Psychopharmacology/Advanced Practice Psychology

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No, that's a very accurate characterization. Were you not stating that the accepted education/training requirements were "abritrary"? Were you not looking to find the minimum? Also, you keep talking about "moving the bar." What bar? You make it sound like RxP at one point satisfied some minimum standards set by the medical community. There is no "moving bar" other than where you want to move it (far downwards)- the standards for what is acceptable for mid-level and physician-level have been static for some time now.

I did say that they were somewhat arbitrary, due to a lack of data that is now being requested. I think that having that data is actually a good thing. It should be required across disciplines, be it MD, NP, PA, RxP, etc. There's nothing wrong with evidence based medicine, I advocate for it daily in my practice. But, I don't think groups can demand it from others, yet claim that they are exempt from it. But, if it pleases you, keep beating that "minimum standard" strawman. He's looking a little thin though, you should add some more straw.

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I did say that they were somewhat arbitrary, due to a lack of data that is now being requested. I think that having that data is actually a good thing. It should be required across disciplines, be it MD, NP, PA, RxP, etc. There's nothing wrong with evidence based medicine, I advocate for it daily in my practice. But, I don't think groups can demand it from others, yet claim that they are exempt from it. But, if it pleases you, keep beating that "minimum standard" strawman. He's looking a little thin though, you should add some more straw.
I don't understand. You don't want to find what the minimum is but you do think we should test to see if standards lower than mid-levels is OK? I don't think there is much room for disagreement here other than the fact that you don't like the fair characterization of "trying to find the minimum." Because I assure you that whatever this theoretical minimum is- it would be higher than RxP in it's current form. And like I said before, I don't think there is anything unfair of wanting a new much lower standard to prove its efficacy and, more importantly, safety. If RxP wasn't so wanting (e.g. if it was a track of PA school and they weren't seeking independent practice rights) then maybe there wouldn't be as much of a clamor for it.
 
Yeah, I would think that having people who know how to evaluate research would actually make that much less likely, given the lack of effectiveness and growing evidence of long-term side effects.
Maybe if clinical practice was mostly about evaluating research. o_O
Honestly I'm amazed that despite being psychologists some of you overestimate your ability to safely practice outside of your training or with only little add-on training. You overestimate the value of your psychology training and underestimate medical training.
 
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I'm saying that there needs to be some way of evaluating efficacy competency in this area other than "the way we do it now is the way that works, because.....just because." These ways of evaluation and evidence based medicine could be very important to the field of mental health as a whole. Maybe there are much more efficient and safe ways to deliver psychopharmacological services than what we already utilize. Maybe we can improve the way we train current providers (e.g., training them to evaluate pharma research) that can improve the way that they prescribe. Clinical practice should definitely involve knowing how to evaluate research. Look at the money spent doing things like prescribing aricpet and like drugs for MCI. Guess what the overwhelming consensus about that is according to the research? It's sad to see providers across a range of fields deride EBM for tradition and arbitrary dogma.
 
I'm saying that there needs to be some way of evaluating efficacy competency in this area other than "the way we do it now is the way that works, because.....just because." These ways of evaluation and evidence based medicine could be very important to the field of mental health as a whole. Maybe there are much more efficient and safe ways to deliver psychopharmacological services than what we already utilize. Maybe we can improve the way we train current providers (e.g., training them to evaluate pharma research) that can improve the way that they prescribe. Clinical practice should definitely involve knowing how to evaluate research. Look at the money spent doing things like prescribing aricpet and like drugs for MCI. Guess what the overwhelming consensus about that is according to the research? It's sad to see providers across a range of fields deride EBM for tradition and arbitrary dogma.
You don't think academic psychiatry is evidence-based and evolving? A psychology PhD can be great research training, but I don't think psychiatry departments need non-medical practitioners to come in and teach them evidence based medicine. Some of what you said isn't so much from lack of research as it is self-interested behavior; something RxP would only add to.
 
