Psychologists Prescribing
The dangers of Psychologists Prescribing:
As leaders of the healthcare community this proposal is deeply concerning for patient safety and will not effectively address the mental health crisis our state is facing.
Briefly, the proposal would allow psychologists — who are not medically trained — to prescribe powerful medications that are used to treat mental illness.
Proposed condensed didactic training of just 450 hours that can be online with 100 hours of supervised cases cannot substitute a physician’s extensive medical education and training.
Patients treated for mental illness are often complex and experience multiple medical physical health issues that are treated concurrently.
Important information to know:
Prescribing psychotropic medications requires a high level of training, as these medications affect the central nervous system, the liver, kidneys, and many other organ systems. Combining these medications with other medications or prescribing them to a patient with an underlying medical illness can be incredibly complicated.
For example, cancer and treatments for cancer, such as chemotherapy, can lead to depression. Antidepressant medications can be helpful but may also dangerously interact with chemotherapy drugs – dose adjustments or medication changes based on liver function, kidney function and other drugs prescribed is essential. There can be serious disabling or deadly side effects of medications if improperly prescribed and managed. Medical providers who treat these patients must be trained to understand and treat all systems of the body to recognize the warning signs of adverse effects.
While the threats to patients that we have noted should be sufficient to halt this proposal, it is important to note that this proposal will not address the very problem it claims to. Psychologists are not practicing in areas that do not already have licensed psychiatrists and family physicians currently practicing. (I have a map that shows this, getting permission from AMA to use it on our page as well!)
The argument that this legislation will increase access to care for underserved and rural communities simply does not hold up to any level of scrutiny. Currently many patients struggle to get adequate therapy services, which psychologists are already prepared to provide, and most wait over 6 months for assessments of developmental or neuro-cognitive issues which also fall within the psychologists’ current scope of practice.
Even the few states that have allowed this policy to be enacted have not seen their access to care issues solved. New Mexico, which enacted this policy in 2002, has just 78 prescribing psychologists practicing. This is clearly not a feasible path to address the mental health crisis.
The physician community is as alarmed by the provider shortage and mental health crisis as everyone else, but we insist that a better, safer way to ensure high-quality care is to utilize telehealth and integrated care services like the Collaborative Care Model. Of course, investments in medical education and training are a key component to addressing the broader issues of the physician shortage, which has already impacted patients by limiting access to care.
Patients Above Politics is here to fight for you.
Paid for by the Arizona Medical Association and the American Medical Association’s Scope of Practice Partnership.