Hubris of the First DNP Dermatologist from USF

[CandidateofDerm]

Originally Posted by DNPgator
I was turned onto this site by a friend and colleague of mine Dr. Debra Shelby. I read all the thoughtless banter and venom spewed by the excessively opinionated and unexpectedly uneducated medical students. I have earned my Doctoral of Nursing Practice degree and the right to be called doctor just as everyone else who earns a doctoral degree. Please study up on the history and meaning of the word "doctor" it would serve the medical profession well for most of you have forgotten or never knew its origin.

I call myself doctor and pursued this educational route, not because of a lack of intelligence or work ethic as many of you have proposed on the blog, but because I love providing care to my patients.

I am not a medical doctor by choice not because I could not hack it. I would invite you all to spend a few months working alongside you RN colleagues in the hospitals before you are so quick to assert your intellectual superiority. Nurses have been providing compassionate, caring, and comprehensive care since before the time that "doctors" were treating the humors and boring holes in skulls to release evil spirits.

I do not try to hide my identity from my patients or try to fool them or mislead them. The insinuation is that everyone wants to be you because you are the standard by which all else should be measured. The arrogance of this concept is beyond reproach. In my opinion, the education that is provided to medical students is substandard because it only focuses on the physical. Mind, spirit, and body cannot be separated. They are intertwined.

Lets call a spade a spade. You don't care about patient safety, if you did then physicians would lobby for every patient to be seen in consultation with a NP. You all care about the title, presitige, and money. NP's are highly educated, well trained, and effective contributors to the health care system with or without physicians. This has been shown in multiple control trials. I will list a few:
Kinnersley et.al. BMJ 320(7241) 1043-1048
Mundinger et.al. JAMA 283(1) 59-68
Shum et.al. BMJ 320(7241) 1038-1043
Venning et.al. BMJ 320(7241) 1048-1053
Ohman et.al. Annals of Family Medicine 6: 14-22

There are many others like these but I only included a few. I would challenge all of you to find one that says otherwise. In primary care of patients, NP's and now DNP's have provided comparable and at times superior care than our physician brethren. Those are the facts. Not opinion as were all of your posts. The truth of the matter is that we are better at caring for people than you people prefer our services to yours time and time again. There are no studies that show to the contrary. We also do a much better job at educating patients on disease processes than you. This is also not an opinion, but proven in these studies, printed in your journals. GET OVER YOURSELVES!!!!! Join the battle for better healthcare and quit worrying about your bank accounts. No one cares when we treat the indigent, underserved, and rural areas without physician supervision but you get your panties in a wad when we say we don't need you to take 70% of what we earn and put it in your pockets despite not doing a damn thing to treat a patient.

I am not claiming, nor do I want to be a surgeon, cardiologist, endocrinologist, or any one of the many specialists who provide comprehensive care to moderate to high acuity patients. I and most other NP's and DNP's know when a patient walks in the door if their problems need referral to more specialized not primary care. I specialize in dermatology and you better believe I can out diagnose, treat, and care for my patients than any of you students. You haven't been around long enough to earn an opinion.

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Oh is that right? Tell the good "Doctor" we said 'This page is currently unavailable'.

Ah, you mean the nurse who made the video about herself calling herself "doctor" and saying she was the program director of the dermatology residency. Sounds like she got called on it.

--------------------------------------------------------------------------------------

.....actually she didn't get called out on anything. The video and powerpoint is down and will be updated with current info. Once again you think you know it all and assume you know what is going on. Sorry boys, you did not win anything.

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[CandidateofDerm]

This is a post from the general residency section. This is either Dr. Debra Shelby or one of her friends.

It is time to to redouble our efforts. This is the type of hubris you can expect from every DNP. Not only are they equivalent in their eyes, but they are actually better than you. She already states that she outdiagnose all the posters in the general residency forum. I can only imagine what she says to her friends at dinner when they ask.

She has also let us know that we have not won this battle and the program is not going away. Now is the time to act.

1. Ask for an update from the AAD on what is happening.
2. Contact fellow residents --> especially any residents who have an affected field ---> dermatology, Emergency medicine, Internal medicine, etc. --> just look at the list. Obviously all residents should be worried.
3. Contact your state medical societies. Be proactive. Make sure the laws and truth in advertising are in the works BEFORE these DNPs reach the market place.


PS: Sorry for the misleading title. This is either Dr. Debra Shelby posting or this is one of her Derm DNP friends. I jumped the gun is assuming this was one of the first graduates of the program who was trying to disguise her identity, but that probably is a stretch!

 

[DrMeditrina]

Please post a link to the original post. Thanks.

 

[skin tag]

This is the kind of monster we can all thank USF's department of dermatology for creating.

I would like to further add to the above suggestions:

4.) This topic absolutely needs to be brought up at either the AAD's summer meeting or next annual meeting in Feb 2011. Calling and emailing the AAD is good for now, but our voices will be best heard in unison during an open forum at the next conference.
5.) Medical students applying for the next match cycle should protest USF by not applying to their dermatology residency program. That would send a very strong message. I know derm interviews are hard to come by, but seriously, would you really want to train at a place where you play second fiddle to DNPs?
6.) When considering hiring mid-levels, PAs should be heavily favored over DNPs. Remember DNPs can leave your practice and easily become your competition after you put in all the hard work to train them.

 

[JaggerPlate]

I think that post should be forwarded to the AAD and USF real derm residency program (if that's kosher though SDN).