I think academic psychiatry is far removed from clinical psychiatry. Just as I think academic (insert field here) is different from clinical (insert field here). It happens across disciplines. And, this rhetoric of "we don't need to prove what we do works, but you do" just adds to this divide. It should be something we strive for, across medical and mental health disciplines. We can just assume that what we are doing in medicine works, because it's the way we've always done it. Or, we can actually examine if there are better ways to do it. Better ways to deliver care. Ways that are both safe, efficacious in terms of functional outcomes, and cost effective. Or, we can stay embroiled in pointless turf warfare.
 
I think academic psychiatry is far removed from clinical psychiatry. Just as I think academic (insert field here) is different from clinical (insert field here). It happens across disciplines. And, this rhetoric of "we don't need to prove what we do works, but you do" just adds to this divide. It should be something we strive for, across medical and mental health disciplines. We can just assume that what we are doing in medicine works, because it's the way we've always done it. Or, we can actually examine if there are better ways to do it. Better ways to deliver care. Ways that are both safe, efficacious in terms of functional outcomes, and cost effective. Or, we can stay embroiled in pointless turf warfare.
I'm not against doing research, so you don't have to convince me of that. If you want physicians to prove their efficacy then that is beyond fair. Though from my understanding its already a common topic in psychiatry especially.
Now if you want to question physicians' efficacy/safety in comparison to RxP- then that is also fair but a little silly. One is the pinnacle of its' medical area and evolved over decades to have a precise and comprehensive body of knowledge and very closely regulated training and the other is a relatively short online program with less-regulated physician shadowing as it's main clinical training.

EDIT: But I think the continued "turf war" comments should stop since there is no evidence of it. The only way I could definitively buy that is if RxP approximated the duration and rigor of med shcool/psychiatry residency and they still didn't want you to practice.
 
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Now if you want to question physicians' efficacy/safety in comparison to RxP- then that is also fair but a little silly. One is the pinnacle of its' medical area and evolved over decades to have a precise and comprehensive body of knowledge and very closely regulated training and the other is a relatively short online program with less-regulated physician shadowing as it's main clinical training.

EDIT: But I think the continued "turf war" comments should stop since there is no evidence of it. The only way I could definitively buy that is if RxP approximated the duration and rigor of med shcool/psychiatry residency and they still didn't want you to practice.

This is exactly the problem. This statement has no objective basis, yet it has been stated over and over again in this argument.

As far as the turf war comments. This is a part of most fields of healthcare. Feel free to pretend it doesn't exist all you want, it doesn't change the fact that it's there.
 
This is exactly the problem. This statement has no objective basis, yet it has been stated over and over again in this argument.

As far as the turf war comments. This is a part of most fields of healthcare. Feel free to pretend it doesn't exist all you want, it doesn't change the fact that it's there.
OK, it's the pinnacle in that it has the hardest, longest and most comprehensive training by a significant margin. If you want people to favorably compare RxP to physician training then you're facing an impossible political campaign.
 
http://www.tampabay.com/news/educat...lp-for-him-months-before-the-shooting/2207514
FSU shooter's friends tried to get help for him months before the shooting
Six months into his job as a prosecutor in the Dona Ana County District Attorney's Office in New Mexico, May couldn't concentrate.
The 31-year-old had become so distractible, he told his friends, that he had decided to see a psychologist. He emerged from the appointment with prescriptions for an antidepressant and an attention deficit drug, which he took faithfully until, about three weeks later, he suffered a panic attack at work.
When another attack followed a week later, he returned to his psychologist and had his medication adjusted, said Nixon, a doctor. May was on a combination of Wellbutrin and Vyvanse — drugs that, in rare cases, can cause paranoia.
By late summer, May had begun acting strangely, his friends said. He was worried his neighbors were watching him. He heard them talking about him through the walls of his apartment.
It was alarming to his friends, but it was nothing, they said, compared to what was still to come....
Unsettled now, May's friends contacted his psychologist's office. They said they told her that May was paranoid, that he was hearing voices, and that he had talked about buying a gun and getting even with his neighbors.
The psychologist made an appointment with May, they said, met with him for about an hour and then declared him to be fine. Nixon and the others were frustrated....
 
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So, it's the pinnacle by subjective means? Regardless of whether or not it is necessary or sufficient to meet a certain need (e.g. delivery of psychopharmacological treatment )? I will agree that it is the longest, but that may be where the agreement ends. I can design a program that takes 20 years to complete. Does that make it better? Does that make it the only and best way to have something done?
 
