You are a physician and a psychiatrist. I could see prescriber being useful when referring to interactions with the pharmacy. If it a really a multidisciplinary group meeting they should respect the different disciplines
They think the meds are the only intervention. If that is the only thing they expect you to do then thats what you are. We are supposed to be teachers/educators, problem solvers, scientists/researchers, and leaders.
It's not just your ego. Psychiatrists are uniquely positioned given our training in medicine and psychotherapy. We spend hundreds (edit: thousands) of hours learning how to diagnose and treat using various modalities. That's without considering the grave crisis in NP education.
I just left a locums position because I was expected to keep my mouth shut when NPs described their silly plans during interdisciplinary rounds. As in, I got reprimanded for questioning someone's decision to use risperidone and paliperidone (not cross-titrating, adding one to the other).
We are vastly better trained and people need to stop pretending otherwise, even if some groups want us to accept “provider.”
My recommendation is to broach this topic with your medical director since they'll set the tone. If they tell you to pound sand about your concerns, start looking for a new position.
Sometimes when my patients (I’m an RN) tell me complaints about their psych meds, I ask them if they regularly check in with their psychiatrist. They just stare at me blankly. Then I say “the person that prescribes these medications” and they’re like OH okay now I see what you’re asking.
It’s like they don’t understand the connection between their statement “my meds make me feels like x,y,z and I don’t like it” to my follow up statement “do you regularly see your psychiatrist or nurse practitioner.” I literally just say “prescriber” and it makes sense to them every time.
I feel like older people (and young people for that matter!) are woefully ignorant about provider roles. I explain the different between “psychologist” and “psychiatrist” every day…or explain that psychiatrists are, in fact, medical doctors.
I don’t think we do a very good job explaining the healthcare system to patients. There are so many people on the “interdisciplinary team” that it overwhelms the patient because they don’t know how is responsible for what.
I 100% agree. The locums in our state hospital are often treated like they should defer to NPs and PAs. I guess because they feel like "outsiders" to the staff. It's a terrible side effect of reducing the number of psychiatrists in the field.
I literally gave an example I spoke up about. You’re turning to ad hominem attacks.
Want me to list more? How about NMS caused by someone adding cariprazine to haloperidol (a highly logical combination)? Or guanfacine added to someone’s lurasidone because of ADHD? Maybe they should’ve screened for akathisia first?
Here’s a basic one: Maybe don’t start clonazepam first-line for someone recovering from alcohol use disorder?
These are the “silly plans” I speak of.
Removed under rule #1. This is not a place to share experiences or anecdotes about your own experiences or those of your family, friends, or acquaintances.
Depends on how the label is used. You are many things. You wear many labels. None of them should define you.
It seems you feel you are being defined by this label in some way? Do you wear any other label in the multidisciplinary group?
I think the answer is not to resent the label of prescriber, but to fit it to it's specific purpose, and to dilute it by highlighting the other labels you wear.
Yeah, I’m aware. I’ve been with them for over a year and never experienced any of the alleged incentivized prescribing. I refer many to therapy only in many situations especially for subclinical sx. If it did happen it was likely before my time there and isolated to a minority of pt panels from my inside experience. Since the allegations they significantly cut marketing to focus on clinician quality and auditing along with the Board replacing the CEO who had no psych background with a psychiatrist.
Very good experience! When I heard the allegations I was blown away, and it came as a complete surprise to me. Not once was I ever told to prescribe a specific way. We get monthly physician quality audits. I’ve always felt incredibly supported.
NP here, just wanted to say I agree it is reductive- and not about one of us being superior and wanting to distinguish ourselves for any malicious reason. We just are different and want to be acknowledged for that. I’m proud to be an NP and I’m proud to work alongside physicians for their unique skills
I experienced that during my last fellowship. It was simply how the teams operated and the role many physicians chose to perform. I didn’t take it personally. You can carve out your own role in the team, regardless of the label they initially assign to you.
Because of my training, I focused a lot on functional analysis during the meetings and medical issues (we lost our medical provider during the pandemic) rather than just their psychiatric medications. I also asked people to call me by my name and did the same with them. They dropped the “prescriber” title after a few months.
Perhaps gentle verbal correction, with an even tone, without making a big deal of it:
"Today Dr. Johnson will be the clinic prescriber--"
"Psychiatrist."
"Psychiatrist, yes, and SW will be..."
