New Mexico Governor Gary Johnson signed a bill March 6 giving psychologists the ability to prescribe medications, but psychiatrists were vowing fight back.
"The new law is the result of a cynical, economically motivated effort by some elements of organized psychology to achieve legislated prescriptive authority without benefit of medical education and training," said Richard Harding, president of the American Psychiatric Association in a statement. "Psychology prescribing laws are bad medicine for patients," he added.
The American Psychological Association countered that letting psychologists prescribe might actually result in better patient care. The organization claimed that there was such a severe shortage of psychiatrists in New Mexico that patients were waiting 6 weeks to 5 months to see a doctor. Suicide rates for 15- to 24-year-old New Mexicans were 75% higher than the national average.
Letting psychologists see patients who desperately need medication might improve mental health services, said the Psychological Association.
The Psychiatric Association called that argument a Trojan horse, noting that the psychologists rejected proposals to limit prescribing privileges to psychologists located in under-served areas.
Under the New Mexico law, psychologists won't be allowed to start prescribing right away. Details still have to be worked out, so psychiatrists may get a say in implementation of the law.
The current plan will require psychologists to complete at least 450 hours of coursework in subjects such as neuroanatomy, clinical pharmacology, psychopharmacology and pathophysiology, and to take a 400-hour practicum where they see 100 patients under physician supervision. Psychologists then will have to pass a national certification exam.
Then, psychologists will be given a 2-year license, allowing them to prescribe under a physician's supervision. The physician has a say in whether the psychologist is allowed to become an independent prescriber after the 2-year probationary period.
The Psychological Association has been fighting for more than a decade to secure prescribing privileges for its members, who have doctoral degrees in psychology but not usually any medical training. The organization has argued that having one practitioner give a patient medication and therapy makes economic sense.
"We know from experience and research that the provision of integrated care -- when it's done by one provider -- has been shown to be more cost-effective than when done by two separate providers," Russ Newman, the Psychological Association's executive director for professional practice, told Reuters Health.
Newman said states may now look more closely at approving prescribing privileges for psychologists, since they would no longer be the first to do so, and because data will eventually be available from New Mexico. "How quickly that will happen, I don't know," he said.
Guam passed a prescribing law in 1999. Over the years, 14 states have rejected such legislation.
The Psychiatric Association said the laws were rejected after legislators objectively considered "the scientific data and the public health risks of placing potent medications for treatment of mental illness in the hands of people with no medical education or residency training." Psychiatrists have gone through medical school.
Reuters March 7, 2002 New York
I personally have no problems with properly trained psychologist prescribing medications for the few who need them. The real problem is that well over 90%, and perhaps as high as 95% of the medications being prescribed are absolutely unnecessary.
These drugs are merely band-aids that in no way shape or form address the cause of the disease.
I frequently tell my patients that symptoms in many ways are like the idiot lights that are on your car's dashboard. When the light goes on it can be distracting and annoying. One solution would be to take a piece of tape or band-aid and put it on the dashboard so you don't see it anymore.
That approach certainly solves the problem in the short-term. You would absolutely not be troubled with the blinking or distracting color of the light. However, most of us will instantly realize the foolishness of this approach as the underlying condition that caused the light to go on in the first place needs to be addressed as soon as possible to prevent a far worse outcome in the near future.
Antidepressants and anti-anxiety agents are wonderful Band-Aids that frequently help ease symptoms. However, unless they are used in comprehensive strategies designed to remove the cause of the problem they are doomed to cause more problems than they solve.
Traditional psychotherapy is a major step in the right direction, but nearly always fails to hit the target as they are only dealing with understanding the problem.
It sure helps to know why you feel so rotten, but that, in and of itself, does absolutely nothing to change the problem.
My experience is that an energetic approach is the key to permanently and quickly removing the underlying cause.
There are many paths one can take to achieve resolution of the problem at the subconscious level. I have found EFT to be particularly helpful, but there are clearly other effective techniques.
EFT was actually developed in the psychological community and most of the people who use it are psychologists.
If those psychologists who wanted to use medications to help their patients only knew about the EFT Resource Page where they could learn how to do EFT far quicker and less expensively than obtain the ability to prescribe drugs, I think they would be far more satisfied with their ability to effectively resolve the complaints that patients come into see them with.