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Opinion: Should pharmacists and psychologists have the power to prescribe?

There is a physician shortage in the U.S., and Utah’s need is particularly acute

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Should pharmacists and psychologists have the authority to prescribe medications?

Should pharmacists and psychologists have the authority to prescribe medications?

Kimberly Boyles, Adobe.com

Like the rest of the United States, Utah doesn’t have enough doctors. In fact, data has generally shown that Utah’s physician shortage is particularly acute and ranks below average relative to the rest of the U.S. in physician density.

The challenge can be explained in simple economic terms. Demand for health care continues to grow as the population grows older. Utah also expanded Medicaid eligibility in 2019, further contributing to increases in demand.

Supply of physicians, however, has not kept up with this growth in demand. As a result, patients have a harder time getting an appointment and may experience longer wait times. Patients may also have long drives to access care.

Thankfully, the Utah legislature has recognized the severity of this problem and taken important action. In March, Gov. Spencer Cox signed SB36. The new law permits nurse practitioners to work to the full extent of their highly specialized training and skill level. With the passage of this law, Utah has joined 26 other states and the District of Columbia that have already granted nurse practitioners this privilege.

Research overwhelmingly shows that allowing nurse practitioners the opportunity to do the work that they have been trained to perform increases access to care and does not jeopardize health and safety.

And Utah has also shown that it does not mind being a leader. In 2021, Cox signed SB27. With the enactment of this law, Utah became the second state to give physician assistants a pathway to independent practice. Physician assistants are also fully capable of providing high quality care. My own research documents the potential cost savings for Medicaid patients after physician assistants are permitted to work to the full extent of their specialized training.

Both of these reforms are excellent steps to help alleviate the shortage of health care providers. Utah can go further, however.

First, Utah should consider empowering pharmacists to prescribe in clearly defined circumstances. Both bordering state Idaho and close neighbor Montana have enacted this reform. My research shows that Idaho has already realized important increases in access to treatment for asthma and diabetes patients as a result of this reform. And there is no evidence of any harm to patients in the state from the reform. Utah could expect similar benefits with the same reform.

Second, Utah should consider empowering psychologists with limited prescription privileges. Twenty-eight out of the 29 counties in Utah are designated as Mental Health Professional Shortage Areas by the Health Resources & Service Administration. Portions of Utah County are also designated as a shortage area. This means that most Utah residents have difficulty finding and receiving timely mental and behavioral health treatments when they are in crisis. 

Psychologist prescriptive authority, which would allow psychologists to prescribe a limited range of mental and behavioral health medications, may be one way to close the gap and provide more options for care in professional shortage areas. Five states (including bordering state Idaho) have already passed this reform. Research by my Knee Center colleague Alicia Plemmons illustrates how this reform can increase the number of mental health providers in a state without compromising quality.

In short, policymakers in Utah should be commended for taking appropriate action to help address health care shortages. Utah has shown the courage in the past to be a national leader. Utah can look to its close neighbor Idaho for guidance on how to take the next steps forward and make sure that its citizens have access to the care that they need.

Edward Timmons is a service associate professor of economics and director of the Knee Center for the Study of Occupational Regulation at West Virginia University.