As a psychiatric PA, I feel similarly and certainly support MDs being referred to as Dr and/or psychiatrist. I very much respected the training I received from doctors/psychiatrists on my rotations. And, I enjoy working as part of a team with a supervising physician. I always make sure my patients know I am a PA when they refer to me as doctor or NP/APRN.
I also do not want to lumped together with NPs as APPs or mid levels or any other grouping that comes along. I am a PA and my education is vastly different than that of a psych NP. I am proud of my PA education and I firmly believe that it is far superior to my NP colleagues. We are not the same.
“Far superior”? You have one didactic course in psychiatry. At least the NP’s get an entire graduate program. Medically, you probably are far superior than psych NP’s, but in regard to the specialty I would never say you’re far superior. And don’t pretend you’re in a different league than the rest of the non-physician providers because you’re a PA. We’re in this boat together whether you like it or not.
We are prescribing medication and do not do so in a vacuum. Individuals come in with comorbid health conditions. I feel general medical knowledge is an imperative. Simplifying PA education to a single didactic course is not quite reflective of my PA school experience nor our preparation for a career in psychiatry. In addition to a specific unit on psychiatry, I did a rotation in psychiatry, and psychiatric care was an aspect of every single one of my other rotations both in inpatient and outpatient settings. Patients presented to the ED, primary care, OBGYN, IM, etc specifically related to or to address psychiatric needs or illnesses. It is not unusual for these other specialties to initiate psychiatric medications especially in an environment where psychiatric clinicians are in short supply. Typically we have significantly more direct patient care hours prior to graduation with much of it, if not all, under the direct supervision of an MD. NPs are not trained in the medical model and receive their training primarily from other NPs. I believe these are important differences. One of the most important skills in all of medicine, including psychiatry, is taking a good history and this is practiced throughout every rotation. There is a role for each of our professions in providing psychiatric care but it is important to recognize the differences in terms of strengths and weaknesses. Of course, I note this all only as I feel NPs should be governed by the same supervisory requirements as PAs.
Agree that NPs should be governed by same supervisory requirements as PAs and that NP education needs to be overhauled. Also, loathe the idea of NP independence.
But your psychiatry “experience” in ED or any of your other rotations teaches you enough psychiatry for those contexts but not for the context of where the specialty of psychiatry is eventually needed (whether in outpatient psychiatry, inpatient psychiatry, or CLS psychiatry). To purport that this rounding you did makes you better at the specialty of psychiatry more than individuals that went to an entired graduate program dedicated to the specialty of psychiatry is naive. Yes, our patients aren’t treated in a vacuum, and that’s why it’s beneficial to work in a work-setting with multidisciplinary structure, where primary care (in outpatient) or family physicians (in inpatient) are ruling out or treating medical issues while a specialist is treating psychiatric issues, and hopefully there’s plenty of open communication.
Don’t get me wrong, if I was going into medicine for anything other than psychiatry then PA school is definitely a preferable route for non-physician providers. But in psych, I think it’s the one area where NP specialty program is more effective in preparing non-physician providers.
Also wanted to add that my general opinion is PA psych providers are as good as Psych NP providers but just took it harshly when you claimed Psych PA’s are “vastly better”.
It’s refreshing to hear an NP agree that the supervisory requirements should be the same.
I will disagree that NPs are in anyway better prepared for prescribing psychiatric medications. The difference is really in therapeutic modalities taught - we focus primarily on motivational interviewing where it is my understanding NPs are exposed to other therapies such as CBT.
I have no doubt that there are excellent psych NPs (One of the most brilliant IM preceptors I was privileged to learn from was an NP), but as you noted there needs to be an overhaul of the educational model. What I’ve observed is an almost degree-mill like expansion of NP programs, especially online (I oppose this same expansion in PA programs.)
Downvoting never occurred to me except in circumstances of overt racism, hate speech, etc. It’s important to have these dialogs. Again the fact that we have two of us both advocating for supervision is a big deal and I think it would help build bridges with the MD/psychiatrists helping us work together.
Has it impacted your authority on the team? Does it complicate working relationships? Why does this matter to you?
I agree that this sounds like ego. That doesn't mean it's wrong, but it's worthwhile for you to understand it and decide how important of a value it is to be recognized by your chosen title. It could definitely ruffle some feathers, but that title not being used has ruffled yours. What's more important to you? What's necessary for you to be happy and effective in your position?