 

[sore eye asses]

DNPgator is purported to have said:

...excessively opinionated and unexpectedly uneducated medical students.

In my opinion, the education that is provided to medical students is substandard...

so, i'm confused. despite your claim that medical students receive substandard education (though you've not been through medical school to certify that claim), you did not expect them to be uneducated?

Where were these mythical med students meant to have learned whatever it is you think they should know?

 

[Dral]

I'd like to see how this person practices. Does she spend an hour with each patient addressing their 'mind, spirit, and body' or does she see patients every 10 minutes like most dermatologists do?

She insinuates that we, as physicians or future physicians are in it for the money, but I wonder if she truly feels she doesn't do it for money, hiding behind the possible excuse of having to see that many patients (if she does) because so many need care.

Sounds like a lot of her arguments may be convenience arguments and not much more.

Making the blanket statement that we don't care about patient safety is just as horrid as any statements some medical student has made about her style of health care delivery. I'm officially disgusted. I need to not return to this thread because I lose huge chunks of respect for these people every time I read something here.

 

[JaggerPlate]

More verbal poetry from DNPgator:

I have had fun with this. I am going to help you all out here. You can thank me later. I figured what I posted would get your attention. You all obviously love your chosen field and are passionate about this issue. You are idealists, I can respect that, but so were those at Jonestown. Don't be so quick to drink the hate the DNP kool-aid. "Can't we all just get along?" Rodney King

You are focusing on the wrong issue. You as a group should be applauding a formalized residency program for NP's and DNP's. These are organized by the nursing programs but are administered in large part by MD's at teaching hospitals alongside medical residents. My biggest problem with my profession as a whole is a lack of standardization in training for advanced practice. Whether you like it or not, there is a need for advanced practice nurses. We are not mid-levels or extenders. My knowledge base and ability to care for patients does not stop at a physicians umbilicus nor am I some phalic extending off the great body of medical knowledge. We, as you all have pointed out, some eloquently, others rudely, are also not physicians. We are health care providers though and most of us do a great job in our roles.

I am not a psycho like some have said nor am I a rogue NP demanding independence and equal pay. Those battles have been raging for years. Do I think we deserve this as DNP's, yes, but that is not why I chose to get this degree. I do like to ruffle feathers and hope that people will stop and think about what we DNP's with clinical degrees are trying to accomplish. Standardized training for advance practice nurses. This is the goal.

A video produced by the college of nursing for prospective nursing students where someone with a doctorate in nursing calling themselves doctor should not upset you this much. By 2015, there will be no more Masters level programs. All NP will have doctoral degrees. It is my hope, and from my understanding, it is the plan, that these programs will be transparent and the learning experiences will be more formalized.

I agree that the NP education and training at the Masters level is insufficient for independent practice, but in some states we already have it. Some of your colleagues train NP's for 6 weeks and set them loose on their patients. This leads to wide disparities in training. This is why the DNP is important.

I do not believe that we as a profession should be in a subservient role to physicians. I work alongside and in collaboration with many excellent doctors including Mohs surgeons, Plastic surgeons, cutaneous surgical oncologists, and dermatologists. They understand and respect my degree and training. I also defer to their expertise when needed. I know when that is needed.

The real patient safety issue regarding Nurse Practitioners is the lack of standardized residency programs to ensure proper training and physicians who are looking to make more money by seeing patients in clinics utilizing undertrained providers. Programs like those at USF and other DNP programs are trying to address this issue.

Is this what physicians and future physicians want?? If not, contact the AMA, AAD, etc, immediately.

thread link:
http://forums.studentdoctor.net/showthread.php?t=718880&page=15

 

[sore eye asses]

Our only real point, DNPgator, is that pay and title should be commensurate with skill and knowledge base.

If you can prove to me that your attenuated education is equivalent to or better than the 20,000+ hours of training a BC derm gets, then I will cede all arguments.

The problem is, you're asking for something you did not earn, and it's offensive to those of us who sacrificed (or are currently in the process of sacrificing) so much to get where we are.

An analogy would be a med assistant asking to be referred to as a nurse. She would claim that despite her having far less training, she still does 90% of what a nurse does. She cares for the patient just the same. Would this offend you, as a nurse? Would this cheapen the hard work you had put in to become a nurse? What if it wasn't just one MA that was making these claims, but a whole group? And what if that group was lobbying to make themselves appear equal to nurses in the clinical setting? Would this offend you? Would this frighten you? It ought to. Would you wonder why they just didn't go to nursing school if they wanted to have the rights and priviledges that go along with that title?

And as a final note, I take no issue with DNP derm programs. Just, when you finish, refer to yourself by your earned title, that of DNP. To call yourself doctor, and leave it at that, purposely creates confusion.

 

[FutureDoc4]

sore eye asses,

I would encourage you to go to the original thread to comment. I don't think many people come over to the derm forum often enough to see your comments.

http://forums.studentdoctor.net/showthread.php?t=718880&page=15

 

[N-Surge]

I do not believe that we as a profession should be in a subservient role to physicians. I work alongside and in collaboration with many excellent doctors including Mohs surgeons, Plastic surgeons, cutaneous surgical oncologists, and dermatologists. They understand and respect my degree and training. I also defer to their expertise when needed. I know when that is needed.

This statement contradicts itself...

 

[illegallysmooth]

Am I the only one who finds it funny she compares her skills to medical STUDENTS?

