NJ Nursing Board allows Noctor to own medical clinic

[cdmguy]

I ratted this Medspa to the NJ State Board of Nursing. It is co-owned by a NP and a vascular surgeon. NPs are not permitted to own medical facilities in NJ. The vascular surgeon has no experience in the aesthetic techniques that he is supposed to be "supervising" the NP in. The NP believes in the weekend seminars and every patient is your guinea pig school of practice (as opposed to supervised credentialing). Have a look at the list of plastic surgery and dermatology services she provides.

http://bodychicmedspa.com/services.html

Body Procedures

• SmartLipo
• Cellulaze
• Mini Tummy Tuck
• Tummy Tuck
• Smartlipo Laser Liposuction
• with Fat Transfer to Breasts
• Brazilian Butt Lift
• G Shot Amplification
• C Section Scar Release
• Varicose Veins
• Venus Freeze
• IPL

She, the NP, is also not supposed to be using lasers or injecting. Again, the nursing board doesn't care.

I sent complaints to the state Attorney General, Nursing Board, Medical Licensing and even state dermatology association and no action was taken after two years. Nursing board just stonewalled the complaint.

Medspa Noctors ally with both their nursing boards and non-dermatologists for strength in numbers. Like cockroaches, they are very dirty and hard to kill.

$400k/year for two year NP degree you can earn at night and is paid for by your employer. Perfect scam.

I don't know what else I can do. There has to be a way to organize and take this down.

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Members don't see this ad.

 

[sliceofbread136]

I might go get a Brazilian butt lift now that you mention it

 

[themoonman2]

This seems ridiculous. I don't understand how this can be legal?

 

[cdmguy]

Laws and regulations are useless when corrupt administrators won't enforce them. For example, Chris "Bridgegate" Christie is the Governor of New Jersey.

 

[Merely]

I like the cockroach part lol very funny

 

[jdh71]

So?

 

[SunsFun]

These types of places don't have patients. They have customers.

Look, they just do their best to make most money possible....since some MD/DOs refuse to pay them on par with themselves.

Relevant: http://nurse-practitioners-and-phys...eatures/Articles/How-Much-Is-a-DNP-Worth.aspx

I especially liked the second dude talking about some marketing/consulting 101 that he did for the old doc that, in his mind, is worthy of MD-level salary.


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[W19]

I am staying away from this thread.

 

[Goro]

The p53 genes are already lost, and the cMycs are activated! Getting my cyclophosphamide ready.

I am staying away from this thread.

 

[Lawpy]

So?

The p53 genes are already lost, and the cMycs are activated! Getting my cyclophosphamide ready.

i learned to follow only what informed members (e.g. attendings, fellows, residents, experienced [usually nontrad with prior extensive clinical experience] medical students etc. ) have to say on this matter and ignore everything else. the rants and toxicity are getting tiresome.

 

[Goro]

i learned to follow only what informed members (e.g. attendings, fellows, residents, experienced [usually nontrad with prior extensive clinical experience] medical students etc. ) have to say on this matter and ignore everything else. the rants and toxicity are getting tiresome.

 

[nowaysanjose]

i learned to follow only what informed members (e.g. attendings, fellows, residents, experienced [usually nontrad with prior extensive clinical experience] medical students etc. ) have to say on this matter and ignore everything else. the rants and toxicity are getting tiresome.

There are plenty of these people saying the exact same thing. That's why anecdotal evidence doesn't work...

 

[BurghStudent]

What the hell is a G Shot Amplification? Will be need to know this for CS?

http://bodychicmedspa.com/g-shot-amplification.html

 

[cdmguy]

Must be something they teach in Surgical First Assistant certification. That's the only surgical experience she has and she feels qualified to practice as both a dermatologist and plastic surgeon. A little knowledge is dangerous.

Shouldn't that G spot page have a before and after youtube video?

Scene 1. Frigid woman complaining about poor sex life.
Scene 2. Woman visits NP Marla Bell from Bodychic to learn about the amazing G shot.
Scene 3. Post G shot "Harry Met Sally" fake orgasms galore.

 

[SunsFun]

What the hell is a G Shot Amplification? Will be need to know this for CS?

http://bodychicmedspa.com/g-shot-amplification.html

That's what they do before beach season at the Jersey shore.

 

[deafdealer]

The p53 genes are already lost, and the cMycs are activated! Getting my cyclophosphamide ready.

