Psychiatric Evaluation

Psychiatry

A psychiatrist is a Medical Doctor (M.D.) who has graduated from a medical school. A psychiatrist’s training focuses on general medicine while in medical school. They will then go on to 3-4 years of residency where they will specialize in psychiatry. While for many years in the past, the psychiatrist normally prescribed medications and also delivered psychotherapy, their roles have changed today. For the most part, psychiatrists now do psychiatric evaluations for the purpose of determining if an individual would be appropriate for treatment with medications. If so determined,  the psychiatrist prescribes the medications and then follows the patient for medication management. Medication management includes initially following the patient closely until they are stabilized with the proper dosage ( usually once every 1-2 weeks until stabilization occurs) and then usually once every 1-3 months for maintenance.

Psychiatrists are medical doctors (MDs) that specialize in the pharmaceutical/biological treatments of psychiatric illnesses as well as their psychological and social aspects.

Psychologists, on the other hand, are doctors of philosophy (PhDs) that specialize in the analysis/understanding of and treatment through therapy, the behavioral, psychological, and sociological aspects of psychiatric conditions.

Actually, the suffix “-iatry” means “medical treatment” while the suffix “-logy” means “science” or “theory.”

As medical doctors, psychiatrists in North Carolina can prescribe medications and other medical interventions, while psychologists cannot.

Whether a psychologist or psychiatrist is right for you or your loved one is based on the specific needs of the individual.

The Differences between Physician Assistants and Nurse Practitioners

While both Physician Assistants and Nurse Practitioners are both noble professions dedicated to the care and welfare of their patients, there are a wealth of differences in education, licensing, responsibilities and philosophy. Physician Assistants are licensed medical professionals who may work independently of the lead physician, while Nurse Practitioners are well trained, but not necessarily licensed caregivers, who must work under the close supervision of the attending doctor.

Contrasts in Academic Preparation

The differences between these two professions begin at the educational level. Physician Assistants must attend a PA program following graduation with a Bachelor’s degree. These Master’s level programs are extremely rigorous and are modeled on the curriculum found in medical schools. In fact, many of the courses like dermatology, hematology and psychiatry are found in both medical schools and Physician Assistant programs, although there is a less in-depth study of these subjects in PA programs. Although the level of comprehensiveness differs between medical schools and PA programs, they are both focused on the medical science.

Nursing programs do provide a strong medical background for Nurse Practitioners, but they are more focused on natural, behavioral and humanistic sciences. This emphasis upon the state of the patient rather than the treatment of the underlying medical affliction reflects a historical origin in which Nurse Practitioners were utilized to ease the discomfort of the ill or injured. Nurse Practitioners do, however, complete a Master’s degree program like Physician Assistants.

Differences in Clinical Preparation

In addition to differences in classroom instruction, there are also many differences in the clinical preparation that Physician Assistants and Nurse Practitioners receive. While Nurse Practitioners may obtain from 500 to 700 hours of experience in a clinic learning about diagnostic techniques, common medical procedures and case management, Physician Assistants are required to spend almost 2,000 hours in a clinical environment prior to licensing.

Furthermore, while Nurse Practitioners are expected to choose a specialty like pediatrics, acute care or oncology in which they can devote their clinical preparation, Physician Assistants are expected to rotate through a wide variety of medical specialties. Ultimately, the difference in clinical preparation provides PAs with more freedom to choose the type of medical practice they wish to join because they already possess a broader based experience, while NPs are more limited to their chosen specialty.

Certification and Licensing

There are also significant differences in the certification and licensing of these two professions. Physician Assistants must be nationally certified to practice and are nationally certified by a single authoritative body, the National Commission on Certification of Physician Assistants. The NCCPA only certifies those who have taken the Physician Assistant National Certifying Exam and passed. Nurses, on the other hand, are not required to pass a national certifying exam, although doing so will permit them advanced credentials.

The state licensing procedures for each profession are slightly different. PAs must submit proof that they have passed the PANCE and completed all educational and clinical prerequisites. Nurse Practitioners typically only need to provide proof that they graduated from a nursing program. Additionally, PAs must complete 100 hours of continuing medical education hours every two years an pass a recertification exam every six years, while NPs need only complete 75 continuing education units every five to six years.

Psychologists

A psychologist is a clinician who holds a Doctorate in Psychology (Psy.D.) or a Doctor of Philosophy in Psychology (Ph.D.). These clinicians have spent at least 5-6 years of graduate work strictly studying psychology, then moving on to complete 1-2 years of internship followed by 1-2 years of supervised clinical work experience before qualifying for the right to sit for the licensing examination. A psychologist does not prescribe medication. Instead, they provide psychotherapy through their in-depth knowledge of  psychological theory, therapy, research and diagnostic testing. Psychologists also specialize in psychological testing and are the only group of clinicians trained to do so. Psychological testing require years of training that involves not only how to give the tests, but also how to score and integrate the test information with clinical interviews, background information, knowledge of personality theory, human development and research.

The title “psychologist” can only be used by someone who has completed the above training and has then passed both national and state licensing examinations. Informally, a psychologist may be referred to as a “therapist,” “counselor,” or “clinician.” However, these are more general terms that can be used by other mental health professionals who are not formally trained and licensed psychololgists.

Social Workers

Licensed Clinical Social Workers (LCSW’s) hold Masters degrees.  Their training consists of typically 2 years of graduate school and 1-2 years of internship. LCSW’s assess, diagnose, intervene and treat individuals, families and groups with psychosocial problems. They will frequently partner with a psychiatrist if they feel medication should be part of the treatment protocol.

Mental Health Counselors

Licensed Mental Health Counselors (LMHC’s) hold Masters degrees in counseling. They have completed 2 years of graduate training and 1-2  years of work experience under supervision. LMHC’s provide counseling to individuals, families and groups. They, too, will partner with a psychiatrist if they feel medications might be included in the treatment protocol.

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In conclusion, the most significant differences between mental health professionals are specialties, education and experience. Most qualified mental health professionals will refer a patient to another professional if the specific type of treatment needed is outside their scope of practice. Additionally, many mental health professionals will often work together using a variety of treatment options such as concurrent medication and therapeutic techniques.

Information gathered from internet from the following websites: 

https://www.physicianassistantedu.org/pa-vs-np/

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