 

[modelslashactor]

She insinuates that we, as physicians or future physicians are in it for the money, but I wonder if she truly feels she doesn't do it for money, hiding behind the possible excuse of having to see that many patients (if she does) because so many need care.

This is always my favorite part about their agenda. They never bother to explain what exactly they are fighting for because it is also money. I doubt it is an undying passion to practice dermatology, they created these degrees to get a piece of the pie, pure and simple.

 

[JaggerPlate]

This statement contradicts itself...

I know ...

 

[ProRealDoc]

Originally Posted by DNPgator
I was turned onto this site by a friend and colleague of mine Dr. Debra Shelby. I read all the thoughtless banter and venom spewed by the excessively opinionated and unexpectedly uneducated medical students. I have earned my Doctoral of Nursing Practice degree and the right to be called doctor just as everyone else who earns a doctoral degree. Please study up on the history and meaning of the word "doctor" it would serve the medical profession well for most of you have forgotten or never knew its origin.

I call myself doctor and pursued this educational route, not because of a lack of intelligence or work ethic as many of you have proposed on the blog, but because I love providing care to my patients.

I am not a medical doctor by choice not because I could not hack it. I would invite you all to spend a few months working alongside you RN colleagues in the hospitals before you are so quick to assert your intellectual superiority. Nurses have been providing compassionate, caring, and comprehensive care since before the time that "doctors" were treating the humors and boring holes in skulls to release evil spirits.

I do not try to hide my identity from my patients or try to fool them or mislead them. The insinuation is that everyone wants to be you because you are the standard by which all else should be measured. The arrogance of this concept is beyond reproach. In my opinion, the education that is provided to medical students is substandard because it only focuses on the physical. Mind, spirit, and body cannot be separated. They are intertwined.

Lets call a spade a spade. You don't care about patient safety, if you did then physicians would lobby for every patient to be seen in consultation with a NP. You all care about the title, presitige, and money. NP's are highly educated, well trained, and effective contributors to the health care system with or without physicians. This has been shown in multiple control trials. I will list a few:
Kinnersley et.al. BMJ 320(7241) 1043-1048
Mundinger et.al. JAMA 283(1) 59-68
Shum et.al. BMJ 320(7241) 1038-1043
Venning et.al. BMJ 320(7241) 1048-1053
Ohman et.al. Annals of Family Medicine 6: 14-22

There are many others like these but I only included a few. I would challenge all of you to find one that says otherwise. In primary care of patients, NP's and now DNP's have provided comparable and at times superior care than our physician brethren. Those are the facts. Not opinion as were all of your posts. The truth of the matter is that we are better at caring for people than you people prefer our services to yours time and time again. There are no studies that show to the contrary. We also do a much better job at educating patients on disease processes than you. This is also not an opinion, but proven in these studies, printed in your journals. GET OVER YOURSELVES!!!!! Join the battle for better healthcare and quit worrying about your bank accounts. No one cares when we treat the indigent, underserved, and rural areas without physician supervision but you get your panties in a wad when we say we don't need you to take 70% of what we earn and put it in your pockets despite not doing a damn thing to treat a patient.

I am not claiming, nor do I want to be a surgeon, cardiologist, endocrinologist, or any one of the many specialists who provide comprehensive care to moderate to high acuity patients. I and most other NP's and DNP's know when a patient walks in the door if their problems need referral to more specialized not primary care. I specialize in dermatology and you better believe I can out diagnose, treat, and care for my patients than any of you students. You haven't been around long enough to earn an opinion.

--------------------------------------------------------------------------------------


Oh is that right? Tell the good "Doctor" we said 'This page is currently unavailable'.

Ah, you mean the nurse who made the video about herself calling herself "doctor" and saying she was the program director of the dermatology residency. Sounds like she got called on it.

--------------------------------------------------------------------------------------

.....actually she didn't get called out on anything. The video and powerpoint is down and will be updated with current info. Once again you think you know it all and assume you know what is going on. Sorry boys, you did not win anything.

--------------------------------------------------------------------------------------

 

[ProRealDoc]

.

Originally Posted by DNPgator
I was turned onto this site by a friend and colleague of mine Dr. Debra Shelby. I read all the thoughtless banter and venom spewed by the excessively opinionated and unexpectedly uneducated medical students. I have earned my Doctoral of Nursing Practice degree and the right to be called doctor just as everyone else who earns a doctoral degree. Please study up on the history and meaning of the word "doctor" it would serve the medical profession well for most of you have forgotten or never knew its origin.

I call myself doctor and pursued this educational route, not because of a lack of intelligence or work ethic as many of you have proposed on the blog, but because I love providing care to my patients.

I am not a medical doctor by choice not because I could not hack it. I would invite you all to spend a few months working alongside you RN colleagues in the hospitals before you are so quick to assert your intellectual superiority. Nurses have been providing compassionate, caring, and comprehensive care since before the time that "doctors" were treating the humors and boring holes in skulls to release evil spirits.

I do not try to hide my identity from my patients or try to fool them or mislead them. The insinuation is that everyone wants to be you because you are the standard by which all else should be measured. The arrogance of this concept is beyond reproach. In my opinion, the education that is provided to medical students is substandard because it only focuses on the physical. Mind, spirit, and body cannot be separated. They are intertwined.