See, the only thing that doesn't fit is that the people you're advocating for have never even had the material you teach--they literally wouldn't know what you were talking about^. Does that make your job irrelevant?

 

[Goro]

And your point? The readers here get what I'm saying.

Mine is that threads like these are toxic. Your own response reeks of elitism (I have more more schooling! I'm better!!!)

See, the only thing that doesn't fit is that the people you're advocating for have never even had the material you teach--they literally wouldn't know what you were talking about. Does that make your job irrelevant?

 

[username456789]

And your point? The readers here get what I'm saying.

Mine is that threads like these are toxic. Your own response reeks of elitism (I have more more schooling! I'm better!!!)

Your kind of attitude is partially to blame for the anti-intellectual nosedive our country has taken over the past ~10 years.

Yes, someone with much much much much much more schooling will tend to be better. This isn't elitism.

So many people want to claim equality with no merit. Hell, most people who read a mommy blog or two already know that they know more than most physicians.

 

[Tenk]

I don't know how much you looked into it but just an FYI, I know multiple vascular surgeons who can do many but not all of those procedures. Also, being licensed to do some of those cometic procedures is not difficult and any determined surgeon could easily get most if not all of those. Hell, I know ER docs who do botox and liposuction and I am like why the f*** are you doing that?!!!?!?!!?! Answer: $$$.

 

[Mad Jack]

Oh teh noes, god forbid the free market does its thing!

 

[Goro]

It's this attitude that reeks in these types of threads that Lee called y'all out the other day, genius. You're a better person just because you went to school for 15 years? Really? Spare me. This has nothing to do with nurses honing in on doctor territory.

And I suspect is why der Trumppenfuher and his minions did so well this past election.

Applying Ignore function now. You feel some pressure between the eyes. Try not to get too offended. Maybe a nurse will hold your hand.

Yes, someone with much much much much much more schooling will tend to be better. This isn't elitism.
So many people want to claim equality with no merit. Hell, most people who read a mommy blog or two already know that they know more than most physicians.

 

[username456789]

It's this attitude that reeks in these types of threads that Lee called y'all out the other day, genius. You're a better person just because you went to school for 15 years? Really? Spare me.

No one said anything about being a better person. Better for a job. A doctor is better at being a doctor than a nurse. Because they have received a doctor's education.

I honestly do think you troll this board hard sometimes. You have one of the biggest chips on your shoulders I've seen on this board and it is apparent nearly every time you post on here.

This has nothing to do with nurses honing in on doctor territory.

This thread is literally about nurses honing in on doctor territory.

And you teach the future physicians? Yeesh. Please take your balls and go home to your Safe Space.

 

[deafdealer]

It's this attitude that reeks in these types of threads that Lee called y'all out the other day, genius. You're a better person just because you went to school for 15 years? Really? Spare me. This has nothing to do with nurses honing in on doctor territory.

And I suspect is why der Trumppenfuher and his minions did so well this past election.

Applying Ignore function now. You feel some pressure between the eyes. Try not to get too offended. Maybe a nurse will hold your hand.

What? Why does your position even exist if these people don't even need to know what you teach to practice medicine? No, seriously, what is the standard of care?

 

[Promethean]

I can't speak to NJ, but in PA, there are at least some medispas that are "supervised" by absentee physicians where "laser technicians" with beauty school educations are performing the laser procedures and the various injections are performed by regular old RNs. No doctor on the premises during the hours of operation, ever. The doc dropped by every other weekend to sign off on charts, but a beauty school grad was the one taking histories, checking med lists for contraindications, and performing the procedures.

My friend (who had 10 full weeks of post high school education) was an esthetician who managed all the on-site operations of one of these places. She made a phone call to the doc if there was something she felt uncertain about, but that didn't happen most days. The RNs were there a couple of days a week to do injections, but most of the time, the only one using clinical judgment was someone who thought that the full 9 month course to get a cosmetology license was more than she could handle.

Now, I'm no more a fan of noctor encroachment than anyone... I wrote and championed a petition at my school to lobby our state legislature during the most recent attempt to grant NPs independent practice. But heck, this seems like an upgrade from what I saw happening. So, are you similarly crusading against every medispa that is allowing underqualified proceduralists to perform functions that should really be at least directly overseen by a physician... or just this one because an NP is involved?

