Governor, please veto SB 1046. Practicing medicine should require medical training.

By Tanya Tompkins of McMinnville, Oregon. Tanya is an associate professor of psychology at Linfield College.

A controversial bill that allows “specially trained” psychologists the right to prescribe medication passed the Oregon Senate and House this past special legislative session. SB 1046 (pdf) still awaits a signature or veto from the Governor.

Several recent items in the Oregonian present both sides of this complex issue:

• Drugs and Oregon: Lawmakers write an Rx for trouble- by Susan Nielsen

• Controversial bill authorizing psychologist prescriptions awaits governor's signature

• Prescribing psychologists: Helping fill a need for the mentally ill - by Laurie Monnes Anderson, Dave Nelson, Tina Kotek and Bill Kennemer

• Governor, don't sign the psychologist prescription bill - by Tanya Tompkins and Alan Bates

Much of the pressure to enact this legislation comes from individuals and organizations that stand to profit from its passage because they train, supervise and certify prescribers. As described in the Lund Report, Senator Alan Bates rightfully raised concerns that Morgan Sammons, of the California School of Professional Psychology (CSPP), had been temporarily licensed in Oregon just prior to joining the workgroup. Sammons participated, despite the fact that he runs a distance-learning program to prepare psychologists to prescribe medication. Should this legislation pass, CSPP stands to reap financial benefits from Oregon psychologists seeking an abbreviated pathway to prescribe. Arguably, Sammons’ participation in the workgroup is a conflict of breaching legal and ethical codes. While he could have served as an expert consultant regarding training programs he should not have held a voting position on the 7-member work group.

But concerns with this bill extend beyond the shady process. Simply put, inadequate training puts patients at risk. Psychologists lack training in the scientific foundations of medical practice. Ninety-three percent have not completed the undergraduate prerequisites — such as biology, organic chemistry or physiology — that physicians and nurses complete. They have no comparable graduate training that gives them an understanding of the effects of medication on the human body. Psychologists are not trained in physical diagnosis, making it difficult for them to identify side effects and drug interactions.

Existing innovative programs currently provide psychiatric care to rural communities, and the less risky alternative is to develop programs that improve mental health training for health professionals who already prescribe psychotropic medications as part of overall patient care. There is little reason to suspect that the law would significantly expand mental health care services to Oregonians. Rather, it might detract from access to psychotherapy, shown to be as effective as drugs for treatment of common mental health problems. Psychotherapy has also been shown to be more effective at reducing relapse.

Economic interests, rather than good science or the public good, appear to be the driving force behind this bill.

Unless the Governor vetoes this bill, mental health consumers will serve as unwitting participants in a risky experiment. Creating a new class of lesser-trained prescribers of medications is simply dangerous. Unlike a legitimate experiment, the legislature has no plans to monitor the safety and efficacy of this radical change.

Please urge the Governor to “Just say no!” to this controversial proposal. Oregonians deserve safer health care.

March 21, 2010 Posted in guest column.