OK, it's the pinnacle in that it has the hardest, longest and most comprehensive training by a significant margin. If you want people to favorably compare RxP to physician training then you're facing an impossible political campaign.

They want to show that it is better than physician training.
In IL, the psychologists were really pissed they couldn't prescribe stimulants. That's what they want to prescribe the most.
 
Grover, so, if I find one case of psychiatrist misconduct, does it make the whole field obsolete?

Also, after reading the story, it's not clear that there was misconduct at all in this case. Without reading the details of the case, it's all speculation. Especially when it comes down to statutes of suicidality/homicidality.
 
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So, it's the pinnacle by subjective means? Regardless of whether or not it is necessary or sufficient to meet a certain need (e.g. delivery of psychopharmacological treatment )? I will agree that it is the longest, but that may be where the agreement ends. I can design a program that takes 20 years to complete. Does that make it better? Does that make it the only and best way to have something done?

You're a neuropsychologist. You may even be board certified.
Would you like anyone dumbing down your education?
 
Grover, so, if I find one case of psychiatrist misconduct, does it make the whole field obsolete?
No, but given the tiny sample size of prescribing psychologists this anecdotal case doesn't bode well. You and others can't declare there are no adverse effects from RxP in NM (as if there was a documented study) and then belittle an example case. Most cases though don't involve high profile actors like the FSU shooter and will thus never come to light by themselves.
 
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Grover, so, if I find one case of psychiatrist misconduct, does it make the whole field obsolete?

Also, after reading the story, it's not clear that there was misconduct at all in this case. Without reading the details of the case, it's all speculation. Especially when it comes down to statutes of suicidality/homicidality.

The Rxp'ers are the ones saying there are no complications with their psychologists prescribing.
You are not using correct logic regarding the psychiatrist misconduct. I never said psychiatrists don't have misconduct.
 
They want to show that it is better than physician training.
In IL, the psychologists were really pissed they couldn't prescribe stimulants. That's what they want to prescribe the most.

RxPers in Illinois and across the country were extremely upset over the IL bill that became law because it makes them get the same training that anyone else would have to get to practice psychiatric medicine. Talk about unfair (excuse the sarcasm).

To add a little more perspective, the IL RxP campaign was looking at certain, massive defeat for the 15th year. So the highly controversial individual leading the campaign, acting alone, accepted the year-old offer of the medical people, who had said that PA-level training would be acceptable since they accept it as the minimal necessary for prescribing medications, along with medical supervision. The training requirements alone make it highly unlikely that any psychologists will prescribe in Illinois as psychologists. Even if an RxP program can be developed (also very unlikely but possible) then the first one would not be writing scripts for about six years, and that's if they apply themselves to full-time education and practicum training.

The law specifically prohibits the prescription of benzodiazepines and a list of other drugs. It also limits the patients to be treated by the RxPers to persons 17-65 years old who are not pregnant or have a major medical illness or developmental disorder. So the IL law may become the perfect barrier to RxP, forcing people to actually get a medical education rather than be the 8.8-class internet prescribing wonders they hope to be.
 
You're a neuropsychologist. You may even be board certified.
Would you like anyone dumbing down your education?
If someone showed that they could adequately do the job with less training, thereby making it more efficient. I would have no argument.

No, but given the tiny sample size of prescribing psychologists this anecdotal case doesn't bode well. You and others can't declare there are no adverse effects from RxP in NM (as if there was a documented study) and then belittle an example case. Most cases though don't involve high profile actors like the FSU shooter and will thus never come to light by themselves.

First, this seems to be more of a Tarasoff deal rather than mis-management of meds. Additionally, which provider is at fault is difficult to tell from the story. It seems multiple ones are involved, and who knows what information was made available to each. I do not belittle a sample case, I just caution against drawing wild conclusions from it with a dearth of details involved.

The Rxp'ers are the ones saying there are no complications with their psychologists prescribing.
You are not using correct logic regarding the psychiatrist misconduct. I never said psychiatrists don't have misconduct.

