SCIENCE / MEDICINE : DEBATE : Hospital Patients Now Have Choice Between Psychologists, Psychiatrists : Pro: A combination of rigorous training and bright students has spawned a young and very competent group of professional psychologists.

The California State Supreme Court’s decision in the case of CAPP vs. Rank will result in better mental-health care for the citizens of California and at lower cost. The decision asserts that patients have the right to choose treatment by a psychologist rather than a psychiatrist upon admission to a hospital if they wish to do so.

Clinical psychologists are extremely well - qualified to assume full responsibility for their hospital patients. A Ph.D. in clinical psychology now takes an average of 7.1 years of graduate study to complete. They have an excellent record of providing safe and effective care in all settings and are well-trained to recognize the signs of organic and physiological disturbances that would warrant a referral to another health care provider such as a physician.

In fact, over the last 15 years, the brightest undergraduate students interested in the mental health field have tended to go to clinical psychology programs, making those programs among the most competitive in the country for admission.

This combination of rigorous training and bright students has spawned a young and very competent group of professionals who have had a significant impact on psychiatric economics. In fact, when patients are free to choose either a psychologist or a psychiatrist, a majority of individuals now choose psychologists.

Other studies also document that psychologists typically provide the services at lower costs than psychiatrists. Psychiatrists and their medical colleagues, for all their wonderful virtues, have a well-documented dark side when economic matters are involved. Their opposition is to be expected.

The growth of professional psychology over the last 20 years has constantly been challenged by organized psychiatry and organized medicine. In every battle in both the out - patient area and the in-patient area, the psychiatrists and medical interests have waged the same scare campaign. They argue that psychologists are not “medical” doctors, and are not qualified to treat hospitalized patients.

In fact, both professions are trained to recognize signs of “medical” conditions leading to mental symptoms. The only studies that exist document the fact that it is psychiatrists themselves who often lose touch with their medical training and fail to make appropriate referrals. In a recent review of malpractice cases in the state of California, no psychologist was found liable for failure to make an appropriate referral to medical colleagues. The same was not true for psychiatrists.

We hope the recent Supreme Court decision will lay this turf issue to rest. The rivalry between the two groups can and should be turned into a healthy competitive struggle designed to improve the quality of services offered to California citizens while encouraging each group to provide those services at the lowest possible cost.