In a segment of the "Today" show on April 10, Russ Newman, PhD, JD, APA's executive director for practice, and Patrice Harris, MD, a psychiatrist from Georgia, brought the prescription privileges debate to the national media stage. But when host Katie Couric asked the psychiatrist if her profession's opposition was really about economics and turf, she hit on the angle most media outlets have already cast as the story--a rivalry between psychologists and psychiatrists. That spirit of contention appears in almost every news story reporting that psychologists' gained the right to prescribe psychotropics in New Mexico. The media may focus on turf issues, but says Newman, "Access to care and alternative ways to meet patients' needs is the story."
The New York Times, for example, ran a March 26 story titled "Psychologists get prescription pads and furor erupts." The callout for the same story read: "At issue: economics, training and professional turf." In one Scripps Howard News Service article, the author wrote "Psychiatrists, who are medical doctors, says psychologists, who aren't, don't have the training to prescribe medication for mental illness."
In the April 6 edition of the Albuquerque Journal, an editorial columnist wrote, "When someone packing pills prescribed by a psychologist commits a crime, there will be an obvious over-the-counter defense: Blame the law that makes New Mexico our nation's psychotropic street corner. Psychiatrists eager to walk psychologists off the pharmaceutical plank will be warming up witness stands all over the state."
Not so, says APA's Newman. As he pointed out on the "Today" show, prescriptive authority for psychologists has been proven to be safe and effective. "That's good news for a state like New Mexico where patient access is a problem," he added. In fact, the care for those with mental health diagnoses in New Mexico's rural areas begs for a solution. Seventy-two percent of the population lives outside Santa Fe and Albuquerque, but less than 20 psychiatrists practice outside those cities, compared with more than 170 psychologists.
The New Mexico law, which passed on March 5, makes the state the first to allow psychologists to prescribe--with appropriate training. Psychologists who want to prescribe must complete 450 hours of coursework, including neurophysiology, pathophysiology, pharmacology, clinical pharmacology, psychopharmacology, and clinical and laboratory assessment, as well as a 400 hour/100-patient practical training. Then they'll receive a two-year "conditional prescribing license," during which time they'll be supervised by a physician. Finally, after undergoing an independent review, psychologists will obtain a license to prescribe independently and will continue in a collaborative relationship with the patient's primary-care physician.
Indeed, when the New Mexico legislature voted and Gov. Gary Johnson (R) signed the bill into law, the issue wasn't professional turf, the issue was access to care for their constituents, says Rochelle Jennings, APA's prescription privileges coordinator.
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