If you aren't equally appalled at all the other shady businesses in this sector that are entirely physician owned, then that tips your hand that this isn't really about protecting patients so much as protecting turf. And that will lose this fight, every time. That is what fuels the success of encroachment efforts. The only moral ground we have to stand on is when we are talking about what is best for the patients. And that will only carry weight if it is applied consistently.

 

[cdmguy]

The level of credentialing necessary to own a clinic or be an unsupervised provider is a different, but important question. I expect a provider should have thorough dissection experience and meaningful supervised experience performing enough procedures to gain competency under someone who is credentialed themselves. So the NJ laws are actually reasonable and consistent with credentialing requirements in dermatology. Saying NPs and other providers who aren't meeting these minimum qualifications are acceptable because they are the best of the worst is a lame argument that might fly in a massively underserved area lacking providers but this certainly doesn't apply to north and central New Jersey. Further, with telemedicine there is no need for this. A dermatologist can consult remotely and the only issue is that the providers aren't really being supervised for the quality of the procedures by competent providers.

The fact remains that this nurse is tacitly breaking her state laws with the nursing board abetting her actions and nobody is doing anything about it.

 

[Promethean]

The level of credentialing necessary to own a clinic or be an unsupervised provider is a different, but important question. I expect a provider should have thorough dissection experience and meaningful supervised experience performing enough procedures to gain competency under someone who is credentialed themselves. So the NJ laws are actually reasonable and consistent with credentialing requirements in dermatology. Saying NPs and other providers who aren't meeting these minimum qualifications are acceptable because they are the best of the worst is a lame argument that might fly in a massively underserved area lacking providers but this certainly doesn't apply to north and central New Jersey. Further, with telemedicine there is no need for this. A dermatologist can consult remotely and the only issue is that the providers aren't really being supervised for the quality of the procedures by competent providers.

The fact remains that this nurse is tacitly breaking her state laws with the nursing board abetting her actions and nobody is doing anything about it.

Again, I ask, have you pursued justice against even a few of the abundant clinics where physicians are also tacitly breaking their state laws by allowing unlicensed personnel or people with non-health related licenses to practice far beyond their scope? Or are you specifically taking up this particular fight because it is an NP? If you were successful in achieving censure of this clinic operators, would that be the end of your advocacy to put down unsafe medispas? Or just until the next time you noticed and NP taking too large a role in one?

It isn't that I am in hearty support of this clinic because it is better than the worst I have seen. It is that targeting this one, which is not the most egregious and patient endangering practice in your area, suggests that patient endangerment is not your concern. Indeed, you haven't really spoken to it at all. All of your arguments come from authority. It is not "they are endangering the public" but "they are breaking rules and it is unfair to those who have followed them!" However right you are in that, it is not a winning argument, as it makes you look like a self-serving tattletale. The public and, as you have seen, the regulators who serve their interests, are not particularly moved by your worry that dermatologists and plastic surgeons are being undercut. They care if they believe that this causes harm to patients.

But if you are going to assert that, you can't focus narrowly on the one clinic that is "best of the worst." If anything, you are almost doing more good for them because you are giving the NPs fodder for their claims that opposition to encroachment is about protectionism and guild-like economic discrimination.

 

[cdmguy]

I'm personally not aware of any. I have filed complaints to state boards regarding other matters.

It is that targeting this one, which is not the most egregious and patient endangering practice in your area, suggests that patient endangerment is not your concern. Indeed, you haven't really spoken to it at all. All of your arguments come from authority. It is not "they are endangering the public" but "they are breaking rules and it is unfair to those who have followed them!" However right you are in that, it is not a winning argument, as it makes you look like a self-serving tattletale. The public and, as you have seen, the regulators who serve their interests, are not particularly moved by your worry that dermatologists and plastic surgeons are being undercut. They care if they believe that this causes harm to patients.

That's an interesting concept. Let's do a study of 100 illegal NPs, let them break the law and see how many injuries they cause. Perhaps you should direct this to the dermatology board and ask them what evidence they have supporting such high minimum standards. According to you they're just discriminating against nurses.

I don't think this is about protectionism at all. In NJ NPs are supervised so there is good reason to not put them in a position where there is a conflict of interest due to business ownership. There is also the pesky requirement that students do dissection and have minimum education in certain subjects before they practice. Stop defending law breakers.

 

[Promethean]

I'm personally not aware of any. I have filed complaints to state boards regarding other matters.