Lets call a spade a spade. You don't care about patient safety, if you did then physicians would lobby for every patient to be seen in consultation with a NP. You all care about the title, presitige, and money. NP's are highly educated, well trained, and effective contributors to the health care system with or without physicians. This has been shown in multiple control trials. I will list a few:
Kinnersley et.al. BMJ 320(7241) 1043-1048
Mundinger et.al. JAMA 283(1) 59-68
Shum et.al. BMJ 320(7241) 1038-1043
Venning et.al. BMJ 320(7241) 1048-1053
Ohman et.al. Annals of Family Medicine 6: 14-22

There are many others like these but I only included a few. I would challenge all of you to find one that says otherwise. In primary care of patients, NP's and now DNP's have provided comparable and at times superior care than our physician brethren. Those are the facts. Not opinion as were all of your posts. The truth of the matter is that we are better at caring for people than you people prefer our services to yours time and time again. There are no studies that show to the contrary. We also do a much better job at educating patients on disease processes than you. This is also not an opinion, but proven in these studies, printed in your journals. GET OVER YOURSELVES!!!!! Join the battle for better healthcare and quit worrying about your bank accounts. No one cares when we treat the indigent, underserved, and rural areas without physician supervision but you get your panties in a wad when we say we don't need you to take 70% of what we earn and put it in your pockets despite not doing a damn thing to treat a patient.

I am not claiming, nor do I want to be a surgeon, cardiologist, endocrinologist, or any one of the many specialists who provide comprehensive care to moderate to high acuity patients. I and most other NP's and DNP's know when a patient walks in the door if their problems need referral to more specialized not primary care. I specialize in dermatology and you better believe I can out diagnose, treat, and care for my patients than any of you students. You haven't been around long enough to earn an opinion.

--------------------------------------------------------------------------------------


Oh is that right? Tell the good "Doctor" we said 'This page is currently unavailable'.

Ah, you mean the nurse who made the video about herself calling herself "doctor" and saying she was the program director of the dermatology residency. Sounds like she got called on it.

--------------------------------------------------------------------------------------

.....actually she didn't get called out on anything. The video and powerpoint is down and will be updated with current info. Once again you think you know it all and assume you know what is going on. Sorry boys, you did not win anything.

--------------------------------------------------------------------------------------

 

[dilated]

Dude, that's like 90% likely to be a forum troll. Don't email it around. The USF "residency" hasn't even happened yet. The idea that the nurse behind the USF derm thing is telling her DNP friends about SDN is, uh... a stretch.

 

[sore eye asses]

DNPgator has since stopped posting to SDN after realizing that his life's purpose is to write for the Lifetime Television Network. This was revealed in his heartrending "final post" yesterday in the DNP thread.

Touching; just so very touching.

 

[CandidateofDerm]

Dude, that's like 90% likely to be a forum troll. Don't email it around. The USF "residency" hasn't even happened yet. The idea that the nurse behind the USF derm thing is telling her DNP friends about SDN is, uh... a stretch.

That is where you are wrong. While what we say and do on the internet not might matter, what we say and do in life does matter.

Since this thread started, I have personally spoken to the AMA federal and state side, American Academy of Dermatology x 3 (They have called me to give me updates), state medical society president, and over 20 residents.

If you do not think my actions above and other people who have undertaken similar actions doesn't actually affect the life of Dr. Debra Shelby and her plans for expansion so that she or someone she knows lashes out at the "uneducated medical students" who they think are causing this phenomenon of someone actually caring, then think again.

Our voices do have power; you just have to speak up! Lawyers would NEVER let paralegals have independent practice with the title of jurisdoctorate in law. They have 3 years of professional training. We have 7-11. We have to stand up for ourselves. If you haven't done anything at this point, you should do something.

It doesn't have to be calling the AMA or AAD, it can as simple as sending an email to your closest 10-20 friends telling them about this situation. The biggest problem that we are facing in order to stop this mess is ignorance. Most of the physicians, residents, and medical students I have talked to about this are ignorant of this information that we now know. Most people do not know that NPs are moving to the DNP title, that they are starting specialty residencies, that they actually have independent practice in 18 states at least, and that their lobby is very powerful. Let's fight this!

 

[dilated]

That is where you are wrong. While what we say and do on the internet not might matter, what we say and do in life does matter.

I think it's great that you're contacting people about the USF derm "nursing residency". That's utterly absurd and it needs to be crushed hard.

My point was that the DNPgator poster is 95% likely to be a forum troll rather than actually being who they say they are, especially since as far as we know the DNP "residency" even never got to the point of taking applications. So even referencing their posts or saying "Dr. Debra Shelby posting or this is one of her Derm DNP friends" is highly likely to be counterproductive when it turns out to be one of the standard forum trolls. I'm sure one of the moderators could probably confirm they're not even from Florida if they care enough to look.

 

[CandidateofDerm]

I think it's great that you're contacting people about the USF derm "nursing residency". That's utterly absurd and it needs to be crushed hard.

My point was that the DNPgator poster is 95% likely to be a forum troll rather than actually being who they say they are, especially since as far as we know the DNP "residency" even never got to the point of taking applications. So even referencing their posts or saying "Dr. Debra Shelby posting or this is one of her Derm DNP friends" is highly likely to be counterproductive when it turns out to be one of the standard forum trolls. I'm sure one of the moderators could probably confirm they're not even from Florida if they care enough to look.

Obviously, it would be foolish to try and use this poster as some sort of hard evidence to turn over to the AAD, AMA, etc. This is a some what anonymous forum! BUT this does not change the basic facts of the case on why we need to be involved and working to crush this hard before it is too late.

