The pressure from psychologists to prescribe psychotropics seems to keep increasing, according to the APA. The psychiatrists’ resistance is fierce.
I don’t recall observing this sort of struggle in other specialties, e.g. between neurologists and clinical psychologists. I wonder if we are asking the wrong question above. Perhaps we should ask if psychiatrists are sophisticated enough to distance themselves from other groups who aspire to prescribe drugs.
Do we know enough about the mechanisms of action of psychotropic drugs? Do we have any solid knowledge of psychiatric pathophysiology? Sadly, the answer to these questions is no.
It’s not only a matter of increasing research funding. The average psychiatrist has already shifted his/her focus from the medical aspects of psychiatry to the more social and behavioral aspects, where he/she is guaranteed to find serious competition from other professionals who come with solid and extensive training in areas like psychotherapy, where the purely medical background has only minor relevance. On the other hand, while discussing medications in psychiatric circles, neurophysiological, molecular or computational/cognitive aspects are only casually addressed, if ever. There is already a significant rift between neuroscience and the practice of psychiatry. This fact may be a contributing factor for other health workers’ eagerness to replace psychiatrists in the prescription area.
Partially relinquishing their medical status through their cognitive choices puts psychiatrists at a feeble position to hold their ground in these matters.
The Brain Shop 