The past has been good to psychology. The number of successful practitioners, as well as our underlying clinical knowledge base, continues to expand nicely. Colleagues such as
Without question, there are several critical provisions within ACA where psychology currently is not recognized; i.e., the very important Accountable Care Organization (ACO) and
What must happen next from my public policy perspective is that our profession's training institutions must learn from their colleagues in medicine and nursing about the importance of possessing "homes of their own." Within ACA there are impressive incentives recognizing the importance of encouraging the educational institutions of both of these professions to address society's pressing needs (i.e., by providing financial assistance). For example, Nurse-Managed Health Clinics that will provide comprehensive primary health care and wellness services to vulnerable or underserved populations; a new Medicare Graduate Nurse Education Demonstration program for up to five eligible hospitals to receive support for clinical training costs attributed to providing advanced practice nurses with qualified training. And, a Teaching Health Centers initiative to expand primary care residency programs. The Senate Appropriations Committee has recommended that not less than $5 million be expended for the nurse-managed health clinic program, within the $231+ million allocated for nursing training. The Children's Hospital GME initiative will receive $265+ million exclusively targeted for medical schools, notwithstanding the important psychosocial component of childhood and family care following accidents and for those children afflicted with potentially devastating diseases such as childhood cancer. Historically, psychology's training programs have expressed little, if any, interest in expanding their legislative presence (other than most recently, under the newly authorized GPE program).
As educated professionals, we should take serious notice of the unfortunate reality of the Institute of Medicine (IOM) finding that: "The lag between the discovery of more efficacious forms of treatment and their incorporation into routine patient care is unnecessarily long, in the range of about 15 to 20 years. Even then, adherence of clinical practice to the evidence is highly uneven." This delay in the translation of evidence to practice is unacceptable and must be addressed. We must come to appreciate that our training institutions are where the next generation of psychology's practitioners will learn their skills and practice patterns for decades to come. They are also absolutely critical in bringing the most up-do-date clinical knowledge to the attention of today's practitioners. With the expanding availability and exciting potential inherent in tele-psychology, virtual realities, and data-driven cross-patient comparisons, it must ultimately be our training institutions (and I expect it will be our professional schools) that must now demonstrate proactive leadership in making these connections – in bringing "town and gown" effectively together.
For those colleagues who argue that we should not consider ourselves "health care providers"; that psychology should not seek to expand its scope of practice (i.e., pursue RxP); and that we need fewer students, rather than more, I can only say that "the train has already left the station." Hopefully, our next generation of colleagues will appreciate what they might have individually contributed to our future, notwithstanding. "I hear the train a comin'." Aloha,
