., medical diagnosis, observation, consultation and supervision by psychiatists and MD's, years of nursing education, 2 years of of a Master's program and clinical work in Psychiaty, psychopharmacolgy and Neuropsychotherapy, continuing edcation classes etc.

Why does everyone want a shorcut-it's dangerous. That's like me saying I'll take a class in Psychology and be a Psychologist! You can't learn the nuances of medical problems that look like psych. problems or treat them or learn the labs to order and how to interpret them. You won't learn a holistic approach to pts. You won't know the OTC meds to suggest for side effects of meds because you've never seen the side effects or the pts. with medical complications.

Maybe Psychologists could prescribe under the direct, on-site supervision of APRN's or Psychiatrists-that would make sense. I learned therapy skills under the tutelage of Psychologists and Psychiatists -it was invaluable.

I agree, as do most of my patients that it is better to have the prescriber also be the therapist-it's also more timely, comprehensive and cost effective.

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Yes but that can't replace years of familarity with pts., medical diagnosis, observation, consultation and supervision by psychiatists and MD's, years of nursing education, 2 years of of a Master's program and clinical work in Psychiaty, psychopharmacolgy and Neuropsychotherapy, continuing edcation classes etc.

Why does everyone want a shorcut-it's dangerous.

The DOD study (major research that looked at exactly your concern) found that the above was not true. Let me look around and see if I can dig up the citation.

You can't learn the nuances of medical problems that look like psych. problems

Do that.

learn the labs to order and how to interpret them.

Do that.

You won't learn a holistic approach to pts.

Covered that.

You won't know the OTC meds to suggest for side effects of meds because you've never seen the side effects or the pts. with medical complications.

Wrong. That's included too.

Maybe Psychologists could prescribe under the direct, on-site supervision of APRN's or Psychiatrists-that would make sense.

They already practice independantly, or in a consulting relationship. It has been 12-15 years (I forget the exact timeframe since the DOD study started) where this was looked at, and the findings were BETTER than the current prescribers.....I think it is because of the frequency of seeing the pt, the time spent with the pt, and combining the clinical knowledge with a thorough pharma knowledge.

-t

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Here is a nice summation of the arguments and training (compared to physicians, not just non-physicians)

Psychiatr Serv 55:1420-1426, December 2004

Patient Safety Forum: Should Psychologists Have Prescribing Authority?

Deanna F. Yates, Ph.D. Jack G. Wiggins, Ph.D.

Jeremy A. Lazarus, M.D.

James H. Scully, Jr., M.D.

Michelle Riba, M.D.

While the issue of psychologist prescribing has become a highly politicized debate, the real issues are the need for—and competence of—prescribing psychologists.

..... more than 70 percent of all psychotropic medications are prescribed by nonpsychiatric physicians, typically after six weeks' training in psychiatry.

By the time prescribing psychologists are allowed to prescribe, they have ten years of .....

-t

Please refer to link above for the article in its entirety.

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Specializes in Psych..

Thanks-I'll check it out. Good luck in your efforts to prescribe. MD's have fought us in the past. Currently there's a bill in Ct. to allow APRN's practice with NO collaboation wih MD's. Hope your path goes easier but I doubt it. MD's already feel thre:) atened by APRN's.

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Psychaprn- hi- Hmmm now that sounds tempting to work in Conn. I have RN/Clinical Pscyh (doctorate)-dually licensed. Have thought from time to time to finish NPP but I'm well into my fifties,so my energy levels wanes.

I would always want to have some "collaboration" in the sense that, any good practitioner would want to "collaborate". But I would really like to work without the "mandatory" collab, if you know what I mean.

Gee- I could do a two day commute from my very humble abode in upstate NY to Conn.

Do you really think this will pass? I'm curious.

Oh and Therapsit 4 change,- Yea,I wish psychology could at least prescribe some basics at least to start, the SSRI's.,for example. But I fear that by the time psychology gets it together I'll fully be in dentures. Believe me I am very frustrated by this issue as well.

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