And you are not using correct logic here in making fairly significant circumstantial leaps based on little evidence. Perhaps some negligence happened here, but there is far too little information to make the conclusions that you are making.
 
If someone showed that they could adequately do the job with less training, thereby making it more efficient. I would have no argument.

Hmm, now wait a minute. Isn't that what we've been saying about RxP? Do I sense a double standard here when it is your area that may be under threat by under-trained wannabes?

I wonder if you would be thus agree that if weekend-wonder neuropsychologists, getting their education through an internet lecture or by taking a couple of seminars, have not been sued or hit with ethics complaints, that would be acceptable evidence that their training is sufficient to do the work of a board-certified neuropsychologist.
 
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Hmm, now wait a minute. Isn't that what we've been saying about RxP? Do I sense a double standard here when it is your area that may be under threat by under-trained wannabes?

I wonder if you would be thus agree that if weekend-wonder neuropsychologists, getting their education through an internet lecture or by taking a couple of seminars, have not been sued or hit with ethics complaints, that would be acceptable evidence that their training is sufficient to do the work of a board-certified neuropsychologist.

Well, we have a lot of outcome data to show. So, no, no double standard. I am not claiming that neuropsychologists are exempt from showing that we contribute to certain things (e.g., diagnosis, prognosis, etc). That data exists. Your claim has no standing here.

Also, the weekend warriors already exist, and we already deal with mid-level providers (SLP, OT) using npsych instruments. There is a reason they are not getting our referrals though, poor quality of reports when they use those things, because they do not know how to interpret them.
 
Well, we have a lot of outcome data to show. So, no, no double standard. I am not claiming that neuropsychologists are exempt from showing that we contribute to certain things (e.g., diagnosis, prognosis, etc). That data exists. Your claim has no standing here.

Also, the weekend warriors already exist, and we already deal with mid-level providers (SLP, OT) using npsych instruments. There is a reason they are not getting our referrals though, poor quality of reports when they use those things, because they do not know how to interpret them.

So the operational definition of certain neuropsychologists practicing ethically, safely and effectively is that they person have not been sued or had a complained filed against them, regardless of how little training they've had?
 
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So the operational definition of certain neuropsychologists practicing ethically, safely and effectively is that they person have not been sued or had a complained filed against them, regardless of how little training they've had?

Once again, mis-characterization of statements to try to prove a point. I have offered that up as one point of evidence, I have even said it is not great evidence and more was needed. I then said that current prescribers should be beholden to the same level of evidence that they are demanding, otherwise they are setting up a bar that they themselves have not yet reached.
 
Once again, mis-characterization of statements to try to prove a point. I have offered that up as one point of evidence, I have even said it is not great evidence and more was needed. I then said that current prescribers should be beholden to the same level of evidence that they are demanding, otherwise they are setting up a bar that they themselves have not yet reached.

Translation: You won't answer the question. And I don't blame you. The standards that RxPers want to be judged by are those they would never allow others to use.

I also don't blame the RxPers who never respond to the analogy of social workers doing the work of psychologist (or better still, neuropsychologists) based on training that almost all of us would consider insultingly insufficient. I imagine many shiver at the thought of SWers calling themselves "Psychological Social Workers" (as opposed to "Medical Psychologists") and practicing all forms of psychology independently under their SW licenses, supervised and licensed by the SW board, educated by SW schools, etc.
 
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...social workers doing the work of psychologist (or better still, neuropsychologists) based on training that almost all of us would consider insultingly insufficient.
...at least we can all unite in our equal disdain for those offensively undereducated social workers! lol
 
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Translation: You won't answer the question. And I don't blame you. The standards that RxPers want to be judged by are those they would never allow others to use.

