Recent Activity en Dilemma of whether to practice in Primary Care or switch to specialty Dermatology with challenges facing in trying to give my clients the best holistic care! <p>Hello everyone reading, &nbsp;</p><p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;I am a FNP also, who took a job in Primary Care, a practice owned by an ARNP! I can say that I love it, as NPs are surely forward thinking. I see client's in the office on Friday's who want their suspicious lesions looked at or who want a skin tag or bothersome Nevi removed. I use a dermatoscope and take pictures with the DL3 model with my iPhone 4s (Awaiting my iPhone 6 Plus to arrive). Deciphering skin lesions is a passion of mine! I am so thrilled that we are offering our client's the option of a one stop shop without having to refer client's out to dermatologists for a second co-pay and long wait times.Additionally, we may offer Botox soon, as I have been trained in that also. I precepted at a derm office and was leary of specializing in just skin as I enjoy treating my clients holistically. As an FNP and previous pediatric experience, rashes are not new to fact 1/2 of the questions for the board seemed to be on skin complaints or dermatological diagnosis and treatment of such. It is very difficult to get into a derm office in Florida with the new Dermatology DNP program at USF, many dermatologists require more than an MSN/FNP. When I attended the 2014 National Association of Dermatology Nurse Practitioner Symposium (which is a great forum for furthering skills and knowledge), I spoke to several Family NPs from around the country who experienced similar difficulty in trying to transition into a dermatology practice. I hope to get some good pointers from the posts, as I my see patients in rehab centers also - where the facility has consulted an organization of NPs who have no further training (as wound care consults) who prescribe my patients the wrong pharmacological treatment in misdiagnosis. I am very frustrated with this, as no one in my office consulted them, and they are not limiting themselves to wound care (e.g., pressure ulcers). Any ideas? Trying not to step on toes, but, the LPNs should not be able to order the consults without the Primary Care Practitioner authorizing it, correct? The company has a dozen NPs with Protocols as FNPs or NPs doing gynecological and other exams and primary care type protocols without any other certifications listed. In Florida it is required NPs practice under the supervision of a physician. Their supervising physician is a primary care physician (Adult). Many of these so called "wound care" NPs are prescribing steroid creams for everything calling it Psychogenic pruritis (diabetic patient with an Hgb A1c of 10.4) when it was Folliculitis and candidal intertrigo- where topical corticosteroids made it worse. Had to d/c their script and write for econizole 1% topical with rash gone in 3 days. Yet, they billed for 2 visits in one month consulting on the patient, which no practitioner of the patient's ordered. How is the Medicare $$$'s going to last? Seems like greed, as well as bad politics/ethics going on! Would love to hear your thoughts ... everyone! Am I alone on this bad feeling... is it so bad out there...this kind of bad business is creeping up? I look forward to your advice!</p><p>In Shock,&nbsp; Diane</p><p>&nbsp;</p><p>&nbsp;</p> Sun, 21 Sep 2014 16:13:26 EDT driggleman Derm Practice Ownership <p>Does anyone own their own Derm practice?</p> Sat, 05 Apr 2014 15:32:18 EDT ragan Laser education Looking for recommendations regarding education with laser procedures. Classes/lectures etc positive and negative feedback would be helpful Wed, 19 Mar 2014 22:06:02 EDT khauserman Calling All Medical Assistants! <p>We are currently seeking authors to submit articles for publication&nbsp;<span style="line-height: 20.799999237060547px;">in our Medical Assistant Column. Your area of expertise may be conventional to you,&nbsp;</span><span style="line-height: 20.799999237060547px;">but to many of your colleagues, it may be quite unconventional. Share your&nbsp;</span><span style="line-height: 20.799999237060547px;">knowledge today by writing for the Journal.</span></p><p>Don’t know what to write or where to start?&nbsp;<span style="line-height: 20.799999237060547px;">Contact Sarah Neider, MA, JDNA Associate Editor at <a href=""></a></span></p><p><strong>Register today for the JDNA “Writer’s Workshop” at the&nbsp;<br><span style="display: none;">&nbsp;</span><span style="line-height: 20.799999237060547px;">2014 DNA Convention in Orlando<br>Saturday, May 3rd&nbsp;from 7:00 am to 8:30 am</span></strong><span style="display: none;">&nbsp;</span></p><p>Board Members will be on hand to review your manuscripts, answer your questions&nbsp;<span style="line-height: 20.799999237060547px;">and guide you through the submission process.</span></p> Tue, 18 Mar 2014 15:48:31 EDT jking Intraoffice Phone Triage <p>The MD I am currently working with is trying to implement a more structured intraoffice phone triage system to avoid patient's not being seen that reall should be. Please share your intraoffice phone triage policy/format of questions that your office uses? Thank you</p> Tue, 07 Jan 2014 9:05:10 EST vit9109 NP Student Needing Advice on Obtaining a Dermatology Position <p>Hello DNA members,&nbsp;</p><p>I am currently a NP student from Kansas City, Missouri that will be graduating in December 2013 and I am seeking any advice regarding getting into the specialty of dermatology. I have been shadowing a dermatopathologist over the last few months in an attempt to expand my knowledge base. I am very willing to relocate and I actually have an interview in Orlando, Florida next week for a dermatology NP position...which brings me to my next question, is there anyone that is familiar with the Central Orlando area that can tell me about some of the dermatology clinics they have worked for and what they did or did not like about that position? Any and all advice on interviewing, salary expectations, CPA agreements, etc would be much appreciated!