SENATE BILL 2050 (POLANCO)
A DANGEROUS PRESCRIPTION TO FILL
Would you want someone without a medical degree prescribing potent brain
medication? Psychologists think it's a great idea.
Under current law, psychologists are prohibited from prescribing drugs.
In addition to psychiatrists and other physicians, only dentists, optometrists,
podiatrists and veterinarians may write prescriptions. Sponsored by the
California Psychological Association, SB 2050 would eliminate current restrictions
in the law that prohibit psychologists to prescribe medication. Psychologists
would be permitted to write prescriptions for psychotropic and other brain
medications, if they take some courses that meet the training requirements
to be set by the state Board of Psychology, as opposed to the Medical
Board of California.
No other state in the nation gives prescription
pads to psychologists.
Social scientists treating brain disease?
A psychologist possesses an academic degree, such as a Ph.D.,
not a medical degree. Psychologists are trained to assess behavioral and
cognitive changes. Their education as social scientists provides them with
no training in physiology, pharmacology, biochemistry or other fields related
to medicine.
Or trained physicians treating brain disease?
On the other hand, a psychiatrist is a medical doctor trained
in medicine to diagnose and treat disease of the brain. While psychiatrists
are trained in psychotherapy, they are also trained in the chemistry and
biology pertaining to medications and how they affect the body functions
and organs and interact with other medications. Psychiatrists focus on the
human brain as part of the neurological system, working with the entire
body of the patient.
Expanding a psychologist's scope of practice to include
"prescriptive authority" would pose a risk to patient safety for
the following reasons:
The medications psychologists would like to
prescribe are powerful and potentially dangerous.
Psychologists want prescriptive authority on drugs that have
a biochemical basis in the treatment of such brain disorders as schizophrenia,
bipolar disorder, severe depression, obsessive-compulsive disorder, and
attention deficit disorder. Drugs
used to treat these disorders are among the most powerful and potentially
dangerous medications available in modern medicine. Dispensing of these
medications requires wide medical knowledge to treat or prevent potential
side effects such as convulsions, heart arrhythmia, blood diseases, seizures,
severe high or low blood pressure, severe constipation, coma, stroke, permanent
disability or even death.
Psychiatrists are the only doctors trained to deal
in an integrated fashion with physical and mental health problems associated
with brain disorders.
Psychiatrists and other physicians are trained to assess whether
the mental symptoms exhibited by a patient are the consequence of some underlying
physical illness. Many patients, whose brain disorders are treated with
brain medications, have other serious medical conditions requiring medications.
Psychiatrists are knowledgeable about the systemic effects of brain medications
and their interaction with patients' other physical conditions and medications,
including both prescribed and illicit drugs. Modern psychiatry takes an
integrated mind-body approach to treating mental illnesses.
The modest training required of certified psychologists
under this measure in no way provides an adequate substitute for the extensive
training required of licensed psychiatrists and other physicians.
Substantial medical training is a prerequisite to prescribing
brain medications. To be licensed as a physician, a person must have more
than 4,000 classroom hours of medical school, including at least 72 weeks
of clinical training in hospitals and clinics, and a one-year internship
within a medical setting. In addition, psychiatrists and other specialist
physicians must have at least three years of residency. This is between
10,000 and 12,000 hours of post medical school training. By contrast, the
training required is SB 2050 for psychologists to be certified to prescribe
brain medication involves certain specified classes with no minimum number
of hours, only one of which involves anything below the neck, plus an 800
hour preceptorship writing brain medication prescriptions. Following that,
any psychologist who receives a "prescriptive authority" certificate
from the state Board of Psychology may prescribe any medication without
physician supervision!
Making California the only state in the country to give prescription pads
to psychologists is "a terrible idea," as The Sacramento Bee
stated in opposing this bill when it was last introduced in 1997.
Please urge the California Legislature to avoid making
California residents human guinea pigs for psychologists with prescription
pads.
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