Psychology Practice Area 171 Practice Area 171 CLINICAL ...

PsryacthicoeloAgyrea 171 Practice Area 171

CLINICAL PRIVILEGE WHITE PAPER

Psychology

Background

Psychology is a broad field that includes the scientific study of mental processes and
behavior. It is similar to the medical field of psychiatry. Psychologists focus on the
development of personality and the workings of the nervous system, and investigate
the attitudes and relationships of human beings in social settings. Most psychologists
have an MA, PhD, or PsyD degree, and may or may not specialize in the treatment of
mental disorders.

The state of Florida, for example, defines psychology as the use of psychological meth-
ods to diagnose and treat:

• mental, nervous, psychological, marital, or emotional illnesses;
• disability, alcoholism, and substance abuse;
• disorders of habit or conduct; and
• psychological aspects of physical illness, accident, injury, or disability, including

neuropsychological evaluation, diagnosis, etiology, and treatment.

The question of whether hospitals should grant admitting privileges to psychologists
is very controversial. Most psychologists are considered allied health practitioners in
many institutions and therefore hospitals do not grant them admitting privileges.
Moreover, most states’ laws do not address this issue. Wisconsin is the only state to
expressly permit psychologists to hold admitting privileges. In comparison, Ohio law
prohibits psychologists from holding admitting privileges.

Involved specialists Psychiatrists and psychologists. Allied health professionals,
such as social workers; marriage, child, and family counselors;
and psychiatric nurse practitioners, very often treat mental,
emotional, or behavioral disorders. Furthermore, studies by
the National Institutes of Mental Health have shown that
family physicians treat more cases of mental or emotional
disorder than psychiatrists.

Positions of societies The APA feels that qualified psychologists have the requisite
and academies skills to provide psychological services to patients in the hospi-
tal setting independent of physician services. This position is
APA based on psychologists’ status as independent mental health
professionals under state psychology scope of practice statutes.

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Psychology Practice Area 171

The APA formed a Task Force on Hospital Privileges to review
the issue of establishing standards for developing criteria nec-
essary for privileges, reviewing credentials, recommending
specific privileges for psychologists, specifying criteria for
renewal of privileges, and participating in the renewal of
privileges. The resulting document, “Guidelines on hospital
privileges: Credentialing and bylaws,” as developed by Robert
Resnick, Michael Enright, and Robert Thomson, was adopted
as official APA policy in August 1991.

In “Analysis of Existing Hospital Practice Laws for Psycholo-
gists,” Elizabeth Cullen, JD, MPA, the APA’s practice
directorate, says the ability of psychologists to practice in
the hospital setting without physician oversight is measured
by the right to apply for membership on a facility’s medical
staff and to enjoy full clinical, admitting, and discharge privi-
leges within the scope of their professional license. It has long
been the position of the APA that qualified psychologists have
the requisite skills to provide psychological services to patients
in the hospital setting independent of physician services.

In October 1993 the American Psychological Association
(APA) conducted a review of state laws. The following table
outlines its findings.

Hospital Admitting Privileges for Psychologists

States Legislation continued
Alabama Limits admitting to physicians
Alaska Permits admitting by not specifically prohibiting it
Arizona Permits admitting by not specifically prohibiting it
Arkansas Limits admitting to physicians
California Authorizes admitting
Colorado Permits admitting by not specifically prohibiting it
Connecticut Limits admitting to physicians
Delaware Limits admitting to physicians (may be revised)
District of Columbia Permits admitting by not specifically prohibiting it
Florida Permits admitting by not specifically prohibiting it
Georgia Permits admitting by not specifically prohibiting it
Hawaii Authorizes admitting
Idaho Permits admitting by not specifically prohibiting it
Illinois Limits admitting to physicians
Indiana Permits admitting by not specifically prohibiting it

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Psychology Practice Area 171

States Legislation
Iowa Permits admitting by not specifically prohibiting it
Kansas Limits admitting to physicians
Kentucky Limits admitting to physicians
Louisiana Permits admitting by not specifically prohibiting it
Maine Limits admitting to physicians
Maryland Permits admitting by not specifically prohibiting it
Massachusetts Permits admitting by not specifically prohibiting it
Michigan Permits admitting by not specifically prohibiting it
Minnesota Permits admitting by not specifically prohibiting it
Mississippi Joint admitting only
Missouri Limits admitting to physicians
Montana Joint admitting only
Nebraska Permits admitting by not specifically prohibiting it
Nevada Limits admitting to physicians
New Hampshire Permits admitting by not specifically prohibiting it
New Jersey Permits admitting by not specifically prohibiting it
New Mexico Limits admitting to physicians
New York Limits admitting to physicians
North Carolina Permits admitting by not specifically prohibiting it
North Dakota Limits admitting to physicians
Ohio Limits admitting to physicians
Oklahoma Limits admitting to physicians
Oregon Permits admitting by not specifically prohibiting it
Pennsylvania Limits admitting to physicians
Rhode Island Permits admitting by not specifically prohibiting it
South Carolina Limits admitting to physicians
South Dakota Permits admitting by not specifically prohibiting it
Tennessee Limits admitting to physicians
Texas Limits admitting to physicians
Utah Permits admitting by not specifically prohibiting it
Vermont Limits admitting to physicians
Virginia Permits admitting by not specifically prohibiting it
Washington Permits admitting by not specifically prohibiting it
West Virginia Permits admitting by not specifically prohibiting it
Wisconsin Authorizes admitting
Wyoming Permits admitting by not specifically prohibiting it

Source: American Psychological Association, October 1993

A supplement to Briefings on Credentialing 781/639-1872 Criteria reviewed 2006 3



Psychology Practice Area P1r7a1ctice Area 171

that a physician is responsible for the necessary
medical care. The court concluded that when
state laws say nothing about who may admit
patients to hospitals, “the psychologists’ statutory
authority to carry out the responsibility of diag-
nosis and treatment implies the authority to
admit patients for these purposes.”

CRC draft criteria The following draft criteria are intended to serve
solely as a starting point for the development of
an institution’s policy regarding this practice area.

Minimum threshold Education: PhD or PsyD
criteria for requesting Minimum formal training: The successful appli-
cant must be able to demonstrate successful
core privileges in completion of an approved doctoral degree from
psychology a regionally accredited training program.
Required previous experience: The successful
applicant must be able to demonstrate that he or
she has provided inpatient, outpatient, or consul-
tative service to at least 30 patients during the
past 12 months.

Note: Three letters of reference must come from practi-
tioners who have known the applicant for at least two
years and who are acquainted with his or her current
professional status.

Core privileges Privileges include being able to diagnose, provide
in psychology treatment, and consult to patients above the age
of 15 who suffer from mental, behavioral, or
emotional disorders. Privileges can include bio-
feedback and hypnotherapy. These privileges do
not include any of the following special requests.

Special requests Hospitals should base their psychologist’s eligibil-
for psychology ity to admit or coadmit on state law as well the
clinician’s training and experience.

For more information For more information regarding privileging this
practice area, contact:

American Psychological Association
750 First Street NE
Washington, DC 20002-4242
Telephone: 202/336-5500

A supplement to Briefings on Credentialing 781/639-1872 Criteria reviewed 2006 5 5