That's an interesting concept. Let's do a study of 100 illegal NPs, let them break the law and see how many injuries they cause. Perhaps you should direct this to the dermatology board and ask them what evidence they have supporting such high minimum standards. According to you they're just discriminating against nurses.

I don't think this is about protectionism at all. In NJ NPs are supervised so there is good reason to not put them in a position where there is a conflict of interest due to business ownership. There is also the pesky requirement that students do dissection and have minimum education in certain subjects before they practice. Stop defending law breakers.

I'm not defending law breakers. I'm saying that your approach to this matter could appear to be motivated by less than pure altruism and concern for public welfare. That perception maybe entirely inaccurate, and probably is. However, perceived motivations do matter in these situations. It is not enough to merely be technically in the right if there is not sufficient political will for enforcement. Building consensus requires speaking to stakeholders about how a situation impacts their priorities. It is the only route to victory in these matters.

However right you may be, and however much you may think your approach should have worked, it still didn't. Adapt your strategy or continue to obtain the same results and enrich your opponent. Saying so is not taking the side of the NPs. If it seems that way to you, I don't know what else to tell you.

 

[cdmguy]

If a state enforcement agency won't follow its own laws there isn't anything I can see doing that would make a difference.

Maybe start a group for NJ patients who are injured by NPs, post their stories and have them sign a petition. It would need media attention. This was done in Connecticut to try to stop chiropractic strokes and that went nowhere. Another case of the foxes (DCs) running the henhouse.

 

[Marrowist]

Money.

 

[Brahnold Bloodaxe]

No one said anything about being a better person. Better for a job. A doctor is better at being a doctor than a nurse. Because they have received a doctor's education.

I honestly do think you troll this board hard sometimes. You have one of the biggest chips on your shoulders I've seen on this board and it is apparent nearly every time you post on here.



This thread is literally about nurses honing in on doctor territory.

And you teach the future physicians? Yeesh. Please take your balls and go home to your Safe Space.

Off Topic and against TOS

 

[SunsFun]

<snip>

Well that's it then. He is officially uninvited from my sweet 16 party and I am not even gonna get on the school bus if he is riding it. I will just ignore him, even on Snapchat.


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[SansaStarkMD]

Worked with a nurse practitioner today at school. She functioned exactly as a nurse except she wore a white coat and stethoscope. I may show up dressed as a firefighter tomorrow.

 

[Bonferroni Correction]

If you want to be Captain... why not go to Captain school?

 

[Favoritefarm]

No one said anything about being a better person. Better for a job. A doctor is better at being a doctor than a nurse. Because they have received a doctor's education.

I honestly do think you troll this board hard sometimes. You have one of the biggest chips on your shoulders I've seen on this board and it is apparent nearly every time you post on here.



This thread is literally about nurses honing in on doctor territory.

And you teach the future physicians? Yeesh. Please take your balls and go home to your Safe Space.

Dude, some people loveeee attention from premeds. I remember med student classmates that loved going to premed gatherings at the undergrad so that premeds can tell them how great they are and so that they can share their "secrets" on getting into med school. You can tell that it was all about trying to look impressive in front of other people that you know want what you have ... a spot in med school. I just dont get how phds (not even mds), like certain people on this forum, are stuck on that premed binge for life. Like spending 6 hours on SDN to give internet advice ... to premeds ... everyday is beyond me. At least in real life you get to see that look of admiration but on the internet? Its strange.

Sent from my SM-G900V using SDN mobile

 

[mehc012]

Goro is not funny enough to be a troll. If you were to distill the essence of the 10 most insufferably holier than thou, preening bores you've ever met in real life, combine them, and spew them forth into the electronic realm, you would get Goro's contribution to this forum. His standard response when confronted by someone who doesn't share his asinine views is to invoke "trumpenfuhrer" and proclaim to "ignore" that person.

https://forums.studentdoctor.net/th...-went-un-matched.1201053/page-6#post-17865815

I sheit you not. He "ignored" me as well a few months ago after I disagreed with him on residency match policy while invoking "trumpenfuhrer" for no apparent reason whatsoever. He now "ignored" you as well for disagreeing with him on nursing practice scope, again invoking "trumpenfuhrer" while doing so. The guy is bonkers.

That's funny, because I've managed to politely disagree with Goro without being Ignored. I did get the snarky MCAT VR score dig once, but I checked and my actual MCAT score was unchanged so I moved on and we have had plenty of informative/interesting interactions since then...even if we don't agree on everything. Now, what do I know, but it seems like it's possible that there's some factor at play here beyond simply disagreeing.