 

[DermMatch]

I have personally spoken to the AMA federal and state side, American Academy of Dermatology x 3 (They have called me to give me updates), state medical society president, and over 20 residents.

That's awesome. The AAD hasn't emailed me back at all, despite my initial contact. I'd love a PM with the contact name so I can follow up.

 

[cancerman51]

I don't pretend to be a nurse. They have a lot of skills that I don't have. I'm not afraid to step in and help them get stuff done when need be, but I'm not about to start telling them how to do their job.

The DNPs seem to want to do just the opposite. The USF curriculum didn't seem to have any medicine in it. Apparently you don't need to know medicine to practice medicine.

Clearly, the idea of the DNP's is to dupe the public by referring to themselves as "Doctor" and make people believe that they are trained in medicine instead of having a graduate degree in nursing.

 

[Dral]

I don't pretend to be a nurse. They have a lot of skills that I don't have. I'm not afraid to step in and help them get stuff done when need be, but I'm not about to start telling them how to do their job.

The DNPs seem to want to do just the opposite. The USF curriculum didn't seem to have any medicine in it. Apparently you don't need to know medicine to practice medicine.

Clearly, the idea of the DNP's is to dupe the public by referring to themselves as "Doctor" and make people believe that they are trained in medicine instead of having a graduate degree in nursing.

This is exactly the point I made in the thread on the nursing forum. If someone really wants to practice Nursing as a primary provider in derm, it seems a specific program geared toward that would be appropriate. Getting a PhD (probably not that good of one at that) is just a way to be called 'Doctor'. Totally weak.

 

[cancerman51]

My dentist is a doctor. I totally respect him. Dental school is serious training and I have great confidence in him.....

When treating my teeth. I'm not going to have him help me with my medical problems because, while he's a "doctor" he's not a medical doctor and doesn't know any more medicine than any other smart person.

DNP's are similar. A PhD in nursing has nothing to do with medicine. I would be happy to enlist their help with projects involving the scope and delivery of nursing care, but would not deem them competent to diagnose and treat medical conditions.

 

[benjee]

The reason why DNPs can bashing medical students, MDs openly in the name of relieving shortage of primary care Mds is because they want to receive the same amount of reimbursement as MDs when it comes to care for patients even they are not equipped. The reason of health care reform started/encouraged by government is to reduce the cost of health care by having these PAs, DNPs to care patients instead of MDs so to reduce reimbursement since these PAs, DNP charged less.This results twenty something states allow Nps to practice medicine independently without supervision of MDs . The whole deal is not about providing care to uninsured, it's all about money.

 

[sore eye asses]

The reason why DNPs can bashing medical students, MDs openly in the name of relieving shortage of primary care Mds is because they want to receive the same amount of reimbursement as MDs when it comes to care for patients even they are not equipped. The reason of health care reform started/encouraged by government is to reduce the cost of health care by having these PAs, DNPs to care patients instead of MDs so to reduce reimbursement since these PAs, DNP charged less.This results twenty something states allow Nps to practice medicine independently without supervision of MDs . The whole deal is not about providing care to uninsured, it's all about money.

WTF?

The whole reason we breath the air into our lungs is because it has the oxygen in it. We need the oxygen to go to our tissues so they dont not have the oxygen. if we had no oxygen, we would die. it's all about the obvious, i mean it's all about oxygen. yeah.

 

[caspian]

WTF?

The whole reason we breath the air into our lungs is because it has the oxygen in it. We need the oxygen to go to our tissues so they dont not have the oxygen. if we had no oxygen, we would die. it's all about the obvious, i mean it's all about oxygen. yeah.

Seems somebody missed out on a few minutes of oxygen themselves. Oxygen man, oxygen. Yeah.

 

[JaggerPlate]

wtf?

+1

 

[GoLytely]

Lets call a spade a spade.
-

Okay, let's do that. You're a nurse, not a doctor. And one who's very insecure with her title, at that.

 

[sore eye asses]

Okay, let's do that. You're a nurse, not a doctor. And one who's very insecure with her title, at that.

Dude, dude's a dude, and a very ladylike one at that.

 

[dubmaster123]

Looks like different specialties including derm are finally stepping up...

http://www.asahq.org/news/asanews051310.htm

scroll all the way down to read the bill and press statement.

 

[Socrates25]

I realize that this is an old thread, but instead of starting a new one with an update I will just add on here.

I found the website that DR DEBRA SHELBY, DERMATOLOGIST is affilated with: http://www.ecdss.com/staff.php

Check out her bio:

In 2000 Dr. Shelby earned a Master of Science in Nursing from Barry University. After graduation she practiced dermatology prior to joining Center for Dermatology and Skin Surgery in 2002 as an Advanced Registered Nurse Practitioner, dermatology specialist. In 2004 she temporarily left the Center to pursue her doctorate at USF. She coordinated the development of the nation’s first Doctorate of Nursing Practice (DNP) Dermatology Residency at the University of South Florida and in 2008 she became the first resident to complete the program. She is board certified in dermatology (DNC) through the Dermatology Nursing Association and has been practicing dermatology since graduating from Barry University.

In addition to her practice at Center for Dermatology and Skin Surgery, Inc., Dr. Shelby is the Perioperative Clinical Specialist at H. Lee Moffitt Cancer Center and holds a courtesy faculty appointment as a Clinical Assistant Professor and Director of the DNP Dermatology Residency Program at the University of South Florida.