&nbsp;</p><p>Thank you very much</p><p>Best Wishes,&nbsp;</p><p>Charity Slayton&nbsp;</p> Mon, 06 Jan 2014 15:47:05 EST clh4g5 Call to Action from AANP <p><span style="line-height: 20px;">Have you ever wondered what just one nurse practitioner could do to help promote the NP role? The next few days will offer two exciting opportunities for NPs to join the conversation, and let their voices be heard in the national health care arena.</span></p><div><strong><span style="line-height: 20px;">Escape Fire - Don't Let This Escape Your Attention&nbsp;</span></strong></div><div><span style="line-height: 20px;">Don’t let the chance to watch and comment on Escape Fire escape your attention when it re-airs on CNN, Saturday, March 16th at 8:00pm ET. It will re-air again at 11pm &amp; 2am ET. An "Escape Fire" is an unconventional or counter-intuitive solution to a difficult problem. To survive approaching forest fires, firefighters will burn the grass around them to create a fuel-free safe spot. Escape fires are needed to fix our health care system in this country in much the same way that NPs need to be recognized for their role as providers of expert primary, acute and specialty health care services.</span></div><div>&nbsp;</div><div><span style="line-height: 20px;">The documentary asked the question, “What is your escape fire?” NPs are an answer to the health care crisis. The documentary does not acknowledge the role of the nurse practitioner but does provide opportunities for viewers to weigh in thru social media. With more than 157,000 NPs practicing in the United States today, the NP has a powerful voice and a compelling message. Let that voice and message be heard by commenting on Escape Fire this Saturday. Reference #RescueHealthcare on Twitter to join the conversation. When the documentary aired for the first time last weekend, hundreds of people joined the conversation and commented. The hashtag continues to trend, with thousands participating, creating an exciting opportunity for nurse practitioners to make their voices heard in this important health care discussion.</span></div><div>&nbsp;</div><div><strong>Pro-Health Care Breakfast Briefing: Defining the Scope of Practice</strong></div><div>AANP President Angela Golden, DNP, FNP-C, FAANP, will join a prestigious panel on Tuesday, March 19 for a discussion on defining the scope of practice. The Pro Health Care Breakfast Briefing is sponsored by Politico, an American political journalism organization based in Arlington, VA that distributes content via television, Internet, newspaper and radio. Its coverage of Washington, D.C. includes the U.S. Congress, lobbying, media and the presidency.</div><div>&nbsp;</div><div>The event will take place at the Newseum in Washington, D.C. Panel members joining Angie include:</div><ul><li><span style="line-height: 20px;">Wanda Filer, Director, American Academy of Family Physicians Board of Directors</span></li><li>Dan Hawkins, Senior Vice President, Public Policy and Research, National Association of Community Health Centers</li><li>Terie Norelli, President, National Conference of State Legislatures; Speaker of the New Hampshire House of Representatives</li><li>Donna E. Shalala, Former Secretary, Department of Health and Human Services</li></ul><p><span style="line-height: 20px;">Joanne Kenen, health care editor for Politico, is moderator of the event, which will include questions submitted thru Twitter by referencing #ProHCBB. Be sure and tune in for this very informative discussion, and remember to join the conversation. The event will be streamed live on <a href=""></a> starting at 8 a.m. ET on the 19th.</span></p><div><strong><span style="line-height: 20px;">Call to Action</span></strong></div><div>There has never been a better time for nurse practitioners to make their voices heard. Health care is at the center of the national agenda, and NPs are a vital part of the solution to the health care crisis facing our country. <a href="">Talking points</a> are available to help facilitate discussions. Please join one or both conversations on Twitter, and follow <a href="">@AANP_News</a> for the most current updates and items of interest to nurse practitioners. Let your voice be heard!</div> Mon, 06 Jan 2014 15:45:33 EST jking Ask an Expert! <p><span style="color: rgb(34, 34, 34); font-family: arial, sans-serif; font-size: 13.333333969116211px;">This question came in to the DNA, does anyone have any advice?</span></p><p><em><span style="font-size: 13.333333969116211px; line-height: 20px; color: rgb(34, 34, 34); font-family: arial, sans-serif;">"I would like to know how do you do site marking for skin procedures,&nbsp;</span><span style="font-size: 13.333333969116211px; line-height: 20px; color: rgb(34, 34, 34); font-family: arial, sans-serif;">such as skin laser for multiple sunspots, seborrheic keratosis etc,&nbsp;</span><font color="#222222" face="arial, sans-serif">or for multiple moles, or&nbsp;multiple skin cancer lesions?"</font></em></p> Fri, 03 Jan 2014 12:58:33 EST jking Best Practices Intraoffice Recall System for Melanoma Patient's <p>What is your intraoffice patient recall policy for melanoma patient's after initial diagnosis? After initial diagnosis, when is the next time that patient would return to your office for a FSE ( i.e. 3 months-for how many months? ). And thereafter? In addition, to the&nbsp;full skin exam schedule, what is your office policy for a&nbsp;patient tracking schedule-(i.e. phone calls, recall cards, and patient letters). Please share your intraoffice patient tracking systems.</p> Thu, 01 Aug 2013 19:29:46 EDT vit9109 Dermatology Conferences <p>Hello!!</p><p>&nbsp;</p><p>Besides the DNA annual conference, what other dermatology conferences do you prefer to attend?</p><p>&nbsp;</p> Fri, 10 May 2013 21:14:28 EDT jamieyoungarnp