QUESTIONS AND ANSWERS
About Prescription Rights for Psychologists
Q. What would SB 2050 do?
A. SB 2050 would authorize psychologists to write prescriptions
for brain medications, provided they meet training requirements for certification
to be set by the state Board of Psychology, not the Medical Board.
Q. What are the requirements a psychologist would
need to meet to be certified to prescribe medicine?
A. To be eligible for certification by the board, SB 2050 states
psychologists must have:
- Earned a doctoral degree in psychology from an educational institution,
- Received a valid license to practice psychology in California,
- Completed a program of education in an organized program of course
work in certain core areas of instruction, and
- Supervised and relevant clinical experience for management of medication
sufficient to attain competency in the treatment of a diverse client population
with a balance as to diagnostic mix, gender, ethnicity, and age under the
direction of qualified licensed health care practitioners, as determined
by the Board of Psychology within a five-year period immediately preceding
the date of application.
- Or, an applicant may be eligible for certification by the board if he
or she is a graduate of the U.S. Department of Defense (DOD) Psychopharmacology
Demonstration program. The DOD permits military psychologists who have completed
the required training of three or more additional years to prescribe medications
for patients. As of March, 1998, no psychologists have been authorized to
practice independently, all DOD psychologists were under the supervision
of a medical doctor, and Congress has terminated the training program. However,
SB 2050 would allow psychologists to practice without physician oversight
after completed far less training. The period of training for psychologists
to be authorized to write prescriptions as stated in SB
2050 is an unspecified number of hours of course work in certain specified
topic areas, and 800 hours of supervised prescribing. Psychiatrists and
other physicians have 4 full years of medical training, including substantial
supervised clinical work (72 weeks or more under California law), and psychiatrists
have 4 more years of intensive training in residency, which involves between
10,000 and 12,000 supervised post-medical-school training.
Q. Do any other states allow psychologists to prescribe
medication?
A. No. Passage of SB 2050 would make California the only state
in the country to give prescription pads to psychologists. Passage of this
bill would significantly compromise public health and safety.
Q. What is the difference between psychiatrists
and psychologists?
A. Psychiatrists are medical doctors trained in diagnosis and
treatment of brain and other diseases, psychotherapy, and in the chemistry
and biology of medications and how they affect body functions and organs
and interact with other medications. Psychologists are trained to assess
behavioral and cognitive changes.
In terms of education, a psychiatrist is a physician (M.D. or D.O.)
who specializes in the treatment of mental illness. A psychiatrist's graduate
education is four years of medical school, a one-year internship and at
least three years of residency, nearly all of which is in a hospital setting,
followed in many cases by two more years of training in a specialty such
as children, adolescents, elderly, etc.
A psychologist holds an academic degree (a Psy.D. or Ph.D.), rather
than a medical degree. A clinical psychologist licensed by the State of
California also has two years of supervised practice, usually in school
counseling departments, family service agencies, hospital outpatient or
inpatient units, or some combination of these.
Q. What types of drugs do psychologists want to
prescribe?
A. Psychologists would like to prescribe antipsychotics, antidepressants,
MAO inhibitors, tranquilizers, hypnotics, lithium carbonate, mood stabilizers,
stimulants and antiparkinsonian medications.
These medications can have medical complications with other parts of the
body and can negatively interact with other medications a patient may be
taking. Health care consumers need to be educated about the potential adverse
psychiatric effects of prescribed medications they are given, and receive
a careful medical review of any drugs they are taking for physical conditions
before counseling, psychotherapy, behavior modification or brain
medication is introduced. Supervision of all medication by a physician is
necessary to ensure safety. Under this bill, psychologists would be allowed
to prescribe any type of medications.
Q. How will SB 2050 affect public health and safety?
A. Public health and safety will be compromised. Medications prescribed
by psychiatrists are for medical, biological diseases of the human brain
whose I symptoms are exhibited in behavior. Medications are used to treat
medical problems, not behavioral ones. The California Psychiatric Association
opposes SB 2050 because it would allow prescription of medicine by individuals
who do I not have comprehensive medical training required to obtain a medical
degree.
An estimated 50 percent or more of patients requiring brain medications
suffer from other serious medical conditions requiring medications. To protect
the health and safety of the patient, the effects of other diseases and
medications
must be taken into account and monitored by a physician when prescribing
brain medication and other psychiatric treatment.
Q. What are the public risks of SB 2050?
A. SB 2050 would be dangerous to public health and safety because it fails
to provide oversight by those specifically trained in prescribing medications
and the chemistry and biology of how those medications operate/interact
with other
medications and disease conditions of the patients.
Q. Will SB 2050 increase access to medical care
for those with mental diseases?
A. No. Because all physicians are legally authorized to prescribe medications
for brain disorders, treatment in rural areas is always available through
primary care physicians. Increasingly, medical schools in California such
as U.C. Davis and U.C. San Diego offer combined residencies in family practice and psychiatry.
Furthermore, it's psychiatrists who traditionally treat the poorer, sicker
patients while psychologists treat a larger proportion of white, employed,
insured, highly educated, wealthy and less impaired people.
Q. How will SB 2050 affect quality of care and
health care costs?
A. Patient care will be at risk. If a patient takes medications prescribed
by a psychologist while on other physician-prescribed medications, there
would be potential for dangerous drug interaction and serious health implications.
Such non-medically supervised interaction could require additional medical
treatment and result in increased health care costs.
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