Prescribing and primary care psychology: Complementary paths for professional psychology.

Abstract

Two paths have been suggested for the future evolution of professional psychology. Prescribing psychology has already been legally authorized in two states, the military, and the Indian Health Service. Primary care psychology does not require legal recognition and has been slowly growing as a career option for psychologists across the nation. Both paths have their obstacles and limitations, but both are also associated with great potential. This article provides a brief summary of the strengths and weaknesses of each path and suggests an integrated perspective for planning the future of the profession. Each is seen as complementary to the other and providing a basis for pursuing the other.Doctoral-level healthcare psychology faces several serious threats to its status quo and perhaps even its survival. The first comes from the pressures all healthcare professions are experiencing from managed care and other third-party reimbursement systems. Involvement in managed care has been associated in psychologists with longer working hours, larger caseloads, less participation in supervision, greater stress, higher rates of premature termination, reduced flexibility, and greater pressure to com-

Psychological practice in rural settings: At the cutting edge.

“…Whether extending prescription privileges to provide care for the underserved would actually increase care or prove to be costeffective and thus reduce costs for the elderly, children, and rural populations are empirical questions for which there are no answers yet (Dittman, 2004;Lavoie & Barone, 2006). McGrath and Sammons (2011) noted that there is a natural link between psychologists practicing in integrated care settings and the pursuit of prescription privileges. Although the use of technology may appear to reduce the need for psychologists who can prescribe on site, the possibility that primary care providers write 60% of the prescriptions for psychotropic medication reveals that as many prescribers as possible are needed in these sites.…”

Integrated health care and professional psychology: Is the setting right for you?

“…Psychologists are increasingly being consulted by primary care physicians on psychotropic medications, and it is believed that with increased training in psychopharmacology, psychologists will be of even greater value to the treatment team (McGrath, 2010;McGrath & Sammons, 2011).…”

The intersection of counseling pychology and the prescriptive authority for psychologists movement

“…While articles debating the merits of the RxP movement represent the majority of published works on prescriptive authority, a sizeable minority of literature consists of theoretical and in vivo explorations of the clinical applications of prescribing psychology (Gruber, 2010;Hoover & Andazola, 2012;LeVine, 2007;McCormick, 2010;McGrath, 2012;McGrath & Sammons, 2011;McGuinness, 2012;Ransom, 2014;Riding-Malon & Wert, 2014;Shearer, 2012;Shearer & Etherage, 2010;Shearer, Harmon, Seavey, & Tiu, 2012;Sutherland & Tulkin, 2012). These articles typically take the form of theoretical discussions on how prescribing psychology could be applied to a certain field, or they consist of single-subject case studies written from the point of view of a prescribing psychologist (Gruber, 2010;Hoover & Andazola, 2012;LeVine, 2007;McCormick, 2010;McGrath, 2012;McGrath & Sammons, 2011;McGuinness, 2012;McGrath, 2012;Ransom, 2014;Riding-Malon & Wert, 2014;Shearer, 2012;Shearer & Etherage, 2010;Shearer et al, 2012;Sutherland & Tulkin, 2012). Applications of prescriptive practice within this literature focus on three types of settings: primary care, the federal level, and practicing in civilian contexts (Gruber, 2010;Hoover & Andazola, 2012;LeVine, 2007;McCormick, 2010;McGrath, 2012;McGrath & Sammons, 2011;McGuinness, 2012;…”

“…These articles typically take the form of theoretical discussions on how prescribing psychology could be applied to a certain field, or they consist of single-subject case studies written from the point of view of a prescribing psychologist (Gruber, 2010;Hoover & Andazola, 2012;LeVine, 2007;McCormick, 2010;McGrath, 2012;McGrath & Sammons, 2011;McGuinness, 2012;McGrath, 2012;Ransom, 2014;Riding-Malon & Wert, 2014;Shearer, 2012;Shearer & Etherage, 2010;Shearer et al, 2012;Sutherland & Tulkin, 2012). Applications of prescriptive practice within this literature focus on three types of settings: primary care, the federal level, and practicing in civilian contexts (Gruber, 2010;Hoover & Andazola, 2012;LeVine, 2007;McCormick, 2010;McGrath, 2012;McGrath & Sammons, 2011;McGuinness, 2012;Ransom, 2014;Riding-Malon & Wert, 2014;Shearer, 2012;Shearer et al, 2012;Sutherland & Tulkin, 2012). The following section of the literature review will examine the applicability of prescriptive authority, all in service of illustrating the relevance of the RxP movement as a professional issue worthy of empirical consideration.…”

“…Primary care psychology represents the integration of psychological services into the realm of primary care medicine, such as family medicine or obstetrics and gynecology (OBGYN) (Gruber, 2010). Many cite primary care psychology as the future of professional psychology, a natural movement towards making professional psychology viable in the face of such factors as managed care, the rise of master's level practitioners, the decline of the fee-forservice model, and changes to the overall health care system in the United States (McGrath, 2012;McGrath & Sammons, 2011). Primary care psychology derives its impetus from the fact that significantly greater numbers of patients are receiving mental health care solely through their PCP's, with 60-80% of all psychotropic medication prescriptions being written by PCP's, and an estimated 50% of patients seen in primary care settings meeting the criteria for a mental disorder (McGrath & Sammons, 2011).…”