• Announcements

    • Gurpal

      New question bank for paper B   05/11/18

      Please see the link below for a new question bank: http://www.superegocafe.com/online-courses/mrcpsych-paper-b-multiple-choice-question-bank/  
Sign in to follow this  
Followers 0
Guest justin

Essay 14: Psychologists and prescribing

5 posts in this topic

In the state of New Mexico, psychologists are now being allowed to prescribe medication. This move may eventually be introduced in the UK. Discuss the advantages and disadvantages.

Share this post


Link to post
Share on other sites

Intro

why the need

can psychologists manage the medication on their own

adv

psychologists sometimes are following patients for long time

routine appt with psychiatrist can take long time

sometimes the need for medication change is immediate rather than few days or weeks later

psychologists can prescribe if they train for it and have appropriate knowledge

for some simple commonly used drugs

can do so in liason with the psychiatrist or the pharmacist

some places the pharmacists do the ward round and can change the medication(in US only)

can prevent the doubling of work (if the pt goes to see the psyhiatrist just for the change of meds)

can work out a system if liase with each other

cost issues - if the pt has to pay for both the appointments(not in uk)

Disadv.

medical training

understanding of pharmacokimetics. and pharmacodynamics of drugs

side effect and drug interaction with other drugs

management of emergencies

do we have evidence that this is a better way?

whats wrong with the current system

any other ideas friends???

Share this post


Link to post
Share on other sites

Nice points thx ;

In New Mexico there is a marked shortage of psychiatrists; This is an emergency measure. However when floodgates opened it will move to rest of USA and then elsewhere;

The point has been raised that the prescription of medication by non-medics would introduce the idea of psychiatry being a second rate medical discipline

Role between psychiatrist and psychologist will become increasingly blurred; Would attract people to option with less training; Pay would need to be similar;

Monitoring side effects may be picked up with time but differentials would not be constructed as knowledge not acquired;

Psychogists spend more time with patients - meaning less patients and less prescribing - means less experience; Psychiatric clinics are medical model clinics - short time - assess medication - need for changes etc;

Psychologists would need to keep up to date with psychiatric pharmacological literature;

Psychologists may eventually work independently and draw population away from psychiatric services

Share this post


Link to post
Share on other sites

May open floodgates for others related specialities to start prescribing;

However there may be drive by psychologists to 'prove themselves' and develop a detailed knowledge of the literature forcing standards up.

Additional body of people to help with workload and conduct research.

More insights into relationship between medication effects and psychological models - predictive power etc

Share this post


Link to post
Share on other sites

there has been a long standing hotility btw psychologists and psychiatrists which may be adding fuel to the fire. In these days whn psychiatry research is opening up and we are understanding more of the complex interplay of genetics, endocrinology, neurology etc it will be even more critical that prescribing is clearly understood. In a multi disciplinary team who will have ultimate responsiblity for prescribing errors made by members of the team. Also there are so many instances when a psychological assessmnet woud add agreat deal to my undersatnding of a case but the waiting lists are so long or there are no psychologists anyway. Why do the sychologists want to take on extra stuff?

Share this post


Link to post
Share on other sites
Sign in to follow this  
Followers 0