Comments keep coming …

Member: “Yes, there are several real issues here. There is the issue of the Medicare rebate disparity. There is the issue of discrimination for employed roles and contracts. There is the issue of limiting the services that many psychologists are able to offer under Medicare. There is the issue of reports not being accepted by Centrelink and other entities. The aforementioned issues are all entwined, and seem to have their roots in the decision to rebate psychologists differently based on whether they have endorsement in clinical psychology. There is also the issue of GPs dictating services. I would hope that the APS is advocating on our behalf on ALL of these issues.

Until recently I was confident that they had been, but seeing the FOI documents has caused me to believe otherwise. I do have some hope that this is changing, but I will be watching much more carefully from now on.”

Member: “This is about the rebates again. A clinical psych can get the tier one rebate whether they got their endorsement yesterday or 40 years ago. A non-clinical psych cannot get the tier one rebate no matter how long they have been registered. No-one (as far as I’m aware) is arguing that a clinical psychologist with decades of experience is inferior, however the rebates imply that a non-clinical psychologist is inferior, even if they have decades of experience, even if they have plenty of training, and even if they have endorsement in other areas. The comparisons between experienced non-clinical psychologists and newly endorsed clinical psychologists keep occurring because this is the aspect that becomes upsetting to an experienced non-clinical psychologist.”

Member: “What seems to be most confusing is what is the real issues. It is delivery of service standards?; is it recognition as a professional?; is it money based on rebates? or what. Reading all comments seems to blur all these line with no discernible way forward. I go back to my other comments that the reality is the system was flawed right from the start.”

Member:“This is the issue myself and many othrs are facing. I was offered a job placement that inluded my 4th year and internship. I took it, not realising that it would then limit my options to specialise down the track. I’ve since become a single mum with my own practice in rural NSW. I would love to specialise in developmental psych, however my only options would be to shut my practice and move my family interstate. All at the end of it, id be no better off financially than I am now. Clinical psych would at least allow me the higher rebate but options are limited, and there is minimal subjects based on child and adolescents, which is my preferred caseload.
Hardly good options and I would not be the only one facing these difficulties.”

10 thoughts on “Comments keep coming …

  1. Ten years ago, I retrained as a psychologist. I was offered a place in Honours and in Post.Grad.Dip. When making the decision, my fellow students and I asked the lecturers for guidance. I was told if I wanted to do a masters/be an academic to choose Honours and if I had not intention for an academic career that the Post Grad Dip was ‘more practical’ for those wishing to ‘practice’ psychology. I chose Post.Grad.Dip on the basis that I wanted to be a practicing psychologist and not an academic . Since, several of my cohort have approached universities to be told that there is little to no chance of us being accepted into a Masters program. No one mentioned it was a path which my own peak body would advocate to reduce in the eyes of my colleagues, other professionals, and the wider community.

  2. I think that the system (Medicare use of psychologists) was not flawed initially, but that one section only wanted to be acknowledged and included and were quite determined that was the only way for it to be done. It was reported to me that after much discussion that the two tier system was devised to have all included, but to calm the heat and enable the proposed agenda to go forward. I do think that using practitioners in Private Practice is a much cheaper way for the Govt. to provide psychological care to citizens than for more Mental Health facilities being built and maintained, plus employing adequately trained people to staff these facilities, plus the on costs of their employment.
    Of course adequate care for the community will mean less suffering and greater ease within relationships. In many cases this will enable these people to either/ both contribute to their community financially via taxes or in less measurable ways such as raising happier kids.
    Some GPs have a good understanding of what I am able to offer patients as a psychologist.
    One of my cousins lectures to psychologists in Britain. Over there they have moved away from more and more training such as PhD as they have discovered that it does not improve outcomes.

    1. Well, Australia also does not give any professional recognition to PhD’s in the context of practicing as a psychologist. Does Britain allow psychologists to practice after completing a four year undergraduate program and then a two year supervised internship?

      1. A PhD is a research degree, it doesn’t make someone a medical practitioner anymore than it makes someone a psychologist…

        1. No, you can’t practice clinically as a psychologist in the UK without a professional postgrad degree

            1. Undergraduate and 4th year programs are not equivalent across international jurisdictions are they? So the argument that other countries require Doctorates etc. is moot. When I was at uni last century the lecturers, some from the US, told us that the US system was “Mickey Mouse” compared to ours such that an honours degree here was equivalent to a Post graduate qualifiction there. Remember they do thinks like ‘pre-med’ and ‘pre-law’ etc. at college, before people go on and do ‘masters’ and things like that. Don’t quote me. The years are marching by quickly and things change.

              1. Hi Greg,

                this is clearly an emotional issue and there are lots of important discussion to be had. But we need to base discussions on concrete facts if they are to be constructive.

                In the UK, you need to have a professional doctorate to be a registered practitioner psychologist. So that is an undergraduate degree, plus a professional doctorate in an area such as clinical, counselling etc.

                If you compare this to Australia, it would mean that only the only people allowed to practice as a Psychologist would be those who have achieved area of practice endorsement such as Clinical or Counselling Psychologists

                People with only an undergraduate degree or a Masters or Doctorate that is not an approved professional degree can work as Psychology Assistants or Clinical Associates under the supervision of Clinical Psychologists. Or as a Psychological Wellbeing Worker in stepped care, also within a supervised practice environment.

                Often people work in these roles to gain experience and improve their chances of gaining entry to professional postgrad training

                You can check it for yourself here:

                https://beta.bps.org.uk/public/become-psychologist/related-roles-and-careers

                As much as you may feel that Australian psychologists are uniquely victimised, they are actually unusual in being able to work clinically using the title Psychologist and without postgraduate training.

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