Dr. Shelby is often guest speaker on dermatologic related issues and throughout her career she has presented nationally, published, served as a contributing editor, and has been involved in clinical research.
Dr. Shelby resides in Tampa.

Ok, so who else works there?

1. Steven Proper, MD
Bio: http://www.ecdss.com/steven_proper.php
FL medical board: http://ww2.doh.state.fl.us/irm00profiling/profile.asp?LicId=32598&ProfNBR=1501
Email: [email protected]

2. Stephen Romagnolo, MD http://www.ecdss.com/stephen_romagnolo.php
Florida medical board profile: http://ww2.doh.state.fl.us/irm00profiling/profile.asp?LicId=88686&ProfNBR=1501
Email: [email protected]

Here's what we need to do:

1. Email Dr Proper and Dr Romagnolo and ask them why they hired a NP who is pretending to be a board certified dermatologist.

2. Contact the clinic and ask them if you are going to see a real dermatologist, or "Dr" Debra Shelby who is a charlatan and a liar pretending to be a real doctor.

 

[JaggerPlate]

Check out her bio:

shes board certified in dermatology

There has to be some legality issues there. I wonder if the AAD/AOCD would be interested ...

 

[vicinihil]

Wow, I never knew how highly these "DNPs" thought of themselves. If they really wanted to be equivalent to physicians, then go to med school.

 

[Taurus]

DR DEBRA SHELBY, DERMATOLOGIST is affilated with: http://www.ecdss.com/staff.php

Just as I predicted. The DNP's are not just simply interested in primary care. They want to stretch their tentacles any specialty that high paying, low liability. Derm and ED are definitely in their crosshairs. They simply create their own residencies and board certifications.

I predict that in the future the biggest threat to derms will be DNP's claiming to be equivalent. They will throw off the supply and demand curve. Translation: derms will have a harder time finding jobs and income will drop.

 

[PharmBound2011]

Just as I predicted. The DNP's are not just simply interested in primary care. They want to stretch their tentacles any specialty that high paying, low liability. Derm and ED are definitely in their crosshairs. They simply create their own residencies and board certifications.

I predict that in the future the biggest threat to derms will be DNP's claiming to be equivalent. They will throw off the supply and demand curve. Translation: derms will have a harder time finding jobs and income will drop.

So, does that mean Derm & Emergency Medicine (among others) are destined to see the same fate as anestesiology?

I have an idea - Lets shut down all medical schools. We should all be eligible for an online 6 month accelerated MD program and be eligible for a 3 month residency in derm. we can make our own boards and certs so it shouldn't be a problem.

 

[JaggerPlate]

Wow, I never knew how highly these "DNPs" thought of themselves. If they really wanted to be equivalent to physicians, then go to med school.

Yup. The DNP movement is one of the most revolting things I've witnessed in my life thus far. I highly encourage everyone who is working their way through medical school, residency, fellowship, or cares about patient safety/transparency to spread the word, report this crap to organizations like the AAD, AOCD, state boards, the practices hiring these individuals, the schools running these DNP residencies, etc. Every time something new pops up, I'm absolutely shocked it's progressed to that step, and there is no end in sight.

 

[cbrons]

I am on the board of a major public university in the Midwest. We are currently in the process of hiring a new president. During our interviews with provosts, AVP and current presidents of institutions around the country, 4 out of 5 of them said that in the past year they have established or have begun the process of establishing a DNP program. Apparently these programs are so dirt cheap and/OR the nursing lobby is supporting them that they are spreading quite rapidly. One individual even stated this quite plainly. It is cheaper to establish a DNP program than a traditional Ph.D. in any of the hard sciences. Well you say, "So what? What does it mean?" I don't know, you decide. The point is there will soon be more DNP programs in the country than medical schools if the current expansion rate continues apace.

 

[Taurus]

I am on the board of a major public university in the Midwest. We are currently in the process of hiring a new president. During our interviews with provosts, AVP and current presidents of institutions around the country, 4 out of 5 of them said that in the past year they have established or have begun the process of establishing a DNP program. Apparently these programs are so dirt cheap and/OR the nursing lobby is supporting them that they are spreading quite rapidly. One individual even stated this quite plainly. It is cheaper to establish a DNP program than a traditional Ph.D. in any of the hard sciences. Well you say, "So what? What does it mean?" I don't know, you decide. The point is there will soon be more DNP programs in the country than medical schools if the current expansion rate continues apace.

Universities love DNP programs like they love law, pharmacy, and MBA programs -- dirt cheap because the accrediting requirements are purposely low. The universities can give a damn if you can find a job once they take your tuition money from you. That's why obtaining a law degree or pharmacy degree is like throwing money down the toilet. The degrees (except if you go to a top 14 law school) have become so commoditized and worthless. The DNP degree is heading the same route. Many, many DNP's will return to floor nursing because they can't find jobs and have 6 figures in debt.

What about DNP's practicing independently then? Even if they obtain the same scope as physicians, they don't have equivalent training and yet they will be held to the same standards. It will be very risky for them. Here's a good example.

