NEW YORK, Mar 07 (Reuters Health) - New Mexico Governor Gary
Johnson signed a bill Wednesday 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.
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