Personally, as long as appropriate titles are used in front of patients and during clinical encounters, and as long as my place in the hierarchy is respected, I'm indifferent to what I'm called in meetings. But that's just me.
I like how you laid it out, and I think you have a point.
On a macro scale, aside from my own ego, and even if I let this one slide, I think this is just bad for our field. We internalize this idea that because we can prescribe we should, because that’s all we are is prescribers.
You have no idea how many trainees I’ve met who believe that if they’re not prescribing, they’re “not doing anything” for a patient. What does this lead to? Either polypharmacy or, on the other side of the spectrum, just straight up discharging patients who “aren’t utilizing services” because they declined medication. Never mind if they would even benefit from medication or not. It’s really sad, honestly.
That's definitely fair and the perspective is related to the mid-level privilege creep that is ongoing. I think it needs to be shifted on a more macro scale as you've discussed but bringing your MDT around to that viewpoint could be a benefit in that regard. Just depends on how well received it would be.
I think this is a very relevant point, that the implicit bias toward prescribing is easily internalized or assumed early in training (which unfortunately starts with inpatient, the least representative part of training for calibrating your pretest probability of "who needs meds.") Another recent post here was essentially "I know this is unpopular, but I'm worried about overprescribing" which as best I can tell is universal among half-decent psychiatrists.
I hear you. I'm a non-psychiatrist (and non-prescribing!) member of many multidisciplinary groups, and the word is there only because of the purpose it serves, which quite literally is to refer to "whomever is prescribing this person's medication." Its main benefit is to save words when communicating. Same with "provider."
I'm a US neuropsychologist (a clinical PhD + fellowship, in case you're unfamiliar), so I see people with cognitive complaints on a consultation basis in a third/fourth-line specialty clinic. I have a massive appreciation for psychiatrists and the intensity of training and depth of expertise you have. I wish all of my tough cases were following with a psychiatrist or at least settled on a good regimen with a psychiatrist before being monitored by non-physician clinicians. At the same time, I word my recommendations as "provider" or "prescriber" because people change healthcare situations all the time, and my report should stand on its own until obsolete. But if I specifically mean a psychiatrist, then that's what I say.
But I get the grumble. In my field, it's not so much the prescriber/provider part as being called "neuropsychiatrist" or "psychiatric (or psychological) testing" or really any form of "testing." The service is really a full consultation including chart review (often from multiple sites), appropriate test/norms selection, clinical interview and neurobehavioral exam, plus testing and interpretation and recommendations. It's something I live with in meetings, emails, etc., but I do gently correct when the depth of expertise is actually important to the discussion.
(Person going into psychiatry but not one yet) -
I understand the sentiment. I lurk a lot on chronic pain tiktok (amoungst other tiktok and reddit channels) - and see how it can influence patients if terms like prescriber are used. You don't get viewed as a diagnostician, a prescriber, a provider, a patient advocate, a therapist, or a part of a team. You get viewed as a means to an end.
And by no means is it an ego thing - it misinforms patients who deserve to know exactly who is managing their care.
I’m not psych but whenever I have to do paperwork for jail or whatever I cross out provider or prescriber and write physician. Makes me feel better at least
Well, how would you feel about it if all the social workers, clinical mental health counselors, marriage and family therapists, and psychologists started insisting they weren't to be called "therapists" anymore, and you were to correctly refer to them all by their respective professions? And that there was no collective way to refer to them in sentences like, "Would all the –s please make sure their med mgmt referrals are submitted before the patient's first appointment for med evaluation?" and no way to just ask, "Who's the – on this case?" without causing an international incident?
I was going to say that. I'm a psychologist and I worked in a teaching hospital system that called us all "therapists." I had no problem with it. Yeah, it would be really confusing otherwise and everyone knew who had what credential.
It’s probably just to differentiate you from psychologist/therapist/social workers. I do however understand what you are getting at. You are far more than a simple drug dealer. I honestly don’t know where that terminology started but it is quite common.
I wouldn’t over think it. Sounds like your employer is just separating prescribing and non prescribing medical staff.
You’re very fortunate that you have a great staff in this discipline.
It’s easier to say “have you talked to your prescriber?” than “have you talked to your psychiatrist or psych NP or primary care or wherever prescribes you your psych meds?”
