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* Despite overwhelming opposition by the state’s editorial boards and fierce lobbying against it by the Medical Society, David Ormsby writes today that legislation to allow psychologists to prescribe certain medication is gaining momentum…
A year-and-a-half battle between Illinois psychologists and psychiatrists may reach a critical point in the House this week. […]
The plan, which is sponsored by State Senator Don Harmon (D-Oak Park) and is being pushed by the Illinois Psychologist Association and community mental health agencies from across the state, cleared the Senate on April 25, 2013 on a bi-partisan roll call, 37-10-4, but stalled in the House last year.
The fight, which has brought out heavyweight lobbyists on both sides of the issue, tilted last week in the psychologists’ favor when a fresh amendment helped House sponsor State Rep. John Bradley (D-Marion) propel the bill out of the House Human Services Committee on a bi-partisan 9-5-1 vote, a vote that drew 34 proponent witness slips and 104 opponents.
The key concession by psychologists was to agree to a “two-year conditional license” supervised by a physician before moving to a permanent “continuing license”.
Only two other states, Louisiana and New Mexico, have similar laws.
Psychologists and community mental health groups say that much of rural Illinois has no access to psychiatrists, which was the same basic argument used by optometrists when they wanted to be given some responsibilities of ophthalmologists a while back.
* The Question: With conditions, and despite physician disapproval of the concept, should psychologists be given the right to prescribe some drugs to their patients? Take the poll and then explain your answer in comments, please.
posted by Rich Miller
Tuesday, May 13, 14 @ 11:44 am
Sorry, comments are closed at this time.
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To me, the deciding factor is that the National Alliance on Mental Illness opposes the bill. They’re the patient advocates. If the bill is safe, why are the patients’ advocates opposed?
Comment by Roland the Headless Thompson Gunner Tuesday, May 13, 14 @ 11:48 am
I think as long as the list of medicines is limited, there should be few problems, Some nurses have authority to write prescriptions, and with training psychologists could help a lot of patients.
But somebody please tell me OxyContin is not one of the meds they would be able to prescribe. I think there are a lot of narcotics that should remain off-limits.
Comment by 47th Ward Tuesday, May 13, 14 @ 11:53 am
Let’s pretend there is no Rx drug epidemic in the nation (i.e. too many drugs being pumped already) and focus on underserved regions. This bill balances that playing field
Comment by CircularFiringSquad Tuesday, May 13, 14 @ 11:58 am
I am fully in favor of this. My wife is under the care of a psychiatrist and psychologist. She sees her psychologist every other week but her psychiatrist can only fit her in every 2-3 months for a 15 minute, at best, appointment. He is a very nice and caring man, but he is so overloaded with patients that it is not always possible to see him quickly if there is a need for adjustments. Her therapist is in a much better informed place to know what her status is and how her medications are working or not working.
The legislation requires a psychologist to get a PhD in psycho-pharmacology. New resident doctors with the most elementary understanding and almost no experience in mental health can write prescriptions for powerful psych drugs. Why can’t seasoned psychologists with an advanced degree in psychological medications prescribe them as well. I think this law places very clear standards of training and over sight of the psychologists.
Comment by Anonish Tuesday, May 13, 14 @ 11:58 am
As long as the keep it to meds that concern ONLY psychological issues, I could go with it.
At this point, most patients see psychiatrists only for Rx’s and not for therapy. Spending more than 15 mins with someone who is writing an Rx that is mind-altering makes sense to me.
I think this cuts both ways and could help both psychiatry and psychology practices.
Comment by Belle Tuesday, May 13, 14 @ 12:02 pm
Roland, NAMI gets most of its funding from the drug companies and doctors groups. The drug makers have an incentive to keep the doctors happy. NAMI does some great work, but its positions on policy have long sought to keep power of care in the hands of the MDs.
Comment by Anonish Tuesday, May 13, 14 @ 12:03 pm
Undecided. What kind of drugs are we talking about? Prescription drug abuse is a serious problem, and there’s no lack of Dr. Feelgood’s out there.
Comment by wordslinger Tuesday, May 13, 14 @ 12:04 pm
This has been legal in New Mexico for over a decade and I haven’t heard any horror stories from there. If problems arise, say with certain individual drugs in the permitted list, then the legislature can deal with them. Tempest, meat teapot.
Comment by lake county democrat Tuesday, May 13, 14 @ 12:04 pm
This bill is a terrible piece of legislation that puts everyone of our Illinois citizens at risk. Why are there standards for training doctors and nurses if legislators can just override decades of educational research with bad legislation? Why would any ethical psychologist want to do this?
Comment by Pin Tuesday, May 13, 14 @ 12:05 pm
Totally unsafe. Psychologists have no medical/ scientific training and are being cranked out like sausages by these (allegedly non-profit) psychology schools. Also, the idea that this would help rural communities is a myth. Psychologists practice in the same places as psychiatrists.
Comment by Ron Del Festo Tuesday, May 13, 14 @ 12:07 pm
PS., Lake County - In New Mexico, MDs have to approve every prescription decision made by the psychologist.
