Nobody should want a different set of medical credentials to apply simply because of where the patient happens to seek treatment.

And yet that is the upshot of a bill that narrowly passed both legislative houses and now awaits a decision by Gov. Linda Lingle.

Her decision should be to veto this measure.

Senate Bill 1004 would authorize prescriptive authority for qualified psychologists who practice at a federally qualified health center.

The impetus for this measure comes from a chronic shortage of psychiatrists available to treat patients in rural areas, especially on the Neighbor Islands.

And that is a crisis. There needs to be more salaried positions for psychiatrists at these centers in the long term. In the short term, psychiatrists statewide need to accelerate efforts to fill the gap through initial face-to-face appointments to begin the treatment, interspersed with teleconference follow-up consultations.

Giving prescription authority to psychologists, who have an entirely different training for therapies that rely less on chemical interventions, is not the right solution to this crisis.

Even though the bill limits the prescriptive authority to antidepressant, antianxiety and mood-stabilizing drugs, some doctors are rightly concerned that even these drugs carry risks that need supervision by a medical doctor.

These drugs can have many medical side effects, and the training being proposed for psychologists falls short of what advanced-practice nurses get in order to be able to prescribe drugs.

Hawai'i has a healthcare system that is struggling to cover the residents' needs. But that effort is hindered, not helped, by establishing a second tier of medical care to our rural communities.