greenlion said: I don't blame med students who shun psychiatry - this week "prescribing psychologists" (some of them actually call themselves "medical psychologists") got the thumbs up in Illinois to prescribe (with heavy restrictions though). Now it's LA, NM and IL. That's the first step. Second step is they'll erroneously claim their performance is equal to BC psychiatrists. Last step? What the CRNAs now do to Anesthesiologists- demand equal scope of practice. Why go through medical hoops if your online PhD in Psychology and some crappy part-time medical training makes you equal under the law? I wouldn't be surprised if psychiatry eventually goes down to 150k again after they plug the demand.



So factor in mid-levels. For example Derm got too greedy- they restrained supply too much and I'm positive Derm NPs will be big within 10 years. Ditto Pain-

states with independent NPs have plenty of shoddy pain clinics where they'll hire a schmuck Anesthesiologist looking for a 2nd job part-time to read charts for a 2-3 hours a week while they do their dangerous quackery. Click to expand...

They’ll only be permitted to prescribe a limited class of drugs and will be prohibited from writing prescriptions for minors, seniors or any patient with a serious mental condition.



“We have to make sure people across Illinois can be properly cared for by a medical professional they know and trust,” Quinn said in a statement. “If someone needs help and lives on a budget, they shouldn’t have to make multiple appointments or travel far and wide to get a prescription.”



Illinois joins New Mexico and Louisiana in granting the right to prescribe to psychologists.



Under the new law, psychologists could earn prescription rights after they have completed 2-1/2 years of additional, postdoctoral training, with course work requirements including graduate-level instruction in numerous areas such as neuroscience and psychopharmacology. In addition, training would require that psychologists treat a minimum of 100 patients under the supervision of a qualified medical practitioner, according to the legislation. Psychologists would be able to prescribe antidepressants, such as Prozac, but not stimulants, such as Ritalin, commonly used for attention deficit disorder. http://www.chicagotribune.com/news/...ist-prescription-bill-20140624,0,953771.story A compromise was reached this spring, and the resulting measure requires psychologists to undergo extensive training and work under the supervision of a physician.“We have to make sure people across Illinois can be properly cared for by a medical professional they know and trust,” Quinn said in a statement. “If someone needs help and lives on a budget, they shouldn’t have to make multiple appointments or travel far and wide to get a prescription.”Illinois joins New Mexico and Louisiana in granting the right to prescribe to psychologists.Under the new law, psychologists could earn prescription rights after they have completed 2-1/2 years of additional, postdoctoral training, with course work requirements including graduate-level instruction in numerous areas such as neuroscience and psychopharmacology. In addition, training would require that psychologists treat a minimum of 100 patients under the supervision of a qualified medical practitioner, according to the legislation. Click to expand...

I would venture to say that the overwhelming (OVERWHELMING) majority of med students that shun psychiatry do so for reasons other than psychologist prescribing rights.I agree with you that the increase in prescribing rights of nonphysicians is less than ideal for actual physicians.That said, in regards to this recent Illinois bill, it looks like there are pretty tight reins on patient population (no one aged under 18, no one aged 65+, no one with a "serious mental condition") and also constraints on the meds which can be utilitzed. As always, things can quickly change from this point.Encroachment is starting to take place at the specialty-level for many different areas of medicine (Psych, Gas, FM, Ophtho, EM, IM, Derm). Other specialties are more insulated against encroachment from midlevels (surgical specialties, RadOnc, Rads, Neuro, Path) -- but have their own problems ranging from hellish lifestyle, to poor job market, to high risk of low satisfaction.The current solution for many of the specialties in the earlier group would be to pick a subspecialty and further differentiate yourself from the midlevels trying to claim equal SOP. For example, Ophtho can do VR surgery, IM can do Heme/Onc, Psych can do CA, etc. The solution for the specialties in the latter grouping is less clear cut.In regards to salaries dropping to 150k... the risk likely largely revolves around your model of employment. If a employer can fill your shoes with a cheaper alternative, of course it will be done. That is just good business. If you are self-employed, with a reliable patient load that you harvested over time and a strong name/reputation in your community...not so sure income will plummet -- especially if you are aligned with cash payment.There will undoubtedly be entrepreneurial psychiatrists that have a net increase in income from the bill by finding a psychologist that can be employed to do bread and butter prescribing for the practice. Granted, when it comes to the kind of psychologist that would go through the extra training and supervision, I bet they would likely prefer hanging their own shingle rather than work for a psychiatrist's practice -- but there will always be exceptions and employees to be found if the net is cast wide enough.