Comment by Ron Del Festo Tuesday, May 13, 14 @ 12:09 pm
There’s a reason why all the newspapers have editorialized against this bill, why NAMI and other public health groups are opposed, and why it has failed over and over again. Allowing people to prescribe medication requires medical training, but this bill is basically would allow psychologists to take a crash course at a professional psychology school. It’s a dangerous proposal and not in the best interest of patients.
Comment by Mr. Snrub Tuesday, May 13, 14 @ 12:12 pm
The State needs more access to mental health resources. Let the psychologists prescribe for the easy cases like smoking cessation programs, and free up the psychiatrists for the harder cases. Plus the docs don’t have a real response when you ask them how they plan to meet the increased need for mental health resources, they just say hire more doctors and pay them more money.
As long as psychologists are working with a doctor, I’m not seeing the problem.
Comment by Just Me Tuesday, May 13, 14 @ 12:15 pm
Anonish - Are all the ed boards in the tank for the doctors, too?
Comment by Roland the Headless Thompson Gunner Tuesday, May 13, 14 @ 12:15 pm
As someone who takes medication for mental health issues, I agree with this bill. Two reasons: I’m more comfortable with a psychologist who is likely more familiar with these types of medications prescribing them, then my primary care doctor. I feel a psychologist is likely better versed in available drugs, side effects, etc. I have had general docs push anti-depressants and other meds, without a full knowledge of them, how they work, etc. Secondly, I’ve found it a pain to have to see both a psychiatrist, just for a medication check, then also a psychologist for therapy/counseling. That takes up a lot of time from work and can make overall treatment disjointed. I would love to be able to have all my needs met by just my psychologist. I do think some extra training would be warranted though.
Comment by Anon Tuesday, May 13, 14 @ 12:16 pm
What’s curious is the sudden speed this bill is now seeing in the House. There really hasn’t been a lot of organized public demand and the majority of the professional medical advocates are strongly against it. Seems like a pretty clear cash grab from the Illinois Psychologist Association to me.
Comment by maxwellsmarts Tuesday, May 13, 14 @ 12:26 pm
Even psychologists oppose the bill because they consider the training inadequate which raises concerns about patient safety.
Comment by William Robiner Tuesday, May 13, 14 @ 12:27 pm
Voted No. Psychotropic meds are already too often abused. More and easier availability will not help. Would vote yes if Psychologists got more training. Such as a Medical Degree.
Comment by SO IL M Tuesday, May 13, 14 @ 12:29 pm
“This bill is a terrible piece of legislation that puts everyone of our Illinois citizens at risk.”
At least we’re not blowing the issue completely out of proportion…
– MrJM
Comment by MrJM Tuesday, May 13, 14 @ 12:29 pm
As someone who has a history of some depression and who has some family/friends with more serious mental health issues, I would have to say no to this plan. While I think the idea is noble and could help some people, the capacity for some to be hurt is probably too great. Most psychological drugs need to be monitored by a medical professional because they can have the potential for tremendous side effects.
In my experience, there is nothing wrong with a psychologist recommending medication and having it overseen by a psychiatrist.
Comment by Bunson8r Tuesday, May 13, 14 @ 12:35 pm
GPs prescribe based on psychologists recommendations all of the time, so the idea that it is incredibly dangerous to let them prescribe is a bit of a stretch. However, the other claim that patients would have better access is ludicrous. Psychologists effectively prescribe medication currently, it just gets reviewed and authorized by an MD. I’m uncertain why the current system needs fixing. If a patient has a doctor, and there is a local psychologist, they have all of the access they need to be treated and get a prescription.
Comment by Jimbo Tuesday, May 13, 14 @ 12:36 pm
This bill requires additional post doctorate Master’s degree training in psychpharmacology - much more then Nurse Practioners receive. They will also be supervised by and work with a physician. Will definitely help with shortages in rural areas. Like others said people can see 1 person instead of 2. Illinois Psychological Association supports it.
Comment by Anna Tuesday, May 13, 14 @ 12:37 pm
Actually, I recall that when I was prescribed SSRIs I had to get my liver enzymes checked semiannually. Are the psychologists going to order those tests too, as certain medications can damage organs in rare cases.
Comment by Jimbo Tuesday, May 13, 14 @ 12:38 pm
This bill allows inadequately prepared and insufficiently trained psychologists to prescribe medications without consideration of broad physiological impact. There is a mechanism in place for psychologists to become prescribers: become an advance practice nurse or go to medical school. Then the appropriate skills and knowledge will be gained to prescribe.
Comment by Chgohunt Tuesday, May 13, 14 @ 12:39 pm
Considering the amount of pharmacology training/education my wife had to get (and has to continue) to be able to prescribe not being an MD I would expect the same level of educational requirement.
Then again the medical association is against just about everything that expands anyone else’s scope of practice.
But if it was always cooperative (like it is for my wife) than I would have voted yes, but a 2 year window seems too small.
Comment by OneMan Tuesday, May 13, 14 @ 12:42 pm
As a licensed psychologist in IL I emphatically say “Absolutely Not!” to allow psychologists prescription rights. The training is dangerously inadequate, not even close to what others w/ prescribing rights are required to complete. Physician Assistants need 420 hours BEFORE beginning their training (in a medical facility under supervision of medical doctors) but this bill would only require a TOTAL of 450 hours for psychologists and it doesn’t occur in a medical facility - it can be done online.
