Rep. Bill Kennemer, a Canby Republican, is backing legislation that would give his old profession of psychology a greater role in solving the mental health gaps in Oregon, by allowing them to prescribe psychotropic medications for their clients.
Psychologists typically spend much more time with patients than psychiatrists, and there are far more of them. But unlike psychiatrists, they are not medical doctors and cannot prescribe medications, sticking instead to talk therapy and counseling.
House Bill 3355 sets up a process through the Board of Psychologist Examiners to authorize certain psychologists to prescribe medication. It seems unlikely that a huge number of psychologists would jump at the opportunity, as they would have to go through a lengthy pharmacology program in a medical setting to get approved.
But it does leave an opening for those who are interested, including those who have gone through a Department of Defense prescribing psychology program like Morgan Sammons, the executive director of the National Register of Health Service Psychologists, who visited from Washington, D.C., to testify.
“In the 1990s, I used to call myself an experiment, but now I can call myself an innovator,” said Sammons, who noted that a law much like HB 3355 was just signed in Idaho, and similar laws are in place in New Mexico, Louisiana, Illinois and Iowa. “It will greatly increase access to mental healthcare medications.”
The hearing got overheated at one point, with Kennemer taken passionate umbrage at Tanya Tompkins, a Linfield College professor of psychology, and adamant opponent of psychologists taking on the role of psychiatrists and prescribing psychotropic medications.
Kennemer dismissed Tompkins’ arguments because she is an academic, and has never worked in private practice. “You’re commenting on a profession that you do not have experience with,” he said.
While there are psychologists who object to the perceived overuse of drugs to treat mental health conditions, the opponents of HB 3355 primarily argued that psychologists are simply not well-versed in the biological underpinning of mental disorders and instead should focus on their core skill of treating cognitive aspects of mental health.
Tompkins said HB 3355 was little changed from a 2010 bill that was struck down by Gov. Ted Kulongoski. According to the Oregonian, Kulongoski vetoed the measure because he thought it and two other bills hadn’t been fully vetted in a short 2010 session intended to pass housekeeping measures.
But Dr. Holly Jo Hodges, a family physician in Eugene, said she welcomed the idea of allowing her psychologist colleagues to prescribe medications because, with so few psychiatrists in Oregon, the task of prescribing mental health drugs often falls on family doctors, who are much less trained in psychological conditions and treatments. “There are not enough psychiatrists to treat the demand.”
Reach Chris Gray at [email protected].
Comments
Just As Dangerous and Amateurish as the Last Time
This is in response to Mr. Allan's claim that the bill calls for significant (his emphasis training for psychologists to prescribe. Let's take a look at that:
Begin with a psychologist with no history of education, training or practice in the biomedical sciences. This person's education consists of the followig:
400-450 "contact hours" of education, which is 8.8-10 college courses. The bill says that these few courses will teach this biomedical newbie everyting he/she needs to know about the basics of chemsitry, biology, organic chemistry, physiology and so forth. Then it would teach this person everything necessary for prescribing powerful drugs (most with "black box" labels signifying extra risk of side effects to persons of all ages (infants to the elderly) who have every imaginable disease and who are taking every imaginable other medication that might interact with these psychiatric drugs. Does Mr. Allan really believe that little education is significant?
But wait, it gets worse. These people will get all of their education on a laptop - through online courses from private psychology schools thae made up these so-called "master's degrees in psychopharmacology." One of these profitable private school programs has open-book tests, guaranteeing no one fails. Another simply presents a series of pre-recorded lectures and the only interaction the studen has is online chat.
One of these schools claims that in an online course lasting 36 clock hours (2.4 credit hours) these miracles of high-speed education will be able to learn how to prescribe these risky medications for children and adolescents (Psychiatrists have specialized fellowships and board certification for this, but these very, very special psychologists learn it as part of an online course), persons who are elderly, those with developmental disorders, chronic pain, personality disorders and victims of trauma.
I don't believe any person can reveal the truth of the education required of these aspiring prescribers in this bill and keep a straight face when calling it "significant." When the truth about this bill, which is hidden from legislators and the public, is revealed, then people turn away from this proposal.
In fact, the only national survey of psychologists on the contents of this and similar bills shows that the vast majority oppose what this bill proposes, especially the scant education requirements.
What does Kennemer get for his part in this nonsense?
"Kennemer dismissed Tompkins’ arguments because she is an academic, and has never worked in private practice. 'You’re commenting on a profession that you do not have experience with,' he said."
Ju
Well if that isn't the pot calling the kettle black I don't know what is.
First, Kennemer got his license in 1976 and is retired. I would not say he's at the top of his game. I think it is HIGHLY HIGHLY LIKELY KENNEMER'S PERCEPTION OF PSYCHIATRIC MEDICATIONS AND THE EDUCATION REQUIRED TO EFFECTIVELY PRESCRIBE THEM IS PROFOUNDLY OUT OF DATE. Second, psychologists on board with Kennemer determining what the necessary educational requirements should be for safe and beneficial prescribing would be hilarious if it wasn't so scary. Let's see, I used to hand off my patients as an EMT to Trauma Surgeons, so I guess it would make sense that after 2 years of fake hodge podge classes online I should be able to do cardio thoracic surgery. When I worked neuro trauma as RN I guess it would make sense that I should have advocated for the creation of a two year program in neurology so I could prescribe drugs and make more money. Now that I am a Psychiatric NP I work with OBGYN and Midwives regularly to meet the psychiatric needs of their patients so I should start catching babies and performing c sections, too. You know what? I have a friend who is a surgical tech in a cardiac cath lab- I'd say with a couple online courses he's ready to clean out occluded cardiac arteries, wouldn't you?
Kennemer is proposing a mere sample platter, a fake masters that really should be called "bogus superficial survey of medicine".
This clown and his clown colleagues don't know what they don't know. Ego and Greed:HB 3355
I would also like to point out that the majority of psychiatric patients in our rural counties are near poverty, on OHP or nothing at all, AND ARE THE MOST MEDICALLY COMPLEX PATIENTS IN OREGON. Psychiatry, at times, can be more challenging than primary care because we are expected to have enough knowledge to identify medical conditions that could be congributing to the chief complaint as well as potentially interfere with treatment. Polypharmacy is a profoundly serious issue and requires a broad spectrum of expertise and caution. It is simply not possible for psychologists to be prepared for these patients with the current qualifications.
Licensing psychologists to prescribe is akin to putting a blindfold on a child, spinning him arounf 10 times, handing him a gun, and telling him to hit a target 100 feet away.
This bill is long overdue. It requires significant training for psychologists similar in intensity to the training nurses must receive to become psychiatric nurse practitioners.
Psychologists already have expertise in diagnosis of psychiatric disorders, knowledge which many nurses lack before their advanced training. Conversely, nurses already have medical training and knowledge, which many psychologists lack. Psychologists will attain that knowledge in the advanced training before being granted prescribing privileges. As it is now, many patients go without psychiatric services due to a national shortage of psychiatrists and psychiatric nurse practitioners. Providing a pathway for well-trained professionals to expand their scope of practice is a reasonable solution.
Among those opposed to this measure are many who are motivated to protect their own professional and economic turf under the guise of patient protection. In fact, this is a low-risk, sensible solution to a serious problem.
Steve Allan