Oregon bill would let psychologists prescribe

CORRECTION: This article incorrectly reported that Oregon Gov. Ted Kulongoski had not yet decided whether to sign the bill allowing psychologists to prescribe. The governor vetoed the legislation April 8, after this article was written but before it was posted. American Medical News regrets the error.

Organized medicine is asking Oregon Gov. Ted Kulongoski to veto a bill that would permit psychologists to prescribe a wide range of psychotropic drugs.

The measure, passed by the House in March after Senate approval, would authorize the Oregon Medical Board to grant prescriptive authority to qualified psychologists who complete certain educational and training requirements. The medical board and Board of Psychologist Examiners also would set rules for collaboration between the prescribing psychologist and the health care professional overseeing the patients' medical care, such as ensuring necessary medical examinations.

Bill sponsors contend that the legislation would help provide access to a broader range of mental health services.

But physicians are concerned that the measure could put patients at risk. They said it would allow psychologists to practice beyond their expertise and without adequate supervision by a psychiatrist or other physician qualified to address medical complications associated with such dangerous drugs.

"Psychologists' education simply does not address the complex interactions between drugs and underlying medical conditions," American Medical Association Executive Vice President and CEO Michael D. Maves, MD, MBA, wrote in a March 18 letter to Kulongoski. Every health care professional plays an important role in patient care and "patient safety demands that the professional prescribing these medications has training and education equal to the task," he said.

The Oregon Medical Assn. raised similar safety issues in a separate letter urging the governor to veto the bill.

Physicians also expressed concern that the measure would allow prescribing psychologists to treat children, who require vastly different considerations.

Debra McHugh, executive director of the Board of Psychologist Examiners, said the measure does include rigorous education and training requirements.

Prescribing authority "would not fall within the scope of practice of every psychologist but only those who are specially trained" and have completed related postdoctorate master's and residency training in psychopharmacology, she added. "Policy-wise, this would help provide more prescribers who have specialized training in mental health."

The governor has until April 8 to approve the measure but has not indicated whether he will sign it.