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New Mexico first to let psychologists give meds

NEW YORK, Mar 07 (Reuters Health) - New Mexico Governor Gary Johnson signed a bill Wednesday giving psychologists the ability to prescribe medications, but psychiatrists were vowing fight back.

"The new law is the result of a cynical, economically motivated effort by some elements of organized psychology to achieve legislated prescriptive authority without benefit of medical education and training," said Richard Harding, president of the American Psychiatric Association in a statement. "Psychology prescribing laws are bad medicine for patients," he added.

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The American Psychological Association countered that letting psychologists prescribe might actually result in better patient care. The organization claimed that there was such a severe shortage of psychiatrists in New Mexico that patients were waiting 6 weeks to 5 months to see a doctor. Suicide rates for 15- to 24-year-old New Mexicans were 75% higher than the national average.

Letting psychologists see patients who desperately need medication might improve mental health services, said the Psychological Association.

The Psychiatric Association called that argument a Trojan horse, noting that the psychologists rejected proposals to limit prescribing privileges to psychologists located in under-served areas.

Under the New Mexico law, psychologists won't be allowed to start prescribing right away. Details still have to be worked out, so psychiatrists may get a say in implementation of the law.

The current plan will require psychologists to complete at least 450 hours of coursework in subjects such as neuroanatomy, clinical pharmacology, psychopharmacology and pathophysiology, and to take a 400-hour practicum where they see 100 patients under physician supervision. Psychologists then will have to pass a national certification exam.

Then, psychologists will be given a 2-year license, allowing them to prescribe under a physician's supervision. The physician has a say in whether the psychologist is allowed to become an independent prescriber after the 2-year probationary period.

The Psychological Association has been fighting for more than a decade to secure prescribing privileges for its members, who have doctoral degrees in psychology but not usually any medical training. The organization has argued that having one practitioner give a patient medication and therapy makes economic sense.

"We know from experience and research that the provision of integrated care--when it's done by one provider--has been shown to be more cost-effective than when done by two separate providers," Russ Newman, the Psychological Association's executive director for professional practice, told Reuters Health.

Newman said states may now look more closely at approving prescribing privileges for psychologists, since they would no longer be the first to do so, and because data will eventually be available from New Mexico. "How quickly that will happen, I don't know," he said.

Guam passed a prescribing law in 1999. Over the years, 14 states have rejected such legislation.

The Psychiatric Association said the laws were rejected after legislators objectively considered "the scientific data and the public health risks of placing potent medications for treatment of mental illness in the hands of people with no medical education or residency training." Psychiatrists have gone through medical school.

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Copyright 2002 Reuters. Click for Restrictions.

Created: 03/07/2002  

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