Louisiana's limit on medical malpractice awards is unconstitutional, a state appeals court ruled.
Joe and Helena Oliver sought relief from the Louisiana Medical Malpractice Act, which shrank the damage award they received from $6.2 million to $500,000. The Olivers' daughter, Taylor, developed severe injuries after she was treated by a nurse who was practicing with only a high school degree.
Susan Duhon, a registered nurse practitioner and sole owner of the Magnolia Clinic, treated Taylor for vomiting, nausea and diarrhea.
Taylor visited the clinic 32 times in the first year of her life, and Duhon prescribed more than 30 medications to her. Duhon had a statutory duty to consult a physician, but Taylor never saw a doctor during any of her visits.
When Taylor was 14 months old, another hospital diagnosed her with neuroblastoma, a childhood cancer. One of the signs is severe bruising around the eyes, which Taylor had presented with at the Magnolia Clinic when she was 6 months old.
If neuroblastoma is diagnosed within the first year of life, the child has a 90 percent chance of an event-free recovery. Because of the delayed diagnosis, the quality of Taylor's life has been severely diminished.
Though Taylor survived the cancer, the tumor caused her head to become misshapen. Her eyes are abnormally large, and she is legally blind.
"Currently, to qualify as a nurse practitioner, a nurse is required to obtain a baccalaureate of science and a masters of science in nursing," the ruling states. "Although Ms. Duhon did not obtain any degree in nursing from an institution of higher learning, she was allowed to escape the more rigorous requirements enacted by statute with only a high school degree, under the 'grandfathered' exception."
The Olivers won their medical malpractice lawsuit, but their $6.2 million award shrank to less than one-twelfth of its original size under the state law.
The trial court ruled in the clinic's favor, but the Lake Charles-based appeals court agreed with the Olivers that the cap on malpractice damages is unconstitutional.
"The state offered no evidence in this case...to refute the fact that the cap discriminates against Taylor and her parents by limiting their general damage recovery to a single $500,000 payment, while allowing other less severely injured victims to fully recover their general damage awards," Judge Sylvia Cooks wrote in the court's lead opinion.
Two other judges on the court wrote concurring opinions, and Judge Shannon Gremillion dissented.​

That's why DNP's will naturally gravitate toward fields where there is good compensation but low liability. Primary care is an obvious choice because it's really hard to kill someone. Derm is another one. ED will be harder because you can kill someone easily by lack of knowledge.

If you assume that all 50 states will give DNP's autonomy, the most important thing that will keep DNP's in check in the future is the lawyers and insurance companies. As more cases like this pop up across the country, the malpractice premiums for DNP's will increase. Hospitals and insurance companies will force DNPs to limit their scope so that it reduces the risk of malpractice. The fields where you can easily kill or hurt someone will benefit the most by limiting the scope of DNP's. Unfortunately for derm, I think DNP's will make significant inroads into the field.

Remember that only like ~400 derm physician graduate annually. If only a fraction of DNP's go into derm, it will greatly flood the field. It will drop income and job opportunities for everyone. I'm not sure how many derms understand this.

 

[N-Surge]

ALL YOUR BASE ARE BELONG TO US...

It's what comes to mind when reading certain posts in this thread...

 

[CandidateofDerm]

Universities love DNP programs like they love law, pharmacy, and MBA programs -- dirt cheap because the accrediting requirements are purposely low. The universities can give a damn if you can find a job once they take your tuition money from you. That's why obtaining a law degree or pharmacy degree is like throwing money down the toilet. The degrees (except if you go to a top 14 law school) have become so commoditized and worthless. The DNP degree is heading the same route. Many, many DNP's will return to floor nursing because they can't find jobs and have 6 figures in debt.

What about DNP's practicing independently then? Even if they obtain the same scope as physicians, they don't have equivalent training and yet they will be held to the same standards. It will be very risky for them. Here's a good example.

Louisiana's limit on medical malpractice awards is unconstitutional, a state appeals court ruled.
Joe and Helena Oliver sought relief from the Louisiana Medical Malpractice Act, which shrank the damage award they received from $6.2 million to $500,000. The Olivers' daughter, Taylor, developed severe injuries after she was treated by a nurse who was practicing with only a high school degree.
Susan Duhon, a registered nurse practitioner and sole owner of the Magnolia Clinic, treated Taylor for vomiting, nausea and diarrhea.
Taylor visited the clinic 32 times in the first year of her life, and Duhon prescribed more than 30 medications to her. Duhon had a statutory duty to consult a physician, but Taylor never saw a doctor during any of her visits.
When Taylor was 14 months old, another hospital diagnosed her with neuroblastoma, a childhood cancer. One of the signs is severe bruising around the eyes, which Taylor had presented with at the Magnolia Clinic when she was 6 months old.
If neuroblastoma is diagnosed within the first year of life, the child has a 90 percent chance of an event-free recovery. Because of the delayed diagnosis, the quality of Taylor's life has been severely diminished.
Though Taylor survived the cancer, the tumor caused her head to become misshapen. Her eyes are abnormally large, and she is legally blind.
"Currently, to qualify as a nurse practitioner, a nurse is required to obtain a baccalaureate of science and a masters of science in nursing," the ruling states. "Although Ms. Duhon did not obtain any degree in nursing from an institution of higher learning, she was allowed to escape the more rigorous requirements enacted by statute with only a high school degree, under the 'grandfathered' exception."
The Olivers won their medical malpractice lawsuit, but their $6.2 million award shrank to less than one-twelfth of its original size under the state law.
The trial court ruled in the clinic's favor, but the Lake Charles-based appeals court agreed with the Olivers that the cap on malpractice damages is unconstitutional.
"The state offered no evidence in this case...to refute the fact that the cap discriminates against Taylor and her parents by limiting their general damage recovery to a single $500,000 payment, while allowing other less severely injured victims to fully recover their general damage awards," Judge Sylvia Cooks wrote in the court's lead opinion.
Two other judges on the court wrote concurring opinions, and Judge Shannon Gremillion dissented.​

That's why DNP's will naturally gravitate toward fields where there is good compensation but low liability. Primary care is an obvious choice because it's really hard to kill someone. Derm is another one. ED will be harder because you can kill someone easily by lack of knowledge.

