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Prescriptions: Psychologists vs. Psychiatrists

February 11, 1998
By: Amy Gaul
MDN Columbia Bureau

Psychologist Tom Lantsberger's hands are tied when he thinks one of his patients would benefit from prescription medicine.. You see, he is a PhD not an M.D., which means, by law, he is not allowed to prescribe medication to his patients. Instead Lantsberger has to send his patient to a psychiatrist.

"I find it frustrating," Lantsberger says, "unless I have a close relationship with the psychiatrist it can be very problematic to have two care providers. It's an issue of too many cooks in the kitchen."

The St. Louis psychologist says that 75 percent of his patients are on some sort of medication. But a proposal in the Missouri General Assembly would give psychologists the right to prescribe after certain requirements are met. These requirements include roughly three-hundred hours of pharmaceutical training and patient rounds with licensed physicians. Missouri would be the first state in the nation to do it. Only Hawaii and California have similar bills introduced and both blocked legislation in years past. This is the third try for this bill in Missouri.

Lantsberger is co-chair of a task force for the Missouri Psychological Association. This group is working on the issue of prescribing privileges for psychologists. It supports the bill proposed by State Senator Jerry Howard of Dexter, Missouri. Howard argues this bill is long overdue.

"It will cut down on duplicate costs to the patient, and will keep the patient from having to go to two sources for treatment."

The only psychologists who can now administer drugs are those involved in the U.S. Department of Defense Psychopharmacology Demonstration Project. This operation involved training half a dozen psychologists to prescribe drugs for the military. The government recently eliminated the project's $6.1million dollar budget, however, it is under review for future funding.

Lantsberger says, "Prescribing is a useful tool that can be used to treat our patients more effectively. We just want the choice."

Tom Anderson says absolutely not. The Columbia psychiatrist claims that giving psychologists the right to prescribe could be very risky.

"They can't learn in that short of time the effects of medicine on the human body. It is not good medicine and it is dangerous."

Anderson, who has a medical degree, has testified before the Missouri legislature for the last three years about this very issue. He says more training is needed before anyone is allowed the responsibility of prescribing drugs.

Anderson says, "Patients would have unqualified people prescribing medication that could have negative effects on the brain."

Anderson says the difference between non-physicians and psychologists is the amount of training involved. Training, he says, that goes way beyond three hundred hours. In fact, medical doctors have trained in excess of 15-thousand hours.

Well, the citizens of Missouri might have to wait a long time before getting an answer to their question. State lawmakers are still discussing the bill in the Aging, Families and Mental Health committee.