LaurelAllison Posted June 9, 2016 Share Posted June 9, 2016 Hello all! I have always had a dream of uniting psychiatry and counseling together in my own practice. I am working on my PA degree now and I would like to get a second masters in clinical counseling. I truly believe mental health needs some serious improvement in this country and I want to do my part. We can't keep pushing psych meds on people hoping that they'll take the step to find therapy. I believe it is imperative that these two practices be combined. Mental health is a multifaceted problem that can't be fixed with drugs alone. (stepping off soapbox now) Plus, I love Psychiatry and Psychology... and neuro... and the brain in general. My question is, is there anyone out there that has done something similar? Does anyone have a practice like this that could tell me what it was like to find patients, how much you charge per session, what its like to have your own psych practice, do you take insurance, if I have a supervising physician am I even allowed to have a practice like this (I know it depends greatly on what state I am in) etc... Thanks! 1 2 Quote Link to comment Share on other sites More sharing options...
LKPAC Posted June 9, 2016 Share Posted June 9, 2016 I can't answer your question, except to say that I am sure this exists. I wish you well. Quote Link to comment Share on other sites More sharing options...
delco714 Posted June 9, 2016 Share Posted June 9, 2016 Hello all! I have always had a dream of uniting psychiatry and counseling together in my own practice. I am working on my PA degree now and I would like to get a second masters in clinical counseling. I truly believe mental health needs some serious improvement in this country and I want to do my part. We can't keep pushing psych meds on people hoping that they'll take the step to find therapy. I believe it is imperative that these two practices be combined. Mental health is a multifaceted problem that can't be fixed with drugs alone. (stepping off soapbox now) Plus, I love Psychiatry and Psychology... and neuro... and the brain in general. My question is, is there anyone out there that has done something similar? Does anyone have a practice like this that could tell me what it was like to find patients, how much you charge per session, what its like to have your own psych practice, do you take insurance, if I have a supervising physician am I even allowed to have a practice like this (I know it depends greatly on what state I am in) etc... Thanks! So essentially you're describing a PsyD who has prescriptive privilege in some states. Best bet would be to look for jobs in a psych institution or group (which has different types of MHPs including md). I see you're describing something unique if you get your mhc degree..but that can likely be skipped Maybe this will help? http://www.pasconnect.org/pas-the-perfect-bridge-between-medical-and-mental-health Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted June 9, 2016 Administrator Share Posted June 9, 2016 So essentially you're describing a PsyD who has prescriptive privilege in some states. Or a Psych ARNP. They exist and do rather well, from what I understand.... Quote Link to comment Share on other sites More sharing options...
DizzyJ Posted June 10, 2016 Share Posted June 10, 2016 I work outpatient psych right now. There would be no reason for me to get a counseling certificate in addition to being a PA other then the additional knowledge that would bring me. I can already bill/collect for visits including psychotherapy. So, you would just need to find the right employment to do what you want to do. My primary focus is medication management, as we have therapists in the office. It is impossible to just prescribe medication without a little psychotherapy along with it for a majority of patients. Your hurdles will be state and insurance dependent on being able to open your own practice, be reimbursed by insurance, having an SP (in some states you are not allowed to employ your SP).....Certainly check on the thread on practice ownership on here. 1 Quote Link to comment Share on other sites More sharing options...
2234leej Posted June 10, 2016 Share Posted June 10, 2016 Hello all! I have always had a dream of uniting psychiatry and counseling together in my own practice. I am working on my PA degree now and I would like to get a second masters in clinical counseling. I truly believe mental health needs some serious improvement in this country and I want to do my part. We can't keep pushing psych meds on people hoping that they'll take the step to find therapy. I believe it is imperative that these two practices be combined. Mental health is a multifaceted problem that can't be fixed with drugs alone. (stepping off soapbox now) Plus, I love Psychiatry and Psychology... and neuro... and the brain in general. My question is, is there anyone out there that has done something similar? Does anyone have a practice like this that could tell me what it was like to find patients, how much you charge per session, what its like to have your own psych practice, do you take insurance, if I have a supervising physician am I even allowed to have a practice like this (I know it depends greatly on what state I am in) etc... Thanks! I would recommend becoming a nurse practitioner and getting your PMHNP (psychiatric mental health board certification). I see much more NP's in psych than I do PA's. That's not to say PA's can't, it's really just not as common (NP's typically do this). Quote Link to comment Share on other sites More sharing options...
Avalon Posted June 14, 2016 Share Posted June 14, 2016 A few thoughts... In most states a PA cannot bill using psychotherapy codes without evidence of additional training and experience in mental health. Simply completing PA school is not viewed by most states and by most third party payers as adequate training to conduct and bill for psychotherapy. I agree completely with this assessment. If you are serious about wanting to impact mental health and want to be both a prescriber and a competent therapist, then seek additional, graduate level training in a mental health discipline. A PsyD degree does not confer prescriptive privileges in any state, unless the holder of that degree completes advanced training in pharmacology. Even with such training, only four states currently grant prescriptive authority to psychologists. The specific requirements for both the didactic and clinical aspects of that advanced training vary across those four states. There is quite strong opposition to the granting of prescriptive authority to psychologists (and I agree), based on the perception that anyone without a medical degree (MD, DO, PA, NP) is inadequately trained to safely and effectively prescribe psychotropics. I often wonder why there is not similar opposition to the conducting of "psychotherapy" by inadequately trained persons? 2 Quote Link to comment Share on other sites More sharing options...
scarfire Posted January 15, 2018 Share Posted January 15, 2018 On 6/10/2016 at 1:13 AM, 2234leej said: I would recommend becoming a nurse practitioner and getting your PMHNP (psychiatric mental health board certification). I see much more NP's in psych than I do PA's. That's not to say PA's can't, it's really just not as common (NP's typically do this). I think OP is already a PA student. 1 Quote Link to comment Share on other sites More sharing options...
corpsman89 Posted January 15, 2018 Share Posted January 15, 2018 It may be a bit difficult. The big push is for PA-Cs to conduct medicine management. I believe it is more lucrative for most business's. That's just the reality of the situation. Quote Link to comment Share on other sites More sharing options...
