Psy D

A company called the “Prescribing Psychologists’ Register” has been around for many years, selling continuing education courses to psychologists looking to learn how to prescribe psychiatric prescription medications for mental disorders.

Psychologists who want prescription privileges claim a shortage of psychiatrists and note that given psychologists’ deep training in mental health problems, they are an appropriate, logical choice to help fill the need. And except for the lack of any medical training required by a Ph.D. or Psy.D. in psychology, the fact that the lack of psychiatrists mainly occurs in rural areas, and that there are other mental health professionals — such as physician assistants and psychiatric nurses — who already can help fill the prescribing gap, they may have a point. But as you can see, it’s a tenuous point at best that requires the suspension of most logic and best practices of care for patients.

Prescribing Psychologists’ Register isn’t an American Psychological Association (APA) approved sponsor of continuing education at this time. Therefore its continuing education courses aren’t recognized as being officially credentialed by the primary credentialing body of psychologists. But never mind, that’s not what caught my eye…

Here’s the copy from its website:

Prescribing Psychologists’ Register, Inc. The first and oldest training and credentialing organization for psychologists in psychopharmacology! PPR, following completion of its Series One through Seven Courses, in cooperation with the International College of Prescribing Psychologists, awards the Board Certified, Diplomate Fellow in Psychopharmacology (FPPR), the most stringent Diplomate in the profession of Psychology.

Really? The most stringent Diplomate? Hmm, that’s quite the claim there. So who is this “International College of Prescribing Psychologists?”

None other than the same people who run Prescribing Psychologists’ Register in Florida. You see, anyone can set up a company with the name “College” in it. It doesn’t have to be an actual educational institution (at least not in Florida). Although they changed their name a few years ago to the International College of Professional Psychology (branching out a bit?), they are apparently still in business and still filing annual reports with Florida’s Secretary of State.

Hundreds of professionals list this credential in their online biographies and resumes, including a president of a college, professors, a director of professional affairs for a state psychology association, and of course, members of a task force set up to make recommendations about prescription privileges for psychologists.

So who runs the company that sells the continuing education, and then provides the “diplomate” status from the “college” afterward? Florida licensed psychologist Samuel Feldman, whom we tried contacting for comment for this article but received no response. The principal address for the International College of Prescribing Psychologists is not a college at all, but Feldman’s home, according to Florida’s Secretary of State, Mapquest and Google Maps.

The Florida Secretary of State’s database is replete with many companies Feldman has set up with names like the “American Board of Integrated/Alternative Medicine,” “American Medical Specialties Board,” the “American College of Advanced Practice Psychologists,” “American Psychologist Physicians’ Register,” and this goodie, “Smoothy Child Pharmaceuticals.” He’s let most of the them lapse for failure to file an annual report (except that last one). Feldman isn’t listed as a current member of the APA, and he also appears to have started something called the American Journal Of Pharmacopsychology in 1998, but we could only find citations to it, not the actual journal itself.

This effort has been so successful, Feldman has had his “college” written into state legislation for standards for prescribing psychologists, such as this Senate bill in Missouri.

The problem isn’t that Feldman created a successful business (after all, there’s nothing illegal about what he’s doing). The problem is that there are many different board certification organizations, and then there’s the single granddaddy in medicine that offers board certification for physicians, the American Board of Medical Specialties. This is what most doctors are talking about when they say they are “board certified.”

Outside of this organization, there are many (dozens, apparently) of associations, companies and other organizations that offer their own version of “board certification.” These folks regularly award board certification and a “diplomate” in specific specialties in medicine, mental and behavioral health, but none of them are recognized by the American Board of Medical Specialties. An alternative organization, called the National Commission for Certifying Agencies (NCCA), also accredits organizations for board certification (but the International College of Professional Psychology isn’t one of them). The legitimacy of these other board certifications vary widely, and there’s no outside organization the evaluates them or lets professionals (or consumers) know which ones are legitimate, and which ones are not so much.

Which brings me back to the bad ones… It’s simply far too easy to set up your own board certification organization and selling Diplomates to anyone who meets your arbitrary criteria. Set up a “college,” a set of credentials in order to award the “certification,” and of course, a fee, and you’ve got yourself a nice business. Nobody will recognize that your organization isn’t quite legitimate until years later (if at all).

So I can’t help but wonder about the International College of Prescribing Psychologists. If this wasn’t an attempt at misdirection (at the very least), why wouldn’t the Prescribing Psychologists’ Register company itself simply award the Diplomate and board certification? Why set up a separate “college” to do it?

While I may be against prescription privileges for psychologists, I don’t think the practices described in this article does the field any favors.