On November 16, Immediate Past President Tom Houston, MD, testified before the Senate Health and Human Services Committee in opposition to Senate Bill (SB) 300, a proposal to grant psychologists prescribing authority for mental health medications. You can send your own message to legislators opposing SB 300 using the SpeakOut website.
In this testimony, Dr. Houston pointed out the vast differences in education and training between physicians and psychologists. He noted, “Psychologists are social scientists. Their training occurs largely outside a medical context. A psychologist possesses an academic degree, such as a PhD, not a medical degree. Psychologists are trained to assess behavioral and cognitive changes. The training required of psychologists under this proposal in no way provides an adequate substitute for the extensive training required of licensed family physicians, psychiatrists, and other physicians.”
He went on to say, “Substantial medical training is a prerequisite to prescribing brain medications which do not just work on the brain, but interact with the whole human physical structure. To be licensed as a physician, a person must have more than 4,000 classroom hours of medical school and at least three years of residency. The training that would be required for psychologist certification—by the Ohio Board of Psychology, not the State Medical Board —involves only a fraction of the medical school classroom hours. Physicians have lengthy instruction during medical school in pharmacology, the study of medication in the treatment of disease that builds on their early courses in biochemistry, physiology, immunology, and molecular biology, and creates a bridge to clinical medicine and the treatment of disease. They learn how drugs affect the body, factors that deal with metabolism, distribution and excretion, and many variables that influence how a medication is influenced by genetics, race, other diseases and other drugs. This is followed by specific instruction regarding medications used in mental health in their psychiatry as well as other clinical rotations in medical school and throughout the three years of residency training.”
Dr. Houston also emphasized the power and dangerous nature of psychotropic medications stating, “The current generation medications used to treat mental illnesses are potent, powerful modifiers of brain chemistry. They also affect other organ systems and interact with other medications. An example – Zyprexa is used to treat bipolar disorder but it can also cause patients to develop diabetes. Can a psychologist take a medical history? Do a physical exam, create a differential diagnosis for a presenting complaint (e.g. nausea, palpitations, weight loss), order appropriate diagnostic studies, and interpret the results – then refine their assessment and make a plan for managing the symptom? Does the limited pharmacology training of a psychologist proposed by SB 300 give them sufficient knowledge to understand interactions of antidepressant medications with other drugs?”
Hearings on SB 300 will continue. Any bill not passed prior to the end of the calendar year will have to be re-introduced in the new General Assembly that commences in January 2017.