Comment by IL licensed psychologist Tuesday, May 13, 14 @ 12:49 pm
No. I’m not against the idea of psychologists prescribing, I’m against this bill. They need a lot more initial training and CME.
Comment by Cheryl44 Tuesday, May 13, 14 @ 12:52 pm
I have been on these medications and I want to be sure the person prescribing is trained as an medical doctor. It’s what people don’t know that will hurt you and with such limited training I am concerned. It will be too late if a trained doctor is consulted after the fact (and who will be doing the supervison?)
Comment by William Tuesday, May 13, 14 @ 1:05 pm
Please see the bill. There is no limitations on what a psychologist can prescribe. After the initial two years of unspecified supervision, there is no requirement the psychologist has to be in collaboration with an MD. Access is not solved if you have no medical training.
Comment by Pin Tuesday, May 13, 14 @ 1:06 pm
The feedback here is confusing and often at odds. Undecided for now.
Comment by A guy... Tuesday, May 13, 14 @ 1:08 pm
I was mistaken, it is a Masters in Clinical Psycho-Pharmacology from an accredited university in the requirements, beyond their doctorate in psychology. That is not a crash course.
They need to work with a supervising psychiatrist or physician. Have at least 80 hours of supervised clinical assessment training/experience with the supervising psychiatrist or physician.
If a psychologist is not in favor of this? Easy solution don’t try for one.
Doctors have always opposed the treatment of patients by non-doctors. When Nurse Practitioners began expanding services in hospitals and clinics with outstanding care results and patient satisfaction the doctors groups demanded that Advance Practice Nurses get a Doctorate instead of Masters as have been the case for decades.
Comment by Anonish Tuesday, May 13, 14 @ 1:25 pm
I’d feel better with having a Registered Nurse provide a prescription than a psychologist. My wife’s an RN, and the public would be shocked to find out how many times MEDICAL Doc’s prescribe the wrong medicine or dangerously wrong dosage. The RNs save their keesters on a daily basis.
That being said, I think Psychos need to take a group of certification courses and pass a written pharmacology exam before they prescribe ANY drug.
Comment by Arizona Bob Tuesday, May 13, 14 @ 1:28 pm
Anonish, with you on the doctors freaking out when anyone else tries to expand scope of practice but the DNP thing is an additional level of education, it doesn’t replace the MSN.
It creates a practice doctorate, not a bad idea.
Comment by OneMan Tuesday, May 13, 14 @ 1:39 pm
@Pin, you might need to re-read the bill.
The bill states that there is a requirement that a prescribing psychologist must be in a collaborative relationship with an MD who regularly prescribes psychotropic medication. This relationship never goes away. A prescribing psychologist will always be under the supervision of a doctor.
The bill also states that a prescribing psychologist can only prescribe medication for the treatment of mental illness. This means drugs for pain like oxy and other opiate medications would not be allowed.
This bill seems like a good idea, but if you want to continue having the mentally ill treated by family docs instead of psychologist trained in mental illness and pharmacology then continue on with your opposition.
Comment by SYSK Tuesday, May 13, 14 @ 1:39 pm
More details? I am not sure, more information is needed on what meds and under what circumstances. The system we have now seems to work for people with good insurance and or a lot of money.
I heard that 80% of homeless people are homeless due to mental illness. This might be a way to help some of them, as well as others that are not homeless but can not afford much.
Comment by DuPage Tuesday, May 13, 14 @ 2:00 pm
In the past optomotrists could not perform medical exams, but since the mid-’80s they have had the authority to do so on a limited basis, with a mandated expansion of their education. That seems to be working well enough. Psychologists often work in a practice with psychiatrists with whom they can consult, and with increased education and continuing education requirements, mental health services will likely improve.
Comment by Observing Tuesday, May 13, 14 @ 2:14 pm
The issue is the very little medical training included in this bill. Doctoral level psychologists have no premedical or medical training. This bill would permit psychologists to practice medicine with two semesters of online medical training. Physicians have 10 years of medical training. Nurses who can prescribe independently in only 14 states have 6 years of medical training.Would you take your pet to a veterinarian with only a year of online medical training? I would hope not.
Comment by Elaine Tuesday, May 13, 14 @ 2:37 pm
Even with the additional training proposed in his bill, the training of psychologists remains inadequate for the complexity of modern psychopharmacology. Psychotropic medications interact among themselves and with nonpsychiatric medications for which more extensive education required. Further, there is no evidence in either NM or LA that prescribing psychologists serve under served populations in either state. This Bill is not in the best interests of the citizens of Illinois.
Comment by Milton Strauss Tuesday, May 13, 14 @ 2:48 pm
I do not think we need additional people prescribing psychotropic drugs. There is no paucity of professionals doing this work.
Comment by Brad Tuesday, May 13, 14 @ 2:50 pm
I am director of clinical training for the clinical psychology training program at UIC and this bill is a terrible idea. The amount of training described in this bill is EXTREMELY inadequate and would put the people of Illinois in great harm. The psychologists who completed this level of training would not have the skills to adequately monitor their patients’ responses to medications.