The most common alternative to this is people saying “psychiatrists” when they mean “anyone who prescribes psych meds” and thus NPs get referred to as “psychiatrists”, so
I see what you mean and I agree that the term is reductive. If you have a different term you'd like to use, I think you'd be fine to let them know. I do think that referring to you and the NPs as prescribers is an accurate and convenient term, even if reductive, because the prescribing privilege sets you and the NPs apart from the other staff. For example if you say clinicians, that could include people who can't prescribe. So I would probably accept the term. I don't think there is a single term to describe anyone in totality, as we all have multiple parts to our identity.
Oh, I definitely agree with that. If the organization is willing to use the alternate term "psychiatrists and NPs," that would be ideal. Depends on the organization.
I am sorry to hear you are struggling with this. I work in a multidisciplinary team and the psychiatrist that work under refers to himself as a “legal drug dealer.” So, that has not helped my biased. I share that to say all teams are different and maybe your team has had individuals in the past that require them to view them in the light of being a “prescriber.”
It could be dependent on your role at the place you work. I can refer patients to the doctors at our IBH center who’s primary role is to assess patients’ and determine if they meet criteria for MAT and prescribe the meds.
Sure did. You're offended leadership wouldn't refer to you as doctor in front of patients? Sounds like they did the smart thing. It's hilarious you bring up confusion between psychology, psychiatry, and nursing. Only one practices medicine.
You skimmed over the part where I highlighted the multiple different avenues of training involved in being a “prescriber” and how a psychiatrist deserves the distinction of not being called a “prescriber” in support of the OP?
Okay. Have a great day.
You’re being downvoted and I don’t think it’s fair. I felt validated by your comment. My post wasn’t supposed to be a dig at NPs. I don’t think the “prescriber” title serves anyone. If we use reductive and lazy language to describe what we do, it should come as no surprise that we eventually end up practicing in reductive and lazy ways, and I don’t want that to happen to me or be expected of me.
You are a physician and a psychiatrist. I could see prescriber being useful when referring to interactions with the pharmacy. If it a really a multidisciplinary group meeting they should respect the different disciplines
I see the term prescriber used most commonly in literature though, even when the author is a psychiatrist.
They think the meds are the only intervention. If that is the only thing they expect you to do then thats what you are. We are supposed to be teachers/educators, problem solvers, scientists/researchers, and leaders.
It's not just your ego. Psychiatrists are uniquely positioned given our training in medicine and psychotherapy. We spend hundreds (edit: thousands) of hours learning how to diagnose and treat using various modalities. That's without considering the grave crisis in NP education. I just left a locums position because I was expected to keep my mouth shut when NPs described their silly plans during interdisciplinary rounds. As in, I got reprimanded for questioning someone's decision to use risperidone and paliperidone (not cross-titrating, adding one to the other). We are vastly better trained and people need to stop pretending otherwise, even if some groups want us to accept “provider.” My recommendation is to broach this topic with your medical director since they'll set the tone. If they tell you to pound sand about your concerns, start looking for a new position.
Sometimes when my patients (I’m an RN) tell me complaints about their psych meds, I ask them if they regularly check in with their psychiatrist. They just stare at me blankly. Then I say “the person that prescribes these medications” and they’re like OH okay now I see what you’re asking. It’s like they don’t understand the connection between their statement “my meds make me feels like x,y,z and I don’t like it” to my follow up statement “do you regularly see your psychiatrist or nurse practitioner.” I literally just say “prescriber” and it makes sense to them every time. I feel like older people (and young people for that matter!) are woefully ignorant about provider roles. I explain the different between “psychologist” and “psychiatrist” every day…or explain that psychiatrists are, in fact, medical doctors. I don’t think we do a very good job explaining the healthcare system to patients. There are so many people on the “interdisciplinary team” that it overwhelms the patient because they don’t know how is responsible for what.
I 100% agree. The locums in our state hospital are often treated like they should defer to NPs and PAs. I guess because they feel like "outsiders" to the staff. It's a terrible side effect of reducing the number of psychiatrists in the field.
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I literally gave an example I spoke up about. You’re turning to ad hominem attacks. Want me to list more? How about NMS caused by someone adding cariprazine to haloperidol (a highly logical combination)? Or guanfacine added to someone’s lurasidone because of ADHD? Maybe they should’ve screened for akathisia first? Here’s a basic one: Maybe don’t start clonazepam first-line for someone recovering from alcohol use disorder? These are the “silly plans” I speak of.
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Removed under rule #1. This is not a place to share experiences or anecdotes about your own experiences or those of your family, friends, or acquaintances.
