For Our Physician Colleagues
Texas physicians and psychologists already work side by side. Sharing patients, referral relationships, and the same daily reality: far more Texans need psychiatric medication management than there are clinicians available to provide it.
This page is written for our colleagues in medicine. It lays out what HB 5537 requires, what the published evidence shows, and what working alongside a prescribing psychologist looks like in practice. Below are some examples of this collaboration.
Training and coursework are covered in detail on our Training page.
The Safeguards Built Into The Law
HB 5537 creates a phased, supervised pathway to prescriptive authority. Before a psychologist writes a single prescription, the law requires, in order:
Completion of a postdoctoral psychopharmacology program;
A passing score on a national examination;
An 80-hour practicum in clinical assessment and pathophysiology supervised by a physician;
A 400-hour supervised practicum treating no fewer than 100 patients.
Completing those four steps earns a conditional certificate only. Prescribing then continues under a supervising clinician (a physician or an experienced prescribing psychologist) for at least two years, followed by an independent peer review, before a full prescription certificate is granted.
The law also keeps the primary care physician in the loop. Under Section 501.375, a prescribing psychologist must notify the patient's primary care practitioner within 72 hours of issuing or changing a psychotropic prescription.
The bill's advisory committee on prescriptive authority is required to include a psychiatrist and a pediatrician or primary care physician. The change is fee-funded and administered by the existing Texas Behavioral Health Executive Council. It requires no new agency, no new appropriation.
What Physicians Report
Two published surveys have asked medical providers who worked directly with prescribing psychologists what they observed.
At a large Army family medicine clinic, Shearer and colleagues (2012) surveyed 47 medical providers, after two years alongside an embedded prescribing psychologist. 95.6% found the arrangement helpful to their practice, 93.6% were confident that referrals for psychotropic management were safe, and 87.2% said their patients' care had improved. No respondent raised a patient-safety concern.
Linda and McGrath (2017) surveyed prescribing psychologists and their medical colleagues. The psychologists were "overwhelmingly perceived positively," and no physician in the sample reported concerns about inappropriate prescribing, incorrect dosages, or failure to consult or refer when needed.
Both samples are small, but both point in the same direction: physicians with direct working experience reported improved care and no safety problems.
A 30-Year Track Record
Properly trained psychologists have prescribed within the U.S. military, the Public Health Service, and the Indian Health Service for over three decades. The program began with the Department of Defense, whose participants the U.S. Government Accountability Office found performed well.
Eight states have since authorized prescriptive authority for psychologists: New Mexico (2002), Louisiana (2004), Illinois (2014), Iowa (2016), Idaho (2017), Colorado (2023), Utah (2024), and Vermont (2026); Hawaii has separately enacted a supervised, pilot program (2026).
The largest population-level analysis to date, with more than 307,000 patients, found that patients of prescribing psychologists had a 24% lower rate of adverse drug events and 20% less psychotropic polypharmacy than patients of psychiatrists.
What Collaboration Looks Like and How You Can Help
McGrath and Sammons (2011) described prescribing and primary care psychology as complementary paths toward integrated care: a clinician who already knows the patient's psychological history, managing medication in coordination with the medical home. HB 5537 is built to support that relationship.
We are glad to connect you with physicians who have worked alongside a prescribing psychologist and can describe the day-to-day directly. If you already support this change, the most useful step is to let your legislator hear it from you.
That the access problem is real, and that you have reviewed this training and trust it.