One of the more exciting trends of extending medical privilege to mid-level providers is that of granting prescribing rights to psychologists. While this idea is not originally mine, I’ll jump on as a fan and claim that licensed psychologist should be allowed to pursue a two-year post-doctoral certification program to obtain prescription rights. Similar to a PA’s training, this new program will require 1 year of classroom work and a year of clinical rotations, with an emphasis on psychiatric experiences.
Two states already have similar programs where Ph.D.’s can spend time learning pharmacology and can then receive a medical license to work under a psychiatrist. With the national shortage of shrinks, particularly pediatric psychiatrists, I would have thought physicians would be eager to have some help in providing medical therapy to mental health patients. Unfortunately, many doctors are against the idea of allowing psychologists to practice medicine.
Some psychiatrists throw out arguments such as “their training isn’t as extensive as ours” or “they wouldn’t be equipped to handle co-morbid conditions.” These points are certainly valid, but we already grant PA’s the right to practice restricted medicine with only two years of training; why shouldn’t we open the doors to others?
Certainly psychologists would not be equipped to work on a patient’s other medical issues, nor should they care for floridly psychotic patients. However, I see no reason that why a psychologist couldn’t write a prescription for Prozac as part of a therapy program. You don’t need 8 years of training to know that SSRI’s are an effective method of treating depression, and you certainly don’t need all of the years of experience to know the adverse effects that can come with giving a mind-altering medication.
The bad news is that psychologists haven’t been on their best behavior. They point out that most psych prescriptions are written by primary care docs, not psychiatrists. Some of the arguments that the psychology crowd throws out include “most MD’s only have six weeks of psychiatry training. Therefore, they are not qualified to fully work with mental health patients, either.” Don’t think that MD’s have only six weeks of training and then they’re done. After two years of basic science to learn how the body would respond to those medications, physicians have lots of training in internal medicine to learn more about clinical aspects of neuropharmacology. The “six weeks” is a time period thrown around to minimize physician training and to try to make grad school in psychology seem more robust than it really is. I’ve heard similar arguments about the length of the pharmacology courses in medical school. True, my pharm class only lasted for a month, but I can guarantee that I’ve been learning drugs for a lot longer than that.
I would love to see other states follow the model led by Louisiana and New Mexico. With adequate pharmacology training, psychologists can make a valuable impact on medical mental health.