Comment by Training director for clinical psychology training program in Illinois Tuesday, May 13, 14 @ 2:51 pm
Right to address this shortage, but the wrong solution.
With the prevalence in technology in our lives, it is time for medicine to embrace it. North Carolina is implementing telepsychiatry to serve rural areas, with success:
http://www.npr.org/blogs/health/2014/05/07/308749287/telepsychiatry-brings-emergency-mental-health-care-to-rural-areas
Comment by Mittuns Tuesday, May 13, 14 @ 2:53 pm
I am one of many clinical psychologists opposed to this bill. Psychologists are not trained in medical matters, and patients come in on many medications. Physicians, Nurse Practitioners, and physician assistants are trained in physical medication, and have far more training than proposed by the proposed law, and they are supervised by a physician. Online training is not equivalent to clinical training, and patients will be at risk. Also, some errors were noted in some of the above comments. First of all, the law does NOT limit the psychologists to psych meds, they want to prescribe narcotics and painkillers, and probably medical cannabis next year. Also, they will receive a masters degree online, not a doctoral degree in pharmacology. It is not merely a fight between psychiatrists and psychologists, as many psychologists oppose the law or are unaware of what the current administration if the IPA is seeking for them. I have no skin in the game, I will be retiring in a year or two, and would not seek prescription privileges if available. I just feel it is a bad idea for the profession, being pushed by a minority of psychologists for their own reasons, while some mental health centers are all for it, as they can pay psychologists a lot less than psychiatrists. As most psychologists practice in metropolitan areas, it will not help the underserved populations very much. Michael Rabin, PhD, Licensed Clinical and Forensic Psychologist.
Comment by Docaloha Tuesday, May 13, 14 @ 3:00 pm
This bill represents a decade-long effort by psychology administrators to gain the legal ability to write prescriptions for medications. The majority of psychologists oppose the bill.
The concerns are several-fold. Proponents of the bill purport it will provide underserved persons in rural areas greater access to medications. However, a study shows that prescriptive privileges for psychologists did not target rural citizens. In one of the two states that allow psychologists to prescribe, Louisiana, it was found that 85.9% of the prescribing psychologists were in non-rural areas. It has also been suggested that the bill will somehow reduce patient care costs. But there is nothing that demonstrates this to be the case; in fact, a greater number of prescribers may increase patient costs. A third concern is that Illinois would be only the third state to enact such a law and the first since 2004. While proponents seem to equate a lack of data with a positive outcome, there are no empirical studies whatsoever that have ever demonstrated success.
My greatest concern is the lack of training needed to prescribe potentially dangerous medications. The bill calls for a program that lacks any empiric grounding for adequacy or safety. According to an independent review of the New Mexico and Louisiana programs (The Prescriptive Authority for Psychologists: Issues and Considerations (2007)), “the training requirements for either state have not been externally evaluated and there have been no external evaluations relating to patient safety or whether access to mental health care services has changed as a result of allowing psychologists to prescribe.”
By comparison, psychiatrists may become certified only after completing 8 years of training under rigorous national standards, pass five national examinations, and must continuously maintain certification requirements thereafter. The proposed law lacks oversight and safeguards for patient safety. The law represents a risky proposition, placing patients in undue jeopardy with little or no clear benefit and should be rejected.
Comment by Concerned Tuesday, May 13, 14 @ 3:03 pm
The main argument is that the psychologists would not have adequate training for prescribing medication; their training would not be comparable to that of registered nurses, let alone that of medical doctors. But there is another concern. Already there is an imbalance, with too much medication vs. too little psychotherapy. As it stands now, the psychologists stand up for the value of psychotherapy. If this bill passes, a number of psychologists would start doing medication prescribing only - and in the areas with many practitioners. The bill would have an impact throughout the state, not just in the so-called underserved areas. The balance between medication and psychotherapy for psychiatric and psychological conditions would become substantially poorer than it is already. That is one reason why the large majority of psychologists oppose this bill.
Comment by a psychologist PhD Tuesday, May 13, 14 @ 3:05 pm
I am a licensed clinical psychologist, and I am opposed to this bill.
Comment by Virginia Kasser, Ph.D. Tuesday, May 13, 14 @ 3:10 pm
I am a licensed clinical psychologist, and I am opposed to this bill for reasons of patient safety.
Comment by Anonymous Tuesday, May 13, 14 @ 3:16 pm
I am a psychologist and oppose most use of these drugs, particularly by psychologists.
Comment by DrGaryG Tuesday, May 13, 14 @ 3:18 pm
As a psychologist myself, I would NEVER refer to one of these prescribing psychologists, and I strongly oppose the bill. The field of psychology is deeply divided on this issue, and I find it distressing that this point is often not made clear. While we psychologists are very well trained in psychotherapy and diagnosis of mental illnesses, we are not required to have any medical or nursing training whatsoever, not even pre-med requirements as undergraduates. The training proposed in this bill is grossly insufficient to make up for that training and education gap. Patients will be at risk. Sooner or later patients will die or be permanently damaged because of a prescribing psychologist who did not understand the patient’s medical condition sufficiently.
