Expanding psychologists’ scope of practice would undermine continuity of care: CFPC

The College of Family Physicians of Canada (CFPC) is calling on the Ontario government to reconsider its plan to expand the scopes of practice of certain health professionals.The CFPC recently released a statement that addressed, in particular, the province’s plan to allow some psychologists (those who hold a postdoctoral master of science degree in clinical psychopharmacology, or an MSCP) the power to prescribe certain medications including antidepressants.The CFPC argued that fragmenting mental-health care among multiple providers undermines continuity of care and patient safety.“We urge the Ontario government to reconsider these proposed changes and to focus on policies that reinforce coordinated, team-based primary care, ensuring that all Ontarians receive safe, effective, and continuous care with the expertise of family physicians.” the statement reads.The CFPC called on the province to support policies that “reinforce coordinated, team-based primary care” and argued that “[t]rue health care transformation” should include the integration of psychologists into family physician-led healthcare teams. It also wrote that the province’s proposal “raises questions” about safe prescribing. It noted that family physicians have to undergo extensive training and education to develop their pharmacological and diagnostic competencies. Family physicians also have a better understanding of the full context of their patients’ health including comorbidities, medication-related syndromes and concurrent treatments, and are better positioned to provide follow-up care, the CFPC argued.Furthermore, the MSCP is currently not offered in Canada, and it would take considerable resources to launch such a program, the CFPC noted.It pointed to a study published in October that found that compared to patients of primary-care providers, patients of prescribing psychologists had higher rates of psychiatric emergency department use (138% more) and higher rates of psychotropic polypharmacy (175% more).The CFPC also noted that the overwhelming majority (70%) of psychologists in Ontario practice in the private sector, which has “concerning implications” for mental health-care accessibility.“Challenges are especially acute for those lacking adequate workplace or extended health coverage. As a result, many Ontarians, particularly those in disadvantaged populations, cannot afford mental health care through these private providers,” the statement reads.

Expanding psychologists’ scope of practice would undermine continuity of care: CFPC

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