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Articles    H2'ed 4/16/10

Psychology and Health Care Reform

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I don't think we would have let this happen in any School of Medicine in the United States. I don't think we would have removed a teacher after one class for proposing problem based learning. In fact, recently another friend interviewed for a position at Stanford University School of Medicine (my alma mater). He was told that he could not lecture from powerpoints, that this was old-fashioned and boring, and that the students would not tolerate it. If he wanted to teach at Stanford, he would have to engage the students in problem-based, experiential learning, which, they said, was a lot more time-consuming and demanding than the old fashioned lecturing from powerpoints (slides in my day).

This and other examples which I will relate in future essays has changed my opinion about psychologists prescribing medications. I no longer think it's a good idea. These other examples include psychologists who prescribe medications for every patient they see (and have abandoned psychotherapy) and my friend's assessment of the readiness of her graduates to function (not at all) and the lack of any independent assessment of their competence other than a 150 question fact-based test.

But we will see how the various mental health professionals fare under health care reform, whether or not psychotherapy is abandoned by psychologists in favor of the 10 minute visit in the primary care office and in favor of prescribing medications. Perhaps it will go full circle and psychiatrists will begin doing the psychotherapy again while all psychologists do is prescribe medications. Whether or not these medications actually work or serve humanity is a different topic.

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Lewis Mehl-Madrona graduated from Stanford University School of Medicine and completed residencies in family medicine and in psychiatry at the University of Vermont. He is the author of Coyote Medicine, Coyote Healing, Coyote Wisdom, and (more...)
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