I also don't blame the RxPers who never respond to the analogy of social workers doing the work of psychologist (or better still, neuropsychologists) based on training that almost all of us would consider insultingly insufficient. I imagine many shiver at the thought of SWers calling themselves "Psychological Social Workers" (as opposed to "Medical Psychologists") and practicing all forms of psychology independently under their SW licenses, supervised and licensed by the SW board, educated by SW schools, etc.
And that my friends is a great example of how to protect your turf. No holds barred, take no prisoners, always attack. MDs are way better at this than us. We play too nicely with others. Of course, collaboration with other professionals is part of our skill set so we don't throw the other people in our field under the bus. That includes all the MDs who prescribe opiates and benzos without any awareness of how dangerous these drugs are to our patients. How many physicianss even know that opiates increase risk for falls in the elderly? Why don't physicians seem to know the difference between dementia and delirium? Why do the LCPCs dig up traumatic experiences in my young patients during "lunch group" at school and then send them back to class in a high state of emotional arousal? The more I think about it the more I think psychologists are the premier profession in mental health and if we spent less time eating our own and more time protecting our turf then our patients lives would be a whole lot better.
 
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...at least we can all unite in our equal disdain for those offensively undereducated social workers! lol

As a side note, LCSWs have approximately the same amount of clock hours/training (hours in a graduate program) in their respective fields as NPs do. Basically the same as any mid-level mental health provider, not just to use the example of the horrible social workers.

I am not for mental health mid-levels prescribing. I hope others don't misconstrue my point.

Just like to point out again: online direct entry NP programs exist and result in nurses being able to prescribe within their scope. Yet some of you are referring back to them as a "medical model."
 
First, this seems to be more of a Tarasoff deal rather than mis-management of meds. Additionally, which provider is at fault is difficult to tell from the story. It seems multiple ones are involved, and who knows what information was made available to each. I do not belittle a sample case, I just caution against drawing wild conclusions from it with a dearth of details involved.



And you are not using correct logic here in making fairly significant circumstantial leaps based on little evidence. Perhaps some negligence happened here, but there is far too little information to make the conclusions that you are making.

So if there was negligence, is that a considered negative? Or no?
And if the article is true, a psychiatrist was left cleaning up the mess in the inpatient hospitalization.
And once again, the same people who argue about physicians and opioids are the first ones to prescribe stims as if they are candy.
 
If there was negligence, yes, it is a negative. But this is a far more complicated case than you would have people believe. Ask any SMI provider what it takes to have someone involuntarily committed.

Second, do you have any data to back up your gross generalization of one case to an entire field? I'd have to do a power analysis, but a n=1 usually has trouble finding an effect.
 
If there was negligence, yes, it is a negative. But this is a far more complicated case than you would have people believe. Ask any SMI provider what it takes to have someone involuntarily committed.

Second, do you have any data to back up your gross generalization of one case to an entire field? I'd have to do a power analysis, but a n=1 usually has trouble finding an effect.

Psychologists say there are NO problems or complications with them prescribing. So ONE is all that is needed to refute it.
And the psychologist in the case did not find a need to involuntarily commit the patient, per the article.
Can stimulants cause mania or psychosis? Do you know?
 
So after the Dod report in Hawaii, why wasn't Hawaii passing the bill to let psychologists prescribe?

Lobbying money, political pressure, any number of extraneous factors?

Psychologists say there are NO problems or complications with them prescribing. So ONE is all that is needed to refute it.
And the psychologist in the case did not find a need to involuntarily commit the patient, per the article.
Can stimulants cause mania or psychosis? Do you know?

You are assuming the problem was with med management. Has that been irrefutably proven in this case? And, I imagine that the psychologist had no legal standing to involuntarily commit this person. I imagine you have no real idea on how hard it is to involuntarily commit, especially when you are dealing with hearsay. You should look up some state laws sometimes, it's actually pretty interesting. Yes, stimulants have been proposed to cause psychosis. Do you know the base rates on that? And, does that mean that they should never be prescribed?
 
Lobbying money, political pressure, any number of extraneous factors?



You are assuming the problem was with med management. Has that been irrefutably proven in this case? And, I imagine that the psychologist had no legal standing to involuntarily commit this person. I imagine you have no real idea on how hard it is to involuntarily commit, especially when you are dealing with hearsay. You should look up some state laws sometimes, it's actually pretty interesting. Yes, stimulants have been proposed to cause psychosis. Do you know the base rates on that? And, does that mean that they should never be prescribed?

According to the article, he thought the patient was fine. Why are you harping on the involuntarily committing point?
And when it comes to lobbying money, the Rxpers have a great deal. Look at Illinois and how much they spent there.
 
