In the July 5 issue, Dr. Carlos Guzman articulated some salient points against the certification of psychologists for prescribing psychotropic medication. The dilemma is, How can a clinician prescribe a medication without full medical knowledge and training?

Knowing the psychopharmacology alone is insufficient in assessing the mental health of a patient, both medically and neurologically. There are many patients who have multiple medical problems and neuralgic disorders that must be addressed in their evaluation. Many can mimic anxiety and depression.

How will a psychologist assess and treat a 72-year-old woman who presents as depressed and anxious with a change in her personality? To miss the diagnosis of a stroke or delirium or cardiac, endocrinoligic, or infectious problems not only is a disservice to patients and their families, but also could result in the death of a patient.

The sphere of psychiatry has to include a full medical perspective. It is imperative to the lives of our patients and their families.