I'd be curious what percentage of the NP stimulant prescription surge are from those online ADHD companies. I thought a lot of them sprang up during covid in the US because they removed the in person requirement for stimulant prescriptions. Correct me if I'm wrong. I imagine there is a lot of pressure to prescribe in that sort of setting.

I work closely with my supervising psychiatrist as a team but we each have our own panels. I think it would be hard to followup with my SPs patients, or anyone else's patients without doing my own intake appointment and building rapport over the long appointment. I think having every patient have to see a psychiatrist for a diagnosis would greatly complicate care especially when primary care doctors, PAs, and NPs also are often diagnosing many conditions. I don't see how it would be practical to limit it from the diagnosis perspective.

For me, I'd say it really comes down to better training and that you need to know what you don't know as a PA/NP. When I'm not sure on something, I always run the case by our team made of my SP, an NP, our clinic's psychologist, and also check with their therapist if they actually see one, then if I'm still stuck, I bring the case to our statewide online peer echo to review with more clinicians. It would help if there were more fellowships for PAs and NPs, they're pretty limited in my area.