What does "fine" mean? That is the writer's interpretation, I am more curious as to what was in the actual patient notes than hearsay twice removed. I am harping on involuntary commitment here because it appears to be the central issue once you consider the facts presented. It's something I've dealt with several times in different states, so I am somewhat familiar with the laws and statutes.

And, I never claimed that the lobbying was one-sided.
 
So after the Dod report in Hawaii, why wasn't Hawaii passing the bill to let psychologists prescribe?

Political motives/forces…just like EVERY OTHER piece of legislation that needs to pass through the system. Trying to tag the RxP bill as an outlier is disingenuous. Horsetrading is required for even the tiniest bit of legislation to get through, so political capital is needed. Whether or not the sponsor/co-sponsor wants/has this to trade…that is why most legislation passes/fails.

The legislative process is where sausage is made….the process is messy and what goes in is often quite different than what comes out; welcome to our political system.
 
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Political motives/forces…just like EVERY OTHER piece of legislation that needs to pass through the system. Trying to tag the RxP bill as an outlier is disingenuous. Horsetrading is required for even the tiniest bit of legislation to get through, so political capital is needed. Whether or not the sponsor/co-sponsor wants/has this to trade…that is why most legislation passes/fails.

The legislative process is where sausage is made….the process is messy and what goes in is often quite different than what comes out; welcome to our political system.

The psychologists have plenty of money to spend on this. And they have.
 
The psychologists have plenty of money to spend on this. And they have.

I honestly haven't looked at/don't know how much they've spent, particularly in the states where legislation as failed, but I can say that as a whole, psychology generally has a pretty crappy track record of funding political efforts on behalf of our profession. It seems to be getting better, though, so maybe I'm wrong re: RxP specifically. And I do know APA has sunk a considerable amount of resources into this over the years, yes.
 
The psychologists have plenty of money to spend on this. And they have.

Really? I am thinking the AMA might have a bit deeper pockets than us. maybe we should make a deal with the devil, I mean pharmaceutical companies, to sponsor our organization and we might get a bit more political traction on this.

2014 Lobbying $'s spent:
AMA: $19,650,000
APA: $1,298,600

That is a 15:1 spending difference in lobbying.

SOURCE: https://www.opensecrets.org/industries/lobbying.php?cycle=2014&ind=H01
 
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2014 Lobbying $'s spent:
AMA: $19,650,000
APA: $1,298,600

That is a 15:1 spending difference in lobbying.

SOURCE: https://www.opensecrets.org/industries/lobbying.php?cycle=2014&ind=H01
The AMA continuously advocates for issues that they feel is in the public's best interest vs. physician's personal interest. For example, they were wholehearted supporters of Obamacare from the beginning. Likewise, I don't think Big Pharma would mind having lower-trained practicioners be their middle-men! So please- stop with the persecution complex/turf war paranoia. APA is by far the biggest source of money and lobbying effort on the RxP issue.
 
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In fact it seems that RxPers care more about the politics then what your proposals will actually have you doing. It's rare when I actually hear a prospective RxPer discussing, honestly, the possible disastrous implications of practicing medicine without proper training.

We can't predict what can go wrong- that's why proper medical training relies on having enough training time and rigor to see as many possibilties as possible. I mean what can I say? Make sure your online class somehow teaches you to catch the induced thrombocytopenia from your psych drug treatment or teaches you enough medicine to put aside (a very large RxP ego) and suggest a proper physician consult before dismissing someone complaining of seemingly-psych related dizzyness. Because once they go to their "medical psychologist" they will take your word for it and proper diagnosis can be delayed to disastrous effects and nobody will ever hear of it.
 
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The AMA continuously advocates for issues that they feel is in the public's best interest vs. physician's personal interest. For example, they were wholehearted supporters of Obamacare from the beginning. Likewise, I don't think Big Pharma would mind having lower-trained practicioners be their middle-men! So please- stop with the persecution complex/turf war paranoia. APA is by far the biggest source of money and lobbying effort on the RxP issue.

There are many times as many physicians as psychologists, so the ratio cited is somewhat misleading. I'm looking at figures that there are 168,000 physicians in just the primary care specializations alone. APA benefits heavily from the lobbying of AMA, on topics such as Medicare reimbursement (although if you read the APAPO propaganda, you might think APA did all by themselves).