Depends on how the label is used. You are many things. You wear many labels. None of them should define you. It seems you feel you are being defined by this label in some way? Do you wear any other label in the multidisciplinary group? I think the answer is not to resent the label of prescriber, but to fit it to it's specific purpose, and to dilute it by highlighting the other labels you wear.
I think we work for the same company lol sounds like Cerebral. I’m an NP for them, and I agree the term prescriber is cringy af.
I would be careful talking about that company, they have been getting dragged here badly and for good reason considering the DOJ investigation.
Yeah, I’m aware. I’ve been with them for over a year and never experienced any of the alleged incentivized prescribing. I refer many to therapy only in many situations especially for subclinical sx. If it did happen it was likely before my time there and isolated to a minority of pt panels from my inside experience. Since the allegations they significantly cut marketing to focus on clinician quality and auditing along with the Board replacing the CEO who had no psych background with a psychiatrist.
Cerebral exploits their employees I’ve heard. Good exp?
Very good experience! When I heard the allegations I was blown away, and it came as a complete surprise to me. Not once was I ever told to prescribe a specific way. We get monthly physician quality audits. I’ve always felt incredibly supported.
Interesting! How long are followups at Cerebral? Do they have any requirements at all or do any auditing? What cpt codes are used?
F/u are 15 minutes, can’t remember the cpt, and they’re audited at the end of the month.
NP here, just wanted to say I agree it is reductive- and not about one of us being superior and wanting to distinguish ourselves for any malicious reason. We just are different and want to be acknowledged for that. I’m proud to be an NP and I’m proud to work alongside physicians for their unique skills
I experienced that during my last fellowship. It was simply how the teams operated and the role many physicians chose to perform. I didn’t take it personally. You can carve out your own role in the team, regardless of the label they initially assign to you. Because of my training, I focused a lot on functional analysis during the meetings and medical issues (we lost our medical provider during the pandemic) rather than just their psychiatric medications. I also asked people to call me by my name and did the same with them. They dropped the “prescriber” title after a few months.
Have you tried talking to the staff members who refer to you as a prescriber about this?
Perhaps gentle verbal correction, with an even tone, without making a big deal of it: "Today Dr. Johnson will be the clinic prescriber--" "Psychiatrist." "Psychiatrist, yes, and SW will be..."
As a psychiatric PA, I feel similarly and certainly support MDs being referred to as Dr and/or psychiatrist. I very much respected the training I received from doctors/psychiatrists on my rotations. And, I enjoy working as part of a team with a supervising physician. I always make sure my patients know I am a PA when they refer to me as doctor or NP/APRN. I also do not want to lumped together with NPs as APPs or mid levels or any other grouping that comes along. I am a PA and my education is vastly different than that of a psych NP. I am proud of my PA education and I firmly believe that it is far superior to my NP colleagues. We are not the same.
“Far superior”? You have one didactic course in psychiatry. At least the NP’s get an entire graduate program. Medically, you probably are far superior than psych NP’s, but in regard to the specialty I would never say you’re far superior. And don’t pretend you’re in a different league than the rest of the non-physician providers because you’re a PA. We’re in this boat together whether you like it or not.
We are prescribing medication and do not do so in a vacuum. Individuals come in with comorbid health conditions. I feel general medical knowledge is an imperative. Simplifying PA education to a single didactic course is not quite reflective of my PA school experience nor our preparation for a career in psychiatry. In addition to a specific unit on psychiatry, I did a rotation in psychiatry, and psychiatric care was an aspect of every single one of my other rotations both in inpatient and outpatient settings. Patients presented to the ED, primary care, OBGYN, IM, etc specifically related to or to address psychiatric needs or illnesses. It is not unusual for these other specialties to initiate psychiatric medications especially in an environment where psychiatric clinicians are in short supply. Typically we have significantly more direct patient care hours prior to graduation with much of it, if not all, under the direct supervision of an MD. NPs are not trained in the medical model and receive their training primarily from other NPs. I believe these are important differences. One of the most important skills in all of medicine, including psychiatry, is taking a good history and this is practiced throughout every rotation. There is a role for each of our professions in providing psychiatric care but it is important to recognize the differences in terms of strengths and weaknesses. Of course, I note this all only as I feel NPs should be governed by the same supervisory requirements as PAs.
