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And So Onward We March...

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Just a few days ago, on May 27th, Iowa governor Terry Branstad signed into law a prescriptive authority bill for psychologists, making Iowa the fourth state in the nation to have such a law enacted. I have written before about the need for psychologists to continue their push for full prescriptive authority. This is a major step forward in that quest.

In my clinical work with primarily geriatric patients, I come across many who are on a variety of psychoactive meds for various illnesses, ranging from depression to dementia, and from schizoaffective personality disorder to sleep issues. I talk to them on a daily basis, and pretty much all of them tell me that psychologists should be able to prescribe. My patients are often surprised that I do not have the authority to prescribe their psychotropic meds when I am spending at least a half hour with them on a regular basis. I know their behavioral issues better than almost anyone who sees them in the nursing home, including some of their family members.

Psychologists have advanced training in assessing and treating mental health and behavioral disorders. We have a doctoral degree that takes an average of seven to eight years to complete. In addition to the classwork, thesis and dissertation requirements, we are also required to complete several clinical rotations, a full year internship, at least another year of postdoctoral fellowship or residency training, and then pass a national as well as a state-level board exam. As if all this were not enough, psychologists who have been allowed to prescribe have to take two additional years of coursework in psychopharmacology, another year of internship, and are mandated to pass a second national board examination in psychopharmacology. How then are we lacking in training to prescribe, as some critics point out?

Besides the four states where psychologists have gained prescriptive rights, we have been prescribing in the armed forces for over two decades now. Additionally, we have been allowed to prescribe in the Public Health Service Corps and the Indian Health Services. There is a bill pending in Congress right now that would also give us prescriptive authority in the Veterans Administration. The march is on. The clarion call has been made. I think the future awaits us with bated breath.

There will still be critics of prescriptive authority, as there always are in any worthy venture. It will still be a difficult road ahead what with the might of organized medicine, and some within our own ranks even, trying to oppose us at every step. But we should never lose hope. The story of the four states where psychologists can now prescribe shows us the way forward amidst all opprobrium. It is a story of hope, of possibility, of achievement. And ultimately we should never forget why we are in this fight in the first place -- for our valuable patients, to ease their pain and suffering, to give them more choices as to who their prescriber should be. And so onward we march...