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Missouri psychologists
close to earning prescriptive privileges
(March 2008
Issue)
By Phyllis Hanlon
Missouri might soon join New Mexico and Louisiana in winning the
right for prescriptive privileges (RxP).
Dan Abrahamson, Ph.D., assistant executive director of state advocacy
for professional practice at the American Psychological Association
notes that the battle for prescriptive privileges has been waging
for the last two decades.
In the Show-Me State, Marci Manna, Psy.D., chair of Missouri's
RxP Task Force, Mark Skrade, Psy.D., president of the Missouri Psychological
Association (MOPA) and Roy Holand, M.D. and former state representative,
have worked tirelessly to garner support for the bill. Manna reports
that 85 percent of the 1,400 psychologists in the state support
the bill and 85 members of the House have co-sponsored the bill.
Also, the Missouri Families for Access to Comprehensive Treatment,
a group of 500 citizens, has joined the effort. "[The group] exists
to support our legislation," says Manna. "They are working to get
on a listserv. It looks favorable this year."
In Missouri, patients often have to wait an average of eight months
and must travel great distances to see a psychiatrist, according
to Manna. Although general practitioners offer some respite, she
says they are often unfamiliar and inexperienced with psychological
issues and specific psychopharmacological treatment. "They rely
on us for help with mental illness issues," says Manna.
Missouri launched efforts to gain prescriptive privileges in the
1990s but failed to earn sufficient support from the psychological
community. The current campaign began five years ago and has managed
to survive several legislative hearings.
While 80 percent of Missouri's psychologists now favor RxP, external
factors still pose a challenge. "The biggest obstacle is medicine,"
says Manna. However, their efforts to block the legislation are
"not highly organized," she adds. "They would send a token psychiatrist
[to meetings] who wouldn't even know what the bill is about," she
says. "There is a lot of misinformation and miseducation among
medical professionals. They don't understand the details."
To opponents of the psychologist's right to prescribe, Manna says,
"Our main platform is that [prescribing] is done in the context
of therapy. We want to get patients off meds."
Abrahamson applauds Missouri's efforts and says, "The Missouri
folks are doing a great job. They are committed and organized. They've
done their homework and are developing an effective relationship
with the legislature."
He also notes that the Missouri legislature "appears to be more
knowledgeable and sophisticated about the arguments made by organized
medicine." He says, "they know that their assertions that giving
psychologists prescriptive privileges will have disastrous consequences
are not accurate."
Abrahamson emphasizes that as more and more psychologists earn
and use their prescriptive rights, history and data show that they
can prescribe safely and effectively. "There are hundreds of counties
in the country that have no psychiatrists. We have a solution to
one important part of a healthcare problem in the country," he says.
Should the bill (House Bill 1739 and Senate Bill 917) earn legislative
approval, prescribing rights in Missouri would become effective
Aug. 28, 2008.
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