Comment by Be safe, not sorry Tuesday, May 13, 14 @ 3:18 pm
Yes, until our state can identify the need for mental health services. Jails are this states primary providers for individuals with severe mental illness. If guards are going to be the counselors, wwell, you get the idea. What did you think was going to happen.
Comment by Throwing Stones Tuesday, May 13, 14 @ 3:28 pm
It makes sense now that Harmon is pushing to save the Poison Control Center. http://www.illinoissenatedemocrats.com/index.php/sen-harmon-home/3853-harmon-proposal-would-help-illinois-poison-center-keep-its-doors-open
Comment by Toto Riina Tuesday, May 13, 14 @ 3:38 pm
It is wrong to allow a master’s level psychologist to prescribe dangerous medications.
Do we want more pills on the street? Do we want our kids to be exposed to more pills?
Why not allow everyone to get pills out of a vending machine??? Why not allow every college graduate to prescribe??? There are countries where meds. are available without a presription!!!
Comment by PschPatient Tuesday, May 13, 14 @ 3:40 pm
I have no problem with PhDs prescribing medications. They just need to get their MD first.
Medical school is the minimum training required to prescribe these powerful psychoactive medications which not only affect the brain but many other / all other biological systems and diseases and interact with many other drugs and substances. Anything less than medical school training is compromising patient safety to an unacceptable degree. The potential benefit of this bill does not outweigh the risks.
Comment by Anon Tuesday, May 13, 14 @ 3:42 pm
I echo Pin and Ron Del Festooned and Mr.Snrub
among many others
Comment by Anonymous Tuesday, May 13, 14 @ 3:43 pm
I work with many psychologists and they are all opposed to psychologists prescribing. These are psychologists who were well trained and have worked alongside psychiatrists for more than 20 years. Their reason is that they have not been trained in the principles of pharmacology and all the complex issues that are important in prescribing including dealing with all the other medical problems that can mimic mental illnesses or that can complicate the treatment of mental illnesses. Psychologists would need a lot of training, much more than what is currently proposed. The way some schools of psychologists are doling out Psy.D. also worries me. Disclosure: I am a psychiatrist with a lot of experience in the US and UK.
Comment by Adedapo Williams Tuesday, May 13, 14 @ 3:43 pm
I am a fourth-year psychiatry resident. About a year-and-a-half ago, I saw a young woman who had been depressed and wanted me to prescribe anti-depressant medication for her. After conducting a thorough history, I thought it was quite likely that this woman was suffering from hypothyroidism and needed Synthroid, not an anti-depressant medication like Zoloft. I arranged for her to get some thyroid function tests and her TSH level turned out to be significantly higher than the reference range — i.e., she had hypothyroidism. Wouldn’t you agree that these are determinations that physicians, not psychologists, should be making?
Comment by Steve Tuesday, May 13, 14 @ 3:52 pm
It appears the psychologists’ own organization profits from the certification of those psychologists who they grant certification to prescribe. I believe MD’s have independent board agencies who pass/fail exam-takers without a finantial relationship.
Comment by ethic-watch Tuesday, May 13, 14 @ 3:53 pm
The prescription of psychiatric medications requires much more than a knowledge of psychopharmacology. It really requires an appreciation of the patient’s whole functioning both physical and psychological and the line/relationship between these two areas is regularly blurred and complicated and one of interdependence. Psychologists do not have the medical training needed to prescribe what are potentially dangerous medications. Psychiatrists spend years working at the interface of the foregoing areas and are really ideally suited to prescribe and monitor the use of psychiatric medications. The idea that granting psychologists prescribing privileges (no matter how closely supervised) will in some way broaden access seems to be a huge miscalculation. I know and work closely with many psychologists, and, while I don’t claim to know all psychologists, for some reason, I have yet to meet one who wants to live in a traditionally underserved area. Also, the vast majority of the many psyhcologists I’ve worked with over the years don’t want prescribing privileges for a number of reasons I won’t discuss here. Overall, granting psychologists the foregoing privileges, in any guise, seems like a dangerous course and really isn’t in the best interests of patients.
Comment by Anon Tuesday, May 13, 14 @ 3:54 pm
Prescribing medications for any condition, including psychiatric conditions, is complex and requires intensive training. Historically, it has been reserved for physicians who undergo a minimum of 11 years of training after college in biomedical sciences before independent practice. This short-sighted bill would allow essentially untrained practitioners to prescribe medications to vulnerable patients. One thing that is missing from the discussion is the difference between how a person becomes a physician and how one becomes a psychologists. The entrance requirements for schools of psychology are minimal and often based on ability to pay whereas the standards for medical school remain very vigorous. Only 50% of applicants are accepted to medical schools whereas virtually anyone can gain admission to a professional school of psychology. Extending rights to these untrained, unskilled, and unscientific psychologists is simply a dangerous and terrible idea.
Comment by Anon Tuesday, May 13, 14 @ 4:00 pm
I’m another psychologist who is opposed to psychologists having prescription privileges. It seems there are actually a lot of us. My biggest concern actually goes to something other than the safety issue. Psychologists have a wide range of behavioral and emotional methods at their disposal that are effective in treating mental disorders, many of which have better or longer lasting effects than medication. They generally require more effort to implement than a pill and I fear psychologists jumping on the pill band wagon will be bad for mental health treatment and bad for the profession of psychology. We would do much better to put energy into creating better collaboration between physicians, GPs and psychiatrists, and psychologists.
