Psychologists see rural areas as entry point to prescribing

But psychiatrists believe primary care physicians are the ones to fill the void, as shown in the controversies in New Mexico and Nebraska.

By Andis Robeznieks, AMNews staff. Dec. 2, 2002.

With less than a dozen psychiatrists to serve the rural communities in the western part of the state, officials with both the Nebraska Medical Assn. and Nebraska Psychiatric Society acknowledge that the state is in the midst of a mental health crisis -- in both rural and urban areas.

But they don't think that allowing psychologists to have prescribing authority is the way to solve the problem. Members of a subcommittee of the state's Rural Health Advisory Commission have tossed the idea around in brainstorming sessions.

In a recent letter to commission member Todd Stuckey, MD, the presidents of the Nebraska Medical Assn. and Nebraska Psychiatric Society, Michelle B. Petersen, MD, and Janet McGivern, MD, argued that there are better ways to achieve the laudable goals of improving mental health care for the state's rural citizens.

"What the commission decides to do is up to them, but we strongly hope they would move in the direction of changing the psychiatric treatment paradigm," said Dr. McGivern, who has a private psychiatry practice in Omaha.

"Rather than being the sole providers of psychiatric care," she said, she envisions psychiatrists becoming consultants and evaluators working in collaboration with primary care physicians.

So far, only one state allows psychologists prescribing rights -- New Mexico. The issue has been brewing in several other states, and those on both sides of the issue are watching the Nebraska debate closely. Both sides hope to learn what will and will not work for them, as the battle there replicates across the country, especially in other states with significant rural populations. [...]