Medication Management and Scope of Practice

[Helperjon]

Hello,

 

I wanted to know if any psychiatric physician assistants would be able to better explain to me what is meant by medication management?  I have a bachelors in psychology and currently work as a respiratory therapist.  I got accepted into a PA program and have a lot of interest in entering this specialty.  In reading about the job everyone mentions psychiatrist do medication management and pscyhologists perform therapy.  Is medication management consist of meeting with the patient and seeing if the psychiatric medication is controlling unwanted behavior?  And watching for harmful side effects from the drugs?  Is it kind of like a quick checkup or interview with the patient?

 

Also, once you get a good understanding of psychiatry and how to diagnosis and treat mental illness do you pretty much carry your own caseload of patients? 

 

Thank you in advance.

[TrekkieByDay]

I'm not a PA (yet) but I'm a mom of four children w/ mental health disorders, and one of them is very complicated, w/ 5 comorbidities.

Psychiatric medications require adjustment as the patient grows, as circumstances and stressors change, and even as the metabolism changes. For example, w/ Zoloft, my oldest daughter was incredibly edgy on 50mg, so we cut her down to 25. Then, as she hit a growth spurt after re-feeding, she suddenly needed an increase. We tried several different doses over a 6-month period, until she's now stable on 100mg. (She has OCD, ADHD, an eating disorder [ARFID],  Asperger's syndrome, and Sensory Processing Disorder)

 

[jdtpac]

Helperjon,

I have been a PA for over 40 years and have practiced in multiple medical/surgical specialties over that time. I have been practicing in psychiatry for the past 3 years (part time, pre-retirement 15-20 hours per week) and I absolutely love it. I practice in a community mental health center, we have 3 psychiatrists, 3 PAs, 1 nurse practitioner (designated as “prescribers”) and multiple therapist (psychologist, licensed counselors and social workers). My main responsibility, as well as, the psychiatrist’s and nurse practitioner is medical management. Typically, our patients are 1^st seen by a social worker for an in-depth intake screening exam. They are then seen by 1 of the prescribers for an initial evaluation, which usually takes 40-60 minutes where we make the initial diagnosis and prescribe medications as necessary. We do not do any psychotherapy. The client is referred to the therapists as a consult. We see the client every 3 to 4 weeks after the initial visit for the 1^st 3 to 4 months to determine the efficacy of any of the medications we have prescribed. If everything’s going well, we will put the client on a every 3 month scheduled visit. We do “counsel” our clients during our visits but the psychotherapy is left up to the individuals who have the training and credentials to do it properly. Even our psychiatrist do not spend a lot of time doing psychotherapy. Remember this is a community mental health center and we are overwhelmed with clients. Practicing in a private practice is much different and depending upon which state you practice in will determine whether or not as a PA you can provide psychotherapy services and bill for them.

This is a brief explanation I hope it helps. Good luck in your training.