On their own

The Decker College of Nursing and Health Sciences alumnae who recently launched their own dermatology practice in Vestal would describe their venture as different, but also business as usual.

In July, Yvonne Chesna ’92, MS ’96; Beth Stewart, MS ’14; and Michelle Winsor, MS ’12, opened Broome Family Nurse Practitioners Dermatology and Skincare, the area’s first practice group owned by nurse practitioners.

“It’s very exciting to be in a pioneer-type mode,” Chesna says. “We had to navigate things we weren’t used to doing, such as the business functions. But our approach to patient care is the same as it has been.”

The three partners have about 80 years of nursing experience combined, and more than 30 of those are in comprehensive skincare for people of all ages. Chesna, Stewart and Winsor had worked together in another dermatology practice in the region before breaking away to form Broome Nurse Practitioners Skincare.

“We bring a lot to the table,” Stewart says. “We’ve gone from bedside nursing to administration to case management before becoming nurse practitioners.”

Not having a medical doctor in the house isn’t going to be a big change, Winsor says, because — like the office where she, Chesna and Stewart previously worked — many of their patients never had to see a physician.

“Patients saw us for their needs,” Winsor says. “If we needed to refer to [a doctor] in our building, the patients had to make a separate appointment and come back anyway.

“We have a network of physicians we can reach out to for consulting or referrals, so there is no change at all to the continuity of care.”

“The biggest change the patients will see is the physical location itself,” Chesna says. “We’re in a different office, but working with a lot of the same people.”

What patients will notice is that they’ll be able to get in the door a lot faster.

In recent years, the need for dermatology in the Binghamton area has increased, and the existing practices haven’t been able to keep up. New patients frequently face wait times of six to nine months for an initial appointment.

“The practices are still out there, but there are fewer providers now because the physicians have retired or relocated,” Chesna says. “We came to this practice with a lot of patients, some of them are adults who we started seeing when they were kids. But we’re able to meet that pent-up demand, too. We’re all SUNY Broome grads and Binghamton University grads. We’re local and we’re not going anywhere. We have a lot of connections to providers in the area.”

Broome Nurse Practitioners Skincare will be connected to Binghamton’s Decker College; the partners are interested in coming to campus to serve as guest lecturers and hope to have students shadow them in the office.

NEW LAW PAVED THE WAY

When Chesna, Stewart and Winsor were in their master’s programs at Decker, the idea of nurse practitioners forming a practice wasn’t even possible, but that changed when the New York State Legislature passed the Nurse Practitioner Modernization Act as part of the 2014–15 budget. Under the law, nurse practitioners with more than 3,600 practice hours don’t need a signed, written practice agreement with a physician. After years of lobbying lawmakers, nurse practitioners have the independence they want.

“Although opening a new medical practice is a daunting task, with the right contacts and assistance, nurse practitioners now have this opportunity,” Winsor says.

“We started our journey at the Koffman Southern Tier Incubator, then had a relative with a strong business background handle the business planning and state paperwork required to form a corporation. There have been hundreds of hours dedicated to the process to make this dream a reality.

“We are all excited to be back doing what we know and love, which is seeing and helping patients,” she adds.