Tug of War for Dermatology Patients

A turf war between doctors and nurses could leave dermatology patients caught in the crossfire. Proposed legislation would require a doctor instead of a nurse to examine all new patients, or existing patients with new skin conditions. It might limit your ability to get potentially life-saving treatment.

More than 51,000 new cases of the most deadly form of skin cancer are reported in the U.S. each year. Dr. Cynthia tie worries some of those cases might not get diagnosed if the patient sees a nurse with less training instead of a dermatologist.

"You could see a potential danger if a nurse practitioner missed a melanoma or worse, like a severe infection as being diagnosed as a plain old dermatitis," she says.

State lawmakers are proposing legislation that would require doctors to see all first-time dermatology patients, or existing patients with a new condition, but nurse practitioners say in rural areas of Florida, it might not always be possible to see a dermatologist for a first visit. Some areas of the state don't even have dermatologists.

Nurse practitioner Roger Green says a law preventing him from seeing a patient could have devastating consequences.

“That would mean the patient would not be able to have the initial workup and treatment and then would have to be sent to the physician for evaluation. It would delay access to care," says Green.

Nurse practitioners are starting to think the turf war is just an effort by lawmakers to help their wealthy doctor friends, and even dermatologists agree seeing someone is better than not getting care at all. The issue may come down to whether there are enough dermatologists to go around.

The Senate version of the bill was amended this week to allow nurse practitioners with advanced training to do initial patient exams.