1. Pearson, Linda RN, FNP, MSN, DNSc(c), Editor-in-Chief

Article Content

For the past 14 years, I've tracked NPs' prescriptive practices through the journal's "Annual Legislative Update" published each January. I've consistently urged that each state must break down barriers to NP prescribing so that patients can access all NP services.


My interest in prescribing practices extends into the issue of psychologists' prescribing rights. About 3 years ago, 24 psychologists enrolled in a New Jersey college's master of science in nursing program. Upon graduation, the psychologists would be certified as advanced practice nurses (APNs) and permitted to prescribe drugs. The ensuing debate among APNs rarely included whether psychologists should prescribe drugs. Instead, APNs questioned whether psychologists graduating as nurses. when they didn't have a nursing background, training, or education, would be detrimental to the nursing profession.


An Alternate Route

Psychologists in New Mexico fulfilled their desire to prescribe through other means: As of July 1, 2002, doctoral-level psychologists can prescribe after they complete 450 hours of coursework, spend 400 hours supervised by a psychiatrist, and pass a national exam. 1


Predictably, organized psychiatry has argued that, in spite of studies demonstrating the contrary, psychologists lack sufficient training and aren't qualified to prescribe. This is the same old argument organized medicine has used against NP prescribing rights.


This is a weak, ongoing argument from organized medicine. Physicians don't retain everything they ever learned in medical school and apply it daily to prescribing. As the mother of a medical school student, I hear continuously that many medical students cram for one test and admit that they forget much of that content while preparing for the next. Qualified clinicians who've completed comprehensive courses can prescribe safely.


A Plus for Patients

Prescribing authority for psychologists will allow patients increased accessibility to mental health care. People often see two different clinicians to meet their mental health needs: One clinician prescribes and the other counsels. Many psychiatrists are "pill pushers" who see patients every 10 minutes to prescribe psychotropic drugs, and then refer these patients for counseling or psychotherapy. Is this practice lucrative for psychiatrists? Undoubtedly, but patients are burdened by having to see two clinicians.


The final kicker: When I mentioned news of the psychologist prescribing law to a doctorally prepared psychologist colleague, he surprisingly said that he views prescribing as a potential destructive force to his profession. He believes that this law will tempt psychologists to prescribe and make the quick buck rather than provide what patients need: good therapy. He wondered: Could prescribing NPs be tempted to write prescriptions rather than listen to patients? I assured him that this wasn't a legitimate concern for our profession.



Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.



1. Goode E: Psychologists get prescription pads and furor erupts. The New York Times, March 26, 2002. [Context Link]