"Prescribing psychologist" bill infuriates MDs

Following a recent one-hour consult with a psychiatrist, my son-in-law was diagnosed as bipolar and prescribed Depakote. (During his visit to the good Dr., the office staff was setting up for a luncheon hosted by a pharm. rep.) Thankfully he talked to me before filling the prescription. After being assured he was not bipolar, he sought another opinion and was declared quite normal although situationally depressed. Psychiatrists spend far too little time with patients to know what is going on with them; psychologists are in a far better position not just to diagnose but to monitor patients on medication based on diagnostic testing and observation over time. (I am no longer a practicing therapist, so I have no professional stake in this issue).

Your statement is inaccurate. The California RxP bill(s) Require prescribing psychologists to have training equivalent to a masters degree (similar to FNP's and more than PA's). The supervised practicum is over 800 hours and isonly for purposes of prescribing as Licensed psychologists have training in psychodiagnosis and evaluation that is far beyond that of a psychiatrist.

There is no way of getting around the fact that psychologists have NO training in physiology or differential diagnosis. Look forward to seeing systemic diseases diagnosed as being psychological, to adverse drug interactions etc.Letting psychologists prescribe because they see people with psychological problems is similar to letting masseuses prescribe because they treat physical ailments.

You argue that a psychologist has no training in the biological aspects of mental health. This is crap, as psychology has moved to a biological model and those of us who are getting Rx rights are going for even more training then the family doctors who prescribe freely.

A Medical Psychologist is able not only to read an EKG (ECG in Europe), but also to read lab tests regarding renal function, urinalysis, liver tests, cardiovascular lab tests, CBC differential, etc.,etc. In addition is able to provide, psychological testing, psychotherapy, work with traumas, etc.,etc. Everything in this life changes, for the better, so as privileges for patients to receive a broader, and more refined treatment.

"There is no way of getting around the fact that psychologists have NO training in physiology or differential diagnosis. Look forward to seeing systemic diseases diagnosed as being psychological, to adverse drug interactions etc.Letting psychologists prescribe because they see people with psychological problems is similar to letting masseuses prescribe because they treat physical ailments."

Please look at current literature to at least try to get a grasp on what psychologists are trained in. That's the problem with politics, too many people opening their mouths and sprewing incorrect information. As for the gloomy epidemic you predicted pertaining to wrong diagnosis and adverse interactions, I have yet to see this happen in LA or NM where psychologist already have RX rights. Furthermore, judging by the average over-medicated American, physicians aren't doing something right.

can the psychologists considers other systems or medical conditions that mimic psychiatric conditions? the need to be trained like psychiatrists and other doctors. an electrician is not an electrical engineer.

psychiatrists have 4 years of college based in medical science, followed by four years of medical school followed by 4 years of residency training before they are qualified to prescribe medication without supervision. It is not just about prescribing medication A for diagnosis B. Interactions between medications and the effects those medications have on the body are very complicated. Psychotropic meds unlike most meds you may get at your family doctor affect numerous organ systems and can cause serious side effects even fatal side effects. Monitoring these side effects and being able to differentiate cause as the medication versus another serious disease requires the ability to diagnose. How would a psychologist with little to no training in anatomy, biochemistry, pharmacology, genetics, immunology, neurology, cardiology, nephrology, etc.. be able to medication were the cause of seizure or chest pain or headache. A patient comes back with headache for example, it could be nonserious side effect, migraine, pseudotumor cerebri, infection, vision problem, or most importantly acute stroke? How could a psychologist treat an AIDS patient who has depression due to their disease and determine whether or not their depressoion was due to their other medication versus new infection? Psychologist simply don't have enough experience with severely psychotic patients to recognize someone who is bipolar or schizophrenic. They often misdiagnose them as simply depressed because that is what they have been taught to treat. Primary care doctors in New Mexico wrote that 80% of the psychiatric medication mismanagement cases they get through the ER are written by psychologists. When you don't know what you don't know that is where the danger lies and in this case the risk is death.