Comment by Mark, Psychologist Tuesday, May 13, 14 @ 4:03 pm
There is a reason why NO OTHER country on the planet allows psychologists to prescribe medication-They are not medically trained to do so.
Just a little bit of training being suggested to allow them to prescribe potentially dangerous medications is nothing compared to the thousands of hours of clinical training a psychiatrist has to undergo through medical school and residency. Prescribing medication is a serious business and needs serious training and expertise. If a psychologist really wants to prescribe I would recommend they go to medical school.
Comment by concerned citizen Tuesday, May 13, 14 @ 4:05 pm
Psychologists do not have the understanding of the complexities of the brain, other diseases that affect neurobiology, how some physical illness can appear in psychiatric symptoms, drug interactions, etc. Far better to use advanced pratice nurse practitioners who have special training in psychiatry and who are more available in under served areas, more affordable, and more knowledgeable about medicine.
Comment by Consuela Tuesday, May 13, 14 @ 4:11 pm
This bill ensures that prescribing psychologists work in a safe and effective manner. Access to mental health care is at a crisis level in IL and specialty trained prescribing psychologists will be a meaningful step in addressing this problem.
Comment by Robert Tuesday, May 13, 14 @ 4:13 pm
Not too hard to see what happened on this thread. I’m still not sure.
Comment by A guy... Tuesday, May 13, 14 @ 4:18 pm
There should be no short cuts when one is dealing with peoples lives. If a psychologist wants to prescribe medication they need to go to medical school.
Comment by seriously wrong bill Tuesday, May 13, 14 @ 4:19 pm
If a neurologist decided (s)he wanted to start doing neurosurgery, claiming 450 hours of training as opposed to doing a neurosurgery residency, would you let that person operate on your brain? Being a physician entails an entirely different method about thinking about symptoms than that of a psychologist. I have very good relationships with psychologists and respect what they do. But they need to get the same training mandated I had to get before prescribing.
Comment by Lee Tuesday, May 13, 14 @ 4:19 pm
There are many comments about how it would be easier to have a psychologist do both therapy and medication management than to see two separate clinicians. I am a psychiatrist who has trained in both medication management and therapy and see patients for both. Why not push for health insurance to cover psychiatrist’s who perform both, rather than have unqualified people deal with serious medications? I had four years of supervision as a resident before being allowed to practice on my own.
Comment by Psychiatrist Tuesday, May 13, 14 @ 4:21 pm
Since when does 2 years of supervision by a medical doctor come close to providing the knowledge and experience of 4 years of medical school and 4+ years of residency?
Comment by perplexed observor Tuesday, May 13, 14 @ 4:27 pm
truck loads of crazey pills on the way to springfield,rauner`s driven everyone nut`s let`s bend reality so everything seams ok who don`t have problems(you can buy the same pills on the streets)
Comment by Anonymous Tuesday, May 13, 14 @ 4:39 pm
I barely trust a psychologist to practice psychotherapy! I think they should be limited to testing and teaching testing in academia.
Comment by Marilyn B. Tuesday, May 13, 14 @ 4:51 pm
The medications used for treatment of psychiatric disorders have many interactions and actions which require a medical education to administer, wisely, and safely. Some are much more dangerous than others. If this goes through, there will be some casualties. In general, this would discourage doctors from choosing psychiatric careers and the net result could be a decrease in the quality, quantity and safety of all available treatment.
Comment by Marc Tuesday, May 13, 14 @ 4:52 pm
Be careful what you wish for, psychologists. If this bill passes, you’ll know what it’s like to pay the sort of malpractice insurance rates that I, as a psychiatrist, have to pay. And, for what it’s worth, to prescribe psychotropic medication for someone who is simultaneously taking four other medications, prescribed by his/her cardiologist and primary care physician, you really ought to be a licensed physician. Potentially dangerous drug interactions are nothing to mess around with. The fact that a bill this irresponsible could have been passed by the Illinois Senate and the House Human Services Committee is yet another indictment of the quality of government in our state. I try not to be cynical about our government — there’s more than enough of that to go around — but I’m sorry to say that the success this bill has enjoyed so far in the legislature has broken the camel’s back in my case.
Comment by Ken Tuesday, May 13, 14 @ 4:55 pm
What’s the problem with psychologists prescribing meds? It’s not like our medical doctors and psychiatrists have been tools of the drug industry bought off with gifts for decades? What’s the harm guys, that’ll you’ll have to share your presents?
Comment by Precinct Captain Tuesday, May 13, 14 @ 5:00 pm
As a practicing psychologist, I am against this bill because I think it encourages shoddy practice.
There is no way that a 30 hour course can teach the complexity of drug interactions that is needed to safely prescribe for people with even one condition other than their mental one.