Lexapro Posted January 17, 2018 Share Posted January 17, 2018 It makes far more sense to become a psych np or psychiatrist if this is your goal, as you can easily bill for both therapy and prescribe medications as needed. PAs are not formally trained in psychotherapy and cannot bill for it in many states unless they can prove they received outside training. It may also be difficult to set up your own practice as a PA. edit: Just realized I am replying to a post that is over a year old. Hah. Quote Link to comment Share on other sites More sharing options...
scarfire Posted January 17, 2018 Share Posted January 17, 2018 7 minutes ago, Lexapro said: It makes far more sense to become a psych np or psychiatrist if this is your goal, as you can easily bill for both therapy and prescribe medications as needed. PAs are not formally trained in psychotherapy and cannot bill for it in many states unless they can prove they received outside training. It may also be difficult to set up your own practice as a PA. edit: Just realized I am replying to a post that is over a year old. Haha yeah... I heavily debated between psych NP and PA and ultimately went with PA because I wasn't positive I wanted to commit to practicing in psych. Some days I wish I had chosen the NP route, some days I wish I had been less lazy and applied to medical school, but most of the time I am happy to be in PA school. 1 Quote Link to comment Share on other sites More sharing options...
Lexapro Posted January 17, 2018 Share Posted January 17, 2018 I love being a psych NP, but I only did it because I knew I was okay being "pigeonholed" into the mental health world. I think PAs are great and it's a great career, especially if you want to work in ER/surgical/acute care settings. Quote Link to comment Share on other sites More sharing options...
runforhotdogs Posted January 26, 2018 Share Posted January 26, 2018 On 1/17/2018 at 10:59 AM, Lexapro said: I love being a psych NP, but I only did it because I knew I was okay being "pigeonholed" into the mental health world. I think PAs are great and it's a great career, especially if you want to work in ER/surgical/acute care settings. What do you mean by pigeonholed? Quote Link to comment Share on other sites More sharing options...
d2305 Posted January 30, 2018 Share Posted January 30, 2018 I've never met a psych PA. One used to post here, but he was a nurse too. Quote Link to comment Share on other sites More sharing options...
Daconssc Posted December 14, 2020 Share Posted December 14, 2020 There are plenty of PA's working in psychiatry, but it is not as popular a field for PAs as it is for NPs. I am not sure why it is, but PA's tend to gravitate towards highly technical hard science fields like surgery, while NPs tend to gravitate more towards roles that focus on the patient interaction like primary care or psychiatry. Perhaps it is because as nurses they focused a lot on working with people while PA school attendees likely worked in technical fields with less human interaction and a heavier focus on academics and hard sciences. Just a thought. But also, I am sure that having a career path focused solely on psychiatry and mental health also encourages more NPs to take that route. I have personally met numerous PA's working in psychiatry, they are just such a small percentage of PA's that they are relatively unknown. 1 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted December 14, 2020 Moderator Share Posted December 14, 2020 On 6/9/2016 at 1:50 PM, rev ronin said: Or a Psych ARNP. They exist and do rather well, from what I understand.... yup mostly in the 150k per year range On 6/10/2016 at 1:13 AM, 2234leej said: I would recommend becoming a nurse practitioner and getting your PMHNP (psychiatric mental health board certification). I see much more NP's in psych than I do PA's. That's not to say PA's can't, it's really just not as common (NP's typically do this). the OP was posting as a PA student..... as well i think that the training of NP is lax in medication management and formal counseling theory. Nursing theory and classes about treating the whole person are not going to get you trained on how to Dx Bipolar I versus II versus simple drug addiction On 1/15/2018 at 11:10 AM, corpsman89 said: It may be a bit difficult. The big push is for PA-Cs to conduct medicine management. I believe it is more lucrative for most business's. That's just the reality of the situation. Med Management is the top of the pile for reimbursement Everything else is lower on the totem pole for reimbursement - is why psychiatrist do not do a lot of counseling. Quote Link to comment Share on other sites More sharing options...
MediMike Posted December 14, 2020 Share Posted December 14, 2020 50 minutes ago, Daconssc said: Perhaps it is because as nurses they focused a lot on working with people while PA school attendees likely worked in technical fields with less human interaction and a heavier focus on academics and hard sciences. Just a thought. Huh? Technical fields? While I agree that HCE has been watered down I don't think we have a bunch of computer coders or medical equipment techs running around campus. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted December 14, 2020 Moderator Share Posted December 14, 2020 49 minutes ago, MediMike said: Huh? Technical fields? While I agree that HCE has been watered down I don't think we have a bunch of computer coders or medical equipment techs running around campus. seems we are starting to get lumped in with the doc's and their "cold technical training" instead of the "Whole person nursing theory" that is taught in nursing school 2 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted April 26, 2022 Share Posted April 26, 2022 The "whole-person" thing makes a great bumper sticker or tag line but is a bit of intellectual sleight of hand. At the end of it all care is provided by individuals and will be different from person to person and practice to practice. I have decided I am only treating 31% of each person. (See it sounds just as stupid when you reverse the "logic"). Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted April 27, 2022 Moderator Share Posted April 27, 2022 “I am treating the whole person” statement by New NPs , Sometimes I think this is really saying (I don’t know what to do next so I am going to give them a hug and hold there hand, then order every test I can think of” Quote Link to comment Share on other sites More sharing options...
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