The intellectually-challenged midlevels over in "The Elite Nurse Practitioner Group" on Facebook have been on a roll recently as they collectively rub their singular brain cells together, generating an abundance of idiotic content for us physicians to gawk at. This recent post by Tennessee-based psychiatric-mental health nurse practitioner (PMHNP) Kevin Conley is the latest WTF-inducing example. Why is he, as a PMHNP, asking for diagnostic "opinions" on this 40-year-old white female's skin lesion? It's so far outside his scope of training and practice that it's not even funny.
At least this Walden-trained midlevel is honest about his sheer fucking lack of knowledge - "all I know about skin is it comes in layers". 🤣🤣🤣 And therein lies the problem with the current sorry state of NP education: while all medical students receive a comprehensive education spanning all the major organ systems and the pathologies that affect them, skin included, NPs don't even receive anything resembling adequate didactic or clinical training in their designated population focus (family, psychiatric-mental health, pediatrics, women's health, etc.), let alone any training outside of said focus. Pick a medical student, resident, or attending physician in any specialty, psychiatry included, and more than likely they'd be able to not only name the three major layers of the skin, but also come up with a reasonable differential diagnosis and treatment plan that doesn't involve consulting "dermatology NPs" on Facebook. No board-certified physician, in psychiatry or any other specialty, survived medical school and passed their USMLE/COMLEX exams by knowing nothing about the skin except that it "comes in layers".
Tennessee is a restricted-practice state that does not allow nurse practitioners to practice independently. So if you want our unsolicited opinion, Kevin, may we kindly fucking suggest that you call up your supervising physician and get some recommendations for board-certified dermatologists to refer your patient to, instead of seeking the useless advice of some "dermatology NPs" on Facebook.