 

[jw3600]

That's funny, because I've managed to politely disagree with Goro without being Ignored. I did get the snarky MCAT VR score dig once, but I checked and my actual MCAT score was unchanged so I moved on and we have had plenty of informative/interesting interactions since then...even if we don't agree on everything. Now, what do I know, but it seems like it's possible that there's some factor at play here beyond simply disagreeing.

I think that you think this post is way more clever than it actually is.

 

[Staphylococcus Aureus]

It's this attitude that reeks in these types of threads that Lee called y'all out the other day, genius. You're a better person just because you went to school for 15 years? Really? Spare me. This has nothing to do with nurses honing in on doctor territory.

To be fair this anti-intellectualism attitude is what breeds "equality" of opinions, thus demoting expert consensus to "one of many schools of thought" and partly a reason we are left with a scientifically illiterate society. OP isn't an elitist for calling out unethical practices, an issue we should all care about no matter the initials behind the name. I'm not interested in the NP debate, but portraying all NP criticism as merely physicians thinking they're from a better caste scared of the caring blue-collar nurses providing equal quality care, is simply incorrect.

 

[sliceofbread136]

Dude, some people loveeee attention from premeds. I remember med student classmates that loved going to premed gatherings at the undergrad so that premeds can tell them how great they are and so that they can share their "secrets" on getting into med school. You can tell that it was all about trying to look impressive in front of other people that you know want what you have ... a spot in med school. I just dont get how phds (not even mds), like certain people on this forum, are stuck on that premed binge for life. Like spending 6 hours on SDN to give internet advice ... to premeds ... everyday is beyond me. At least in real life you get to see that look of admiration but on the internet? Its strange.

Sent from my SM-G900V using SDN mobile

I just wished it was kept in the premed forum. He keeps coming to allo to give his 2 cents on issues that he knows nothing about.

 

[neusu]

But we need more NPs to fill the gap in primary care!

 

[SansaStarkMD]

But we need more NPs to fill the gap in primary care!

Yea forget all that knowledge stuff, complete waste of time. We need more actors acting. Put on a good show for the patients.

 

[NickNaylor]

Yea forget all that knowledge stuff, complete waste of time. We need more actors acting. Put on a good show for the patients.

Quite frankly, to those that actually have the power (politicians, payers, etc.), that is really all that matters. When people can be successfully convinced that MDs and NPs are equivalent because HbA1c is equivalent when people are put on appropriate insulin regimens or that SBPs are equivalent in patients with hypertension when started on an anti-hypertensive, physicians have lost.

The information asymmetry inherent in medicine is essentially being used as a tool to encroach on physician practice by allowing non-physicians to act as physicians because those in power don't understand that the findings above are completely meaningless and useless. Combine this with an inability or unwillingness to pay a for a physician-only healthcare system and you have the current trend.

 

[IlDestriero]

I don't think I'm better than any PA or NP because I had 25 years of education, but I'm fairy certain I forgot more than they probably ever learned along the way.


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Il Destriero

 

[Winged Scapula]

1) Singling out specific SDN users to insult them is a violation of the SDN Terms of Service.

2) This topic is not relevant to Allopathic medicine; moving to TIH for those that wish to follow

 

[caffeinemia]

I don't think I'm better than any PA or NP because I had 25 years of education, but I'm fairy certain I forgot more than they probably ever learned along the way.


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Il Destriero

You also forgot the l in your adverb. Bam!

 

[IlDestriero]

You also forgot the l in your adverb. Bam!

I never said I was any smarter either!


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Il Destriero

 

[cdmguy]

Our favorite NP, Marla Bell is back. Now she's doing cancer nutrition. An education PhD with no credentials in health care named Susan Silberstein has been approved by nursing continuing education to 9.5 self reported approved CEU nursing credits in cancer nutrition. and guess who signed up? Yup, our favorite aesthetics dermatology expert and plastic surgery expert nurse practitioner, Marla Bell NP from BodyChic in Hillsborough, NJ.

I look forward to reading her articles telling me how RDs are screwing cancer nutrition up. Someone should tell all those RD students that they are wasting their time. Just pay $500 and in a short 9.5 hours they will know more than they ever could wasting years studying traditional nutrition for oncology.

I've created a main thread page on this fake nursing nutrition class.

Nursing licensing boards give 9.5 continuing ed hours for quacky cancer nutrition course