Comment by anon Tuesday, May 13, 14 @ 5:38 pm
I have been practicing for more than 25 years and agree with everything “better safe than sorry” indicated in the comments that were made. The complexity associated with psychotropic medication management is such that I would never refer a patient to someone other than a well-trained psychiatrist who is at the top of his/her profession. We’re talking about saving people’s lives and doing no harm — I find the proposed bill and the whole notion of training non-medical people (psychologists) to prescribe these medications both arrogant and dangerous.
Comment by Another Il psychologist adamantly opposedn Tuesday, May 13, 14 @ 5:43 pm
we need more mind control experts reality bits
Comment by Anonymous Tuesday, May 13, 14 @ 6:04 pm
I am a psychiatry resident. Some people have asserted that psychologists should be able to prescribe only medications that have a psychological effect, but the thing is that is impossible. ALL medications have potentially systemic side effects, and interact with other medications prescribed for different conditions. To manage uncomfortable, or potentially life-threatening med interactions without a medical degree and training is simply dangerous.
Comment by Gus Warner Tuesday, May 13, 14 @ 6:17 pm
There are already well-defined and available prescribing training for non-MDs to which psychologists can apply: namely Advanced Nurse Practitioner and Physician Assistant programs, the training advocated for PhD psychologists is inadequate and will lead to dangerous situations. Increasing the availability and quality of NP and PA training is a much better and safer way of covering health care where there are not adequate resources.
Comment by PhD in Neuroscience Tuesday, May 13, 14 @ 6:21 pm
Next thing you know massage therapists and nail salons will want the right to prescribe medications. I want my medications prescribed by someone that has been through intense training, and knows what the dangers are of certain medications interacting with other medications. Even if the psychologists prescribe only a limited number of medications, they haven’t studied and experiened what other medications do and how they can interact.
Comment by DieselDude Tuesday, May 13, 14 @ 6:24 pm
If a legislator doesn’t like one of his/her family members to be prescribed and followed up for medication adjustment by someone who hasn’t gone to medical school and only had read courses online should not want the same for others.
Comment by Sound mind Tuesday, May 13, 14 @ 6:31 pm
Earlier in the day this thread was 55 - 45 opposed. It has moved to 75-25 opposed. I just don’t see that happening by chance. The opposition is very organized.
There is an extra credential that must be earned under vigorous schooling, and professional advancement. The opposition has demeaned many psychologists for even suggesting this idea. I don’t think the opposition is due to patient concern, but rather, is due to the size the wallet concern.
Comment by A modest proposal Tuesday, May 13, 14 @ 7:00 pm
As a psychiatry resident, I am opposed to the bill in its current form because the training is insufficient. I’m not necessarily opposed to the idea of psychologists prescribing, but if they are going to prescribe they should also have medical training like nurse practitioners, physician assistants or physicians. You can’t just separate out medications for mental health to prescribe because medications affect ALL organ systems and other disease states can resemble psychiatric illness. There are medication interactions, side effects and potentially life threatening conditions that can result from these medications. Would a psychologist be able to determine if a patient’s reflexes are hyperactive as could happen in serotonin syndrome or if their muscles are rigid as could happen in neuroleptic malignant syndrome? Not to mention interpretation of vital signs that would be needed to diagnose these conditions in normal patients and those with other comorbid medical illnesses.
I understand that a lot of posters have said that they feel more comfortable with their psychologist– I think it’s natural to feel more comfortable with someone you have a closer relationship with, but it doesn’t necessarily mean they are qualified to prescribe.
I’m also a DO, or an osteopathic physician, and at one point osteopathic physicians did not have prescription rights either. Eventually osteopathic medical schools started offering the same medical exposure and training, and this is why I have prescription rights today. So, I think if a psychologist wants to prescribe, that’s fine, but they should get at least comparable medical training to providers that already have the license to prescribe.
Comment by Psychiatry Resident Tuesday, May 13, 14 @ 8:49 pm
I can’t wait for the first psychologist to be sued for malpractice. Let’s dance.
Comment by It's simple! Tuesday, May 13, 14 @ 9:04 pm
As an active clinical psychiatrist, I believe it would be a huge mistake to allow psychologists to prescribe without full medical training required to become a physician. This would represent a safety risk to patients. Psychologist prescribing privileges will not fix the many deficiencies in our mental health systems in Illinois. This is simply a ruse put forth by a small group of psychologists fighting for this bill. Most psychologists, physicians and psychiatrists do not support this bill.
I am humbled on a daily basis by the complexity required in assessing and treating my patients. Psychiatrists have very unique and highly specialized training to manage the immense complexity that mental illnesses represent. Psychotropics medications are among the most powerful and complex medications in all of medicine. Many of these medications require very close monitoring of multiple organ systems including but not limited to blood testing of kidney/liver function, and cardiac testing including EKG’s. Many medical conditions masquerade as mental illness which if not properly diagnosed can lead to disastrous consequences.
I have great respect for psychologists and the expertise they provide patients regarding the psychological assessment and treatment. However, I witness on a regular basis, the lack of knowledge that most have regarding the use psychotropic medications. I do not see a realistic way to train psychologists to be effective and safe prescribers in the absence of a formal medical education.
Let’s not allow a very small minority of psychologists and lobbyists determine what is safe and effective medical treatment for people with mental illness in Illinois. The rationale vote is NO!
