According to the Academy of Medical Psychology (AMP), there are two educational paths to becoming a medical psychologist. One is to complete medical school and earn a license to practice medicine in the United States. The other is to complete an American Psychological Association-accredited Doctor of Philosophy (Ph.D.) in Psychology or Doctor of Psychology (Psy.D.) program, followed by a post-doctoral master’s degree or certificate program in clinical psychopharmacology (www.amphome.org).
I have my Ph.D. in clinical psychology and spent 23 years working in a pharmacy as a pharmacy technician. I then spent two years working with a general medical practitioner in his office with his patients. In the process of all that I learned clinical medicine: the ability to evaluate and diagnose medical disorders based on clinical symptoms and physical signs.
The “art” of clinical medicine is being lost. It requires considerable time and, in essence, a mentorship with a physician to notice and understand what is being observed. Unfortunately that training in clinical medicine is becoming rare. Instead of clinical medicine leading laboratory medicine, laboratory medicine has ineffectively replaced clinical medicine. The physicians who know clinical medicine are older. The impact of managed care on the ability of a physician to take a history has led to nurse practitioners and medical assistants getting that information as a more cost effective method. But it’s more costly to the patients and adds to the level of misdiagnosis being significantly high. It’s also led to concierge medical services outside of managed care.
Medical psychology effectively bridges the gap for a physician in providing medical education, ensuring compliance with treatment plans and getting that needed history. Unfortunately, there are few medical psychology practitioners and fewer still know what we do. I have to explain my role to physicians and psychologists alike. Most equate what I do to “Dr. House” from the television series. I just think of it as saving people’s lives.
Margaret A. Donohue, PhD