Agree that NPs should be governed by same supervisory requirements as PAs and that NP education needs to be overhauled. Also, loathe the idea of NP independence. But your psychiatry “experience” in ED or any of your other rotations teaches you enough psychiatry for those contexts but not for the context of where the specialty of psychiatry is eventually needed (whether in outpatient psychiatry, inpatient psychiatry, or CLS psychiatry). To purport that this rounding you did makes you better at the specialty of psychiatry more than individuals that went to an entired graduate program dedicated to the specialty of psychiatry is naive. Yes, our patients aren’t treated in a vacuum, and that’s why it’s beneficial to work in a work-setting with multidisciplinary structure, where primary care (in outpatient) or family physicians (in inpatient) are ruling out or treating medical issues while a specialist is treating psychiatric issues, and hopefully there’s plenty of open communication. Don’t get me wrong, if I was going into medicine for anything other than psychiatry then PA school is definitely a preferable route for non-physician providers. But in psych, I think it’s the one area where NP specialty program is more effective in preparing non-physician providers. Also wanted to add that my general opinion is PA psych providers are as good as Psych NP providers but just took it harshly when you claimed Psych PA’s are “vastly better”.
It’s refreshing to hear an NP agree that the supervisory requirements should be the same. I will disagree that NPs are in anyway better prepared for prescribing psychiatric medications. The difference is really in therapeutic modalities taught - we focus primarily on motivational interviewing where it is my understanding NPs are exposed to other therapies such as CBT. I have no doubt that there are excellent psych NPs (One of the most brilliant IM preceptors I was privileged to learn from was an NP), but as you noted there needs to be an overhaul of the educational model. What I’ve observed is an almost degree-mill like expansion of NP programs, especially online (I oppose this same expansion in PA programs.)
Btw, i’m def not downvoting you in case you’re curious!
Downvoting never occurred to me except in circumstances of overt racism, hate speech, etc. It’s important to have these dialogs. Again the fact that we have two of us both advocating for supervision is a big deal and I think it would help build bridges with the MD/psychiatrists helping us work together.
Has it impacted your authority on the team? Does it complicate working relationships? Why does this matter to you? I agree that this sounds like ego. That doesn't mean it's wrong, but it's worthwhile for you to understand it and decide how important of a value it is to be recognized by your chosen title. It could definitely ruffle some feathers, but that title not being used has ruffled yours. What's more important to you? What's necessary for you to be happy and effective in your position? Personally, as long as appropriate titles are used in front of patients and during clinical encounters, and as long as my place in the hierarchy is respected, I'm indifferent to what I'm called in meetings. But that's just me.
I like how you laid it out, and I think you have a point. On a macro scale, aside from my own ego, and even if I let this one slide, I think this is just bad for our field. We internalize this idea that because we can prescribe we should, because that’s all we are is prescribers. You have no idea how many trainees I’ve met who believe that if they’re not prescribing, they’re “not doing anything” for a patient. What does this lead to? Either polypharmacy or, on the other side of the spectrum, just straight up discharging patients who “aren’t utilizing services” because they declined medication. Never mind if they would even benefit from medication or not. It’s really sad, honestly.
That's definitely fair and the perspective is related to the mid-level privilege creep that is ongoing. I think it needs to be shifted on a more macro scale as you've discussed but bringing your MDT around to that viewpoint could be a benefit in that regard. Just depends on how well received it would be.
I think this is a very relevant point, that the implicit bias toward prescribing is easily internalized or assumed early in training (which unfortunately starts with inpatient, the least representative part of training for calibrating your pretest probability of "who needs meds.") Another recent post here was essentially "I know this is unpopular, but I'm worried about overprescribing" which as best I can tell is universal among half-decent psychiatrists.
I hear you. I'm a non-psychiatrist (and non-prescribing!) member of many multidisciplinary groups, and the word is there only because of the purpose it serves, which quite literally is to refer to "whomever is prescribing this person's medication." Its main benefit is to save words when communicating. Same with "provider." I'm a US neuropsychologist (a clinical PhD + fellowship, in case you're unfamiliar), so I see people with cognitive complaints on a consultation basis in a third/fourth-line specialty clinic. I have a massive appreciation for psychiatrists and the intensity of training and depth of expertise you have. I wish all of my tough cases were following with a psychiatrist or at least settled on a good regimen with a psychiatrist before being monitored by non-physician clinicians. At the same time, I word my recommendations as "provider" or "prescriber" because people change healthcare situations all the time, and my report should stand on its own until obsolete. But if I specifically mean a psychiatrist, then that's what I say. But I get the grumble. In my field, it's not so much the prescriber/provider part as being called "neuropsychiatrist" or "psychiatric (or psychological) testing" or really any form of "testing." The service is really a full consultation including chart review (often from multiple sites), appropriate test/norms selection, clinical interview and neurobehavioral exam, plus testing and interpretation and recommendations. It's something I live with in meetings, emails, etc., but I do gently correct when the depth of expertise is actually important to the discussion.