If you assume that all 50 states will give DNP's autonomy, the most important thing that will keep DNP's in check in the future is the lawyers and insurance companies. As more cases like this pop up across the country, the malpractice premiums for DNP's will increase. Hospitals and insurance companies will force DNPs to limit their scope so that it reduces the risk of malpractice. The fields where you can easily kill or hurt someone will benefit the most by limiting the scope of DNP's. Unfortunately for derm, I think DNP's will make significant inroads into the field.

Remember that only like ~400 derm physician graduate annually. If only a fraction of DNP's go into derm, it will greatly flood the field. It will drop income and job opportunities for everyone. I'm not sure how many derms understand this.

Yes and no. You have to remember that dermatologist are somewhat of an anomaly in medicine. We have very poor hospital representation because we actually aren't worth that much to hospitals because there is no facility fee for them to skim off of us. We are small potatoes compared to ortho, rads, cards, neurosurgery, etc. In other words, we make good money personally but we don't make others a lot of money.

Why is this important? Most practices are still independent practices owned by dermatologists. What bank is going to loan the big bucks to to a dnp to start a practice especially if things get so saturated as you predict? What dermatologist will make a dnp full partner in their practice when there are a million of them graduating a year? There are not a substantial number of employee only dermatology jobs compared to other fields because hospitals have no incentive to fund these types of practices and get fully entangled in dermatology.

Overall this will not help dermatology, but it won't be the end of the world either. Remember there are tons of pas and nps who want to get in derm right now, but they can't because there aren't enough jobs for them. This will not change in the future and if you were a bank you would not bet 500000 dollars that this will change. And if you are a hospital you are going to yawn whena group of nps say they can earn you 250000 a year in profit after accounting for the salaries and the overhead of clinic. So the final roadblock is you... The independent private practice dermatologist. Never let an np buy into your practice and all will be fine.

 

[CandidateofDerm]

Of course, like I said it won't be a good thing for dermatology or for derm patients. That is why we must fight this to the bitter end.

 

[Taurus]

Yes and no. You have to remember that dermatologist are somewhat of an anomaly in medicine. We have very poor hospital representation because we actually aren't worth that much to hospitals because there is no facility fee for them to skim off of us. We are small potatoes compared to ortho, rads, cards, neurosurgery, etc. In other words, we make good money personally but we don't make others a lot of money.

Why is this important? Most practices are still independent practices owned by dermatologists. What bank is going to loan the big bucks to to a dnp to start a practice especially if things get so saturated as you predict? What dermatologist will make a dnp full partner in their practice when there are a million of them graduating a year? There are not a substantial number of employee only dermatology jobs compared to other fields because hospitals have no incentive to fund these types of practices and get fully entangled in dermatology.

Overall this will not help dermatology, but it won't be the end of the world either. Remember there are tons of pas and nps who want to get in derm right now, but they can't because there aren't enough jobs for them. This will not change in the future and if you were a bank you would not bet 500000 dollars that this will change. And if you are a hospital you are going to yawn whena group of nps say they can earn you 250000 a year in profit after accounting for the salaries and the overhead of clinic. So the final roadblock is you... The independent private practice dermatologist. Never let an np buy into your practice and all will be fine.

The whole point of the DNP degree and derm residency is to eliminate the need to be hired by a derm. Just open your own shop. Even if the DNP derm makes less than a physician derm, they will still open their own shop just because people prefer to be their own bosses. What specific market will the DNP's target? It's the same one that makes the most bank for derms: cosmetics (ie, cash paying patients). Botox. Derm fillers. Etc. DNP derms, let's be clear, have no interest in knowing more medical derm than you. They just want to increase their bank accounts, at your expense.

Regarding, how will they get the money to open their own businesses? Duh. How do people get the money to open a McDonald's? Anyway you can. Use your savings. Borrow from family and friends. Try to get a small business loan. Etc. By the number of small businesses out there, this should give you an idea that getting the funds to start a business is not an obstacle for most people who are determined. What stopped NP's before? 1) they couldn't call themselves "Dr." 2) they couldn't say they were board-certified in dermatology (albeit from a nursing society and not a medical one). Now, both barriers have been eliminated and now they will work to convince the lawmakers and the public that there is no difference between a med derm and a nursing derm. Because the liability to doing cosmetic derm or derm in general is very low and the income is very attractive, this is the perfect recipe for a flood of DNP's into derm. If you just follow the money, you can pretty accurately predict people's behaviors. The writing is on the wall.

So I hope that you people who went into derm really wanted to take care of people with psoriasis and pemphigus vulgaris. Because that's the kind of stuff you'll have to do more and more. I'll concede that that med derm probably can retain Moh's surgery, but the reimbursements for that has been slashed so drastically that it's not as attractive as it once was.

 

[asmallchild]

That sounds great but it's not as easy (or as fun) accumulating all those cosmetic patients as one might think.

Unbeknownst to those outside of derm, many of us do graduate to practice, gasp, medical dermatology...