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Standing Up for Nurse Practitioners: For Us and for Our Patients

by | 06/03/21 | 0 comments

As an advanced practice provider, and specifically, as a doctorate prepared nurse practitioner, I feel it is my duty to uphold our standards and defend our field when others try to knock us down, whether blatantly or inadvertently. I recently came across a line in an article on PubMed that falsely claims that only physicians are able to properly interpret Woods Lamp findings. I could not believe what I read, so I dug a little deeper into the “source” of the information in the misleading line and found nothing to support the claim that only physicians can properly use the device and interpret the findings.

I have worked too hard and I have cared deeply for my patients, as my advanced practice colleagues have as well, to allow this misinformation to be published online in a national scientific database.

I did not go quietly into the night.

I have worked too hard and I have cared deeply for my patients, as my advanced practice colleagues have as well, to allow this misinformation to be published online in a national scientific database.

All articles on PubMed have an associated link to contact the editors. So without further ado, see my message to the editors below.

I am writing to request a revision to the last sentence of the Introduction. The sentence reads, "This test is performable by any healthcare worker, but to properly interpret the findings, it is best if a dermatologist or other physician administers the test." The authors then cite an article published in 2018 in the journal Clinical and Experimental Dermatology. I read the 2018 article, and nowhere in the article does it mention anything about the Wood's Lamp requiring a physician for "proper" interpretation of findings. Please correct this error, as it is demeaning to other healthcare providers that provide excellent care to their patients with training and experience with the Wood's Lamp. It is also misleading to the general public that may read the article and incorrectly believe that they will not receive "proper" care from their advanced practice providers. In addition, the authors' attempt to pass off their personal opinions about other healthcare providers as fact by falsely citing another article is unprofessional and reflects poorly on NCBI and PubMed. 
I suggest a change within that same sentence: Remove the piece starting with, "but to properly interpret…" and change the term "healthcare worker" to "healthcare provider," thus clarifying that the administration of the Wood's Lamp test is within the scope of practice of physician assistants, physicians and nurse practitioners alike. 
Below is a link to the article from Clinical and Experimental Dermatology, which the authors cite as the source of the incorrect statement.
I hope you will take this matter seriously as we are all a team in healthcare and wish for the same excellent care and outcomes for our patients. 
Thank you for your consideration,
Patricia Delgado, DNP, APRN, DCNP

It took a few months, but to my surprise, I did eventually receive a response. I was not disappointed.

See below.

Patricia Delgado,
Thank you for your comment. I apologize for missing it in November. The article will be revised based on your recommendation. We apologize for the omission of advanced care nurses from those who can adequately do this evaluation. We make an effort to use inclusive language for our articles and questions. We strive to use the terms healthcare provider or clinician.
Unfortunately, due to our database's large size and multiple authors, we occasionally make this error.
With your help, our educational project will be a success. Please let us know if you find any other corrections that are needed.
Thank you,
Scott Dulebohn, M.D.
StatPearls Publishing, Ltd.

As nurse practitioners, it is not only our duty and responsibility to advocate for our patients, but it is also imperative for us to defend our profession. Our communities count on us as providers of their care. If false information is allowed to circulate, they will lose trust in us and lose the desire and opportunity to be seen in clinic with excellent healthcare providers that provide excellent outcomes for their patients and equal if not better outcomes than physicians.1-7 I do not know why these authors decided to falsely claim that only physicians know how to interpret Woods Lamp findings, but I hope that they have since realized how much of an impact nurse practitioners make in the healthcare landscape and how important we are to our patients and the health of our communities.

If you ever see something in the literature that questions the skill or abilities of your profession, dig deeper! Most likely, the information is false, and the writer just needs some guidance. If you need help putting together a letter, or if you are wondering if something needs to be refuted, feel free to reach out!

1. Lenz ER, Mundinger MO, Kane RL, Hopkins SC, Lin SX. Primary care
outcomes in patients treated by Nurse Practitioners or Physicians:
two-year follow-up. Med Care Res Rev. 2004;61(3):332-351.

2. Muench, U., Guo, C., Thomas, C., & Perloff, J. (2019). Medication adherence, costs, and ER visits of nurse practitioner and primary care physician patients: Evidence from three cohorts of Medicare beneficiaries. Health Services Research54(1), 187–197.

3. Mundinger MO, Kane RL, Lenz ER, et al. Primary care outcomes
in patients treated by nurse practitioners or physicians. J Am Med
Assoc. 2000;283(1):59.

4. Naylor MD, Brooten DA, Campbell RL, Maislin G, McCauley KM,
Schwartz JS. Transitional care of older adults hospitalized with
heart failure: a randomized, controlled trial. J Am Geriatr Soc.

5. Venning P, Durie A, Roland M, Roberts C, Leese B. Randomised
controlled trial comparing cost effectiveness of general
practitioners and nurse practitioners in primary care. BMJ.

6. Newhouse RP, Stanik-Hutt J, White KM, et al. Advanced practice nurse outcomes 1990-2008: a systematic review. Nurs Econ.

7. Buerhaus P, Perloff J, Clarke S, O’Reilly-Jacob M, Zolotusky G,
DesRoches CM. Quality of primary care provided to Medicare
beneficiaries by nurse practitioners and physicians. Med Care.


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Patricia M. Delgado

Dermatology Nurse Practitioner, Entrepreneur, Real Estate Investor, and Speaker

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