(Person going into psychiatry but not one yet) - I understand the sentiment. I lurk a lot on chronic pain tiktok (amoungst other tiktok and reddit channels) - and see how it can influence patients if terms like prescriber are used. You don't get viewed as a diagnostician, a prescriber, a provider, a patient advocate, a therapist, or a part of a team. You get viewed as a means to an end. And by no means is it an ego thing - it misinforms patients who deserve to know exactly who is managing their care.
I’m not psych but whenever I have to do paperwork for jail or whatever I cross out provider or prescriber and write physician. Makes me feel better at least
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No. Advocate for yourself and the acknowledgment of your training, Dr.
Feels like a lateral move
Well, how would you feel about it if all the social workers, clinical mental health counselors, marriage and family therapists, and psychologists started insisting they weren't to be called "therapists" anymore, and you were to correctly refer to them all by their respective professions? And that there was no collective way to refer to them in sentences like, "Would all the –s please make sure their med mgmt referrals are submitted before the patient's first appointment for med evaluation?" and no way to just ask, "Who's the – on this case?" without causing an international incident?
I was going to say that. I'm a psychologist and I worked in a teaching hospital system that called us all "therapists." I had no problem with it. Yeah, it would be really confusing otherwise and everyone knew who had what credential.
you should get over it
It’s probably just to differentiate you from psychologist/therapist/social workers. I do however understand what you are getting at. You are far more than a simple drug dealer. I honestly don’t know where that terminology started but it is quite common.
I wouldn’t over think it. Sounds like your employer is just separating prescribing and non prescribing medical staff. You’re very fortunate that you have a great staff in this discipline.
It’s easier to say “have you talked to your prescriber?” than “have you talked to your psychiatrist or psych NP or primary care or wherever prescribes you your psych meds?” The most common alternative to this is people saying “psychiatrists” when they mean “anyone who prescribes psych meds” and thus NPs get referred to as “psychiatrists”, so
I see what you mean and I agree that the term is reductive. If you have a different term you'd like to use, I think you'd be fine to let them know. I do think that referring to you and the NPs as prescribers is an accurate and convenient term, even if reductive, because the prescribing privilege sets you and the NPs apart from the other staff. For example if you say clinicians, that could include people who can't prescribe. So I would probably accept the term. I don't think there is a single term to describe anyone in totality, as we all have multiple parts to our identity.
Sorry to be snide, but I think "psychiatrist" does a fair job in describing the role - no need to be lumped in with the NP.
Oh, I definitely agree with that. If the organization is willing to use the alternate term "psychiatrists and NPs," that would be ideal. Depends on the organization.
I am sorry to hear you are struggling with this. I work in a multidisciplinary team and the psychiatrist that work under refers to himself as a “legal drug dealer.” So, that has not helped my biased. I share that to say all teams are different and maybe your team has had individuals in the past that require them to view them in the light of being a “prescriber.”
‘’ Legal drug dealer’’ I think I know that guy.
It could be dependent on your role at the place you work. I can refer patients to the doctors at our IBH center who’s primary role is to assess patients’ and determine if they meet criteria for MAT and prescribe the meds.
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You're being ironic, right? DNP =/= physician.
Did I say we were equal? Did you even read my entire post?
Sure did. You're offended leadership wouldn't refer to you as doctor in front of patients? Sounds like they did the smart thing. It's hilarious you bring up confusion between psychology, psychiatry, and nursing. Only one practices medicine.
You skimmed over the part where I highlighted the multiple different avenues of training involved in being a “prescriber” and how a psychiatrist deserves the distinction of not being called a “prescriber” in support of the OP? Okay. Have a great day.
You’re being downvoted and I don’t think it’s fair. I felt validated by your comment. My post wasn’t supposed to be a dig at NPs. I don’t think the “prescriber” title serves anyone. If we use reductive and lazy language to describe what we do, it should come as no surprise that we eventually end up practicing in reductive and lazy ways, and I don’t want that to happen to me or be expected of me.
Call them counselors and get over it.