APA created the APAPO specifically to act as its lobbying arm, with an annual budget of $5 million, so the cited figures are also not accurate. Add the APA lobbying, then you have about $6.2 million, which is likely far greater per capita than what AMA spends.

Edit: OK, Dr. Google says there are about 10 times as many physicians as practicing psychologists in the United states, so actually APA spends about three times as much as AMA per capita.

APAPO's fundraising method of lying to the membership of APA, to make them think that donating to APAPO was required for membership has been unmasked as a scam and APA has agreed to a class-action lawsuit settlement in the matter.

APA has spent more than $3 million just on grants to state associations alone for RxP lobbying. It's spent a lot more in other ways. In Illinois, the RxP campaign spent hundreds of thousands of dollars, and hired a platoon of 8 lobbyists to push their failed RxP bill. You can be sure that the psychiatric or medical societies didn't have those resources. So let's not shed too many tears for those poor underdogs, they have all that APA/APAPO money to play with. But you won't read about that in the American Psychologist.

I'd say this IS a turf war. APA is trying to steal the business of another profession without having to actually do the work it takes to practice it properly. The purpose is to make more money and have more political power, even though it very likely puts people at risks and it helps keep our profession from exploring far better alternatives.
 
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Really? I am thinking the AMA might have a bit deeper pockets than us. maybe we should make a deal with the devil, I mean pharmaceutical companies, to sponsor our organization and we might get a bit more political traction on this.
lol I'm sure your RxP cronies, I mean colleagues, have already been doing that. An RxPer that cares about public health over his pocketbook is about as realistic as the tooth fairy.:meh:
 
APA created the APAPO specifically to act as its lobbying arm, with an annual budget of $5 million, so the cited figures are also not accurate. Add the APA lobbying, then you have about $6.2 million, which is likely far greater per capita than what AMA spends.

They were required to create a separate PAC, just like every other non-profit organization who wants to lobby because it is illegal to be a non-profit and directly lobby; the gov't would revoke non-profit status of any organization that doesn't distinctly separate those activities. Yes there are ways to "lobby" without meeting the current definition, and the AMA does an excellent job of toeing that line and maximizing the benefits.

As for the rest of it, your math doesn't make sense, someone's "annual budget" does not equal the $ spent lobbying, so please stop distorting the information. The data I cited is non-partisan and references actual $'s spent…not budgets. :rolleyes:
 
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They were required to create a separate PAC, just like every other non-profit organization who wants to lobby because it is illegal to be a non-profit and directly lobby; the gov't would revoke non-profit status of any organization that doesn't distinctly separate those activities. Yes there are ways to "lobby" without meeting the current definition, and the AMA does an excellent job of toeing that line and maximizing the benefits.

As for the rest of it, your math doesn't make sense, someone's "annual budget" does not equal the $ spent lobbying, so please stop distorting the information. The data I cited is non-partisan and references actual $'s spent…not budgets. :rolleyes:

Ah, yes, but you cited APA, not APAPO. The APAPO's only function is political advocacy. It was indeed created because APA wanted to spend more than $1 million a year on advocacy, and a big reason for that was RxP. It was started when RxP godfather Pat DeLeon was APA president ... and in his administration the massive deception of APA members began, eventually leading to a major scandal that cost APA about 7 percent of its membership ... you can write Pat and thank him some time. The RxP campaign also was cited in Risen's book as one of the reasons that APA got involved in the torture scandal, bringing more shame and controversy to the organization. RxP is the gift that just keeps on giving, eh?
 
lol I'm sure your RxP cronies, I mean colleagues, have already been doing that. An RxPer that cares about public health over his pocketbook is about as realistic as the tooth fairy.:meh:

LOL, it's all about money and power, and then sometimes power and money.

Or does anyone think that millions are being spent just because they want to see people get more medications, but not through any alternatives that are safer, non-controversial, and easily implemented. Nope, they want to do this the worst way, the hardest way, the most controversial way, the least effective way, and the most expensive way because they care so much about getting people more psychoactive medications.
 
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