Turf war over whether psychologists should be able to prescribe

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On his blog, psychiatrist Daniel Carlat has touched off quite a furor over what he calls “probably the hottest topic in psychiatry: whether psychologists should obtain prescription privileges.”

It started here when he wrote that it may be the best thing that can happen to psychiatry. He wrote:

“As psychologists gradually become serious competitors for our patients, we will have to re-evaluate how we practice and how we are trained. We will have to take a close look at our catastrophically inefficient medical school-based curriculum. We will have to decide which medical courses are truly necessary and which are not.”

It continued here after he got about 100 online comments to the first post. This time he wrote:

“I see my role, hopefully, as being an information broker between the psychologists and psychiatrists. I want to nail down some of the safety figures. I want to figure out what kind of safety surveillance would be adequate. There is so much animosity between the two organizations that it is nearly impossible to have a civil and rational conversation. I find that unfortunate, because the best psychiatric treatment is inegrative treatment, and the best way to achieve it is for the two professions to share information.

Whether psychologists end up continuing to snap up states in their quest to prescribe or not, I hope that we can all agree that patient care is our number one priority. Squabbling amongst ourselves over turf is not helping anybody. “

Read both posts and the ensuing comments if you want to learn more. It’s not just “inside baseball” – it’s a professional issue that impacts delivery of care.

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Paul Scott

April 1, 2010 at 8:28 am

Let’s see, one division offers empirically supported treatments that have low relapse rates and come with no debilitating side effects, without lifelong dependency on pharmaceuticals, costs the system billions less, and they can actually visit with a patient for more than fifteen minutes. The other division is over worked and dragged around by the nose by an industry that is only interested in the latest class of meds now on patent and gets very little training in empirically supported talk therapies. Why would the former want to join the latter? Psychologists can’t fix everything — and not all meds are oversold — but the stuff they can treat they can do so very efficiently and humanistically, for what it’s worth. Those in their ranks arguing to prescribe probably don’t know enough about the strengths in their own field and the weaknesses in the pharmaceutical approach.