Comment by Frank, Psychiatrist Tuesday, May 13, 14 @ 9:43 pm
Lack of psychiatrists in rural areas is highly concerning but also allowing inadequately trained psychologists to prescribe serious mind altering medications is yet more concerning, irresponsible and offers an unsafe solution to the problem. It can only be done with relative safely if psychologists go through the same full training of nurse practitioners and are subject to the ongoing oversight afterwards
Comment by Illinois resident Tuesday, May 13, 14 @ 9:45 pm
Probably “No”. Instead they could make an official recommendation to the family doctor or some other licensed physician to do the actual prescribing.
Comment by steve schnorf Tuesday, May 13, 14 @ 11:09 pm
I am a Ph.d psychologist and am strongly opposed to this bill. I had a GPA and mcat score good enough for med school. I chose to pursue my becoming a psychologist as my real interest lay in the non pharmacological treatment of psychiatric disorders. There are many lpsychologists like me who are very good psychotherapists ant the passage of this bill would dilute and do irreperable damage to this group. If i had any interest in prescriptive privileges I would chosen to go to med school. we have to be practical and let sanity prevail for the sake of our profession and our patients.
Comment by let sanity prevail Wednesday, May 14, 14 @ 12:31 am
As a long time experienced psychiatrist who has worked with PhD psychologists for years I am against this bill. I admire my psychologist colleagues and their ability to interpret psych and neuropsych testing. These tests are invaluable as are their skills in the psychotherapists. Psychiatric patients die 25 years earlier than the average person with no mental illness. I constantly worked with people with metabolic syndrome and was often the first physician to diagnose diabetes, hypertension and hepatitis c, lung cancer and even congestive heart failure. Many of the psychotropic meds contribute to the metabolic issues. I believe medical
training is essential to care for these difficult patients and to prescribe and monitor psychiatric medications.
Comment by Retired Wednesday, May 14, 14 @ 7:09 am
Absolutely not. I personally know this can lead to an incredible disaster of psychopharmacological addition and mistreatment.
I know this is a very bad idea.
Comment by VanillaMan Wednesday, May 14, 14 @ 7:45 am
I have served the rural areas of Illinois in the mental health field, and am well-versed in the use of psychotropic medications. The proposed training is NOT enough to use these well. I fear well-intended misuse by psychologists. The fact that the bill is proposed probably demonstrates “they don’t know what they don’t know”, a very dangerous attitude. Let’s support primary care and obtain/pay more good therapists- there are very few psychologists in underserved areas anyway….
Comment by prof in underserved area Wednesday, May 14, 14 @ 11:01 am
So if this does not pass, is everyone in agreeance that the state needs to increase funding for psychiatrists and medicaid reimbursement rates? If the answer to that question is a yes, then I change my answer to no as this is surely a bad idea. So the next question is, where are the funds going to come from to provide this vital service as this seems to be the primary reason on why this will probably pass. Just sayin!
Comment by Throwing Stones Wednesday, May 14, 14 @ 11:04 am
Prof, all for that, now who pays for the service? Tax increase during election year? Cut pay for state workers? Sounds good, but let’s be realistic here.
Comment by Throwing Stones Wednesday, May 14, 14 @ 11:11 am
In 35 years of practice, I have worked with many responsible psychologists and psychiatrists who understand and respect each discipline’s training and expertise. No psychologist I know is in favor of this bill, nor is any professional or non-profit organization. We do need to advocate for advanced practice nurses with expertise in psychiatry to make medication services more available and affordable. They have the medical knowledge and connections with physicians.
Comment by Clinical Social Worker Wednesday, May 14, 14 @ 11:36 am
As a practicing Licensed Clinical Psychologist, as well as a former licensed clinical social worker and school psychologist, I am strongly against psychologists having prescription privileges. As several respondents have said, we need to respect the expertise that each profession brings to the effort to help people. Psychologists cannot possibly have the amount and degree of training and experience to address the physical/mental/emotional factors that present themselves to psychiatrists, who, after all, are physicians.
Comment by LCP Wednesday, May 14, 14 @ 12:30 pm
I have practiced as psychiatrist for 2 decades. It remains an enigma for me to get the right medication the first time. It takes a long time it get the medications right. I am not sure how anyone with no training and knowledge in complex fields of physiology, biochemistry and anatomy can prescribe medications with confidence.
Comment by Physician Wednesday, May 14, 14 @ 4:59 pm
Has anyone thought that if this passes psychologists could start doing 15′ med checks? And justify raising their rates ?
Comment by Jk Thursday, May 15, 14 @ 6:41 am
Inadequate training is a major problem. Although the motivation is supposedly public service, it is much more mixed, with financial interests a large component.
Comment by SAK Thursday, May 15, 14 @ 7:31 pm
Medicine seems to keep deteriorating to the lowest common denominator despite recent scientific advances!!!
Comment by MAD Thursday, May 15, 14 @ 10:43 pm
Psychologists do not have the extensive medical knowledge that would allow them to safely prescribe and manage medication for patients.
Comment by Marie Claude Rigaud MD, MPH Friday, May 16, 14 @ 8:05 am