List of Degrees No Longer Professional Under Trump: What Nurses Need to Know
In the first three parts of this series, we've covered what H.R. 1 actually changes, how to negotiate compensation that reflects doctoral preparation, and what DNP and PhD nurses uniquely bring to healthcare leadership. This is Part 4 of our 5-part series on navigating H.R. 1 as a doctorally-prepared nurse. Now we're getting tactical. When systems contract, and they're about to, innovative practitioners who understand how to serve underserved populations don't just survive. They lead. Here's what I know about doctorally-prepared nurses: We don't wait for permission. We don't wait for systems to fix themselves. We design the interventions, publish the evidence, train the next generation, build the businesses, and lead.
H.R. 1 & Nursing Doctorates: Complete Series
Confused about whether nursing degrees are still "professional"? This 5-part series breaks down what Trump's H.R. 1 actually changes, and what it doesn't.
Research Opportunities: Abstracts, Conference Presentations & Publications For PhD Nurses:
This is your moment. H.R. 1 creates a natural experiment in health policy, and we need nurse scientists documenting what happens next.
Priority research questions:
• How does Medicaid coverage instability affect dermatologic outcomes in skin of color populations?
• What are the barriers to early intervention for keloids, CCCA, and acne in populations experiencing coverage gaps?
• How do eligibility redeterminations impact continuity of care for chronic skin conditions?
• What community-based intervention models improve access to dermatologic care when traditional systems contract?
Actionable steps:
• Submit abstracts to the Dermatology Nurses' Association (DNA) Annual Convention (early bird deadline typically February for summer conventions)
• Target the National Black Nurses Association (NBNA) Annual Conference for work focused on health equity and skin of color
• Present at Elevate Derm - a conference built by and for advanced practice providers (NPs and PAs) in dermatology and aesthetics, where APP research and clinical innovation are centered (not sidelined)
• Explore American Association of Nurse Practitioners (AANP) National Conference for policy-focused presentations
• Consider poster presentations at interdisciplinary dermatology conferences where APP contributions are welcomed
Publish in journals that value nursing science and NP expertise:
• Practical Implementation of Nursing Science (PINS) - A nurse-led, peer-reviewed journal founded by Dr. Kimberly Souffront, PhD, RN, FNP-BC, FAHA, FAAN, specifically to bridge the gap between nursing research and practice implementation
• Journal of Cosmetic and Aesthetic Dermatology (JCAD): NP + PA Dermatology Perspectives - Where I serve on the editorial advisory board, focused on advanced practice provider contributions to dermatology
• Journal of Dermatology for Nurse Practitioners and Physician Assistants - Peer-reviewed publication centering APP clinical expertise and research
• Journal of the Dermatology Nurses' Association (JDNA) - The established publication for nursing contributions to dermatology
• Journal of the American Association of Nurse Practitioners (JAANP) - For broader NP practice and policy research
• Journal of Advanced Nursing - For theoretical and conceptual work in nursing science • Health Affairs or Health Services Research - For policy analysis with broader impact
Why this matters:
Nurses have already built peer-reviewed journals where nursing research is valued, understood, and implemented. PINS exists because Dr. Souffrant saw the gap and filled it. JCAD created an NP + PA section because we needed it. These aren't consolation prizes - they're the journals where your work will actually reach the practitioners who will implement it, where your methodology will be respected as nursing science, and where doctoral-level nursing expertise is the standard.
For DNP Students & Graduates:
Your DNP and capstone projects and quality improvement initiatives are practice-changing work. Document them. Present them. Publish them.
QI project ideas tied to H.R. 1 implications:
• Implementing telehealth models to maintain continuity when patients lose coverage
• Developing sliding-scale payment structures that keep care accessible
• Creating community partnership models with safety-net clinics
• Building patient navigation systems for Medicaid redetermination periods
• At the table where innovation and creation are taking place
Curriculum Development: Teaching the Next Generation
If you're teaching, whether in a university, a clinical setting, or through your own practice, this is what the next generation of NPs needs to know:
Core Competencies for the New Landscape:
• Business models that aren't payer-dependent: Teaching NPs how to build hybrid practices that serve Medicaid, cash-pay, and private insurance patients without financial instability
• Health equity and policy literacy: Understanding how legislation like H.R. 1 impacts patient populations and how to advocate effectively
• Community-based care delivery: Moving beyond clinic walls to reach patients where they are
• Telehealth and digital health integration: Maintaining care continuity when patients can't afford in-person visits
Actionable curriculum additions:
• Add a module on "Health Policy and Practice Viability" to entrepreneurship courses
• Integrate case studies on managing patients through coverage transitions
• Create simulations around discussing cost and payment options with patients
• Develop workshops on building community partnerships and safety-net collaborations
For independent educators (like us):
Consider creating:
• A CE course on "Navigating Medicaid Policy Changes in Aesthetic Practice"
• A workshop on "Building a Financially Sustainable Dermatology Practice in Underserved Communities"
• A masterclass on "Skin of Color Dermatology: Clinical Excellence When Systems Fail"
Media & Thought Leadership: Shaping the Narrative
Nurse practitioners need to be the ones explaining what's happening and what's next, not just to each other, but to the public, to policymakers, and to the media.
Op-Eds & Commentary:
Pitch to:
• Nursing publications: American Nurse Journal, Nurse.com, NP News
• Health policy outlets: Health Affairs Blog, The Commonwealth Fund Blog, STAT News
• General audience: Local newspapers, Medium, LinkedIn articles
Angle: "As a nurse practitioner serving [specific population], here's what I'm already seeing, and here's what we need to do about it."
Pitch: "I'm a doctorally-prepared NP working at the intersection of health equity, dermatology, and policy. Let me explain what H.R. 1 means for patient access, and what nurse-led solutions look like."
Social Media Strategy:
Use LinkedIn, Instagram, and TikTok to:
• Break down H.R. 1 in plain language
• Share patient stories (with permission) that illustrate the impact
• Highlight nurse-led solutions and innovations
• Position yourself as the expert on this intersection
Sample post topics:
• "What dermatology NPs need to know about Medicaid changes in 2027"
• "Why coverage instability means you'll see more late-stage skin conditions, and what to do about it"
• "How I'm redesigning my practice model to serve patients regardless of insurance status"
Community Outreach & Prevention: Meeting Patients Where They Are
When patients lose coverage or delay care, community-based interventions become critical.
Screening & Education Programs:
Partner with:
• Community health centers and federally qualified health centers (FQHCs)
• Churches, mosques, and community organizations
• Beauty schools and barbershops (particularly for scalp health and CCCA awareness)
• Senior centers and aging-in-place programs
What to offer:
• Free or low-cost skin cancer screenings
• Educational workshops on managing chronic skin conditions
• Resources on navigating Medicaid redetermination
• Referral pathways for patients who need specialty care
Mobile or Pop-Up Clinics:
Consider building a mobile dermatology model that:
• Brings care directly to underserved communities
• Offers sliding-scale pricing
• Accepts multiple payer types, including cash-pay
• Partners with local organizations for space and outreach
Digital Health & Telehealth:
Expand access through:
• Asynchronous teledermatology for initial consultations
• Follow-up care via video for established patients experiencing coverage gaps
• Educational content (YouTube, Instagram, blog) that serves as prevention
Global Partnerships: Expanding Impact Beyond U.S. Policy
If U.S. Medicaid policy is contracting, consider how your expertise in skin of color dermatology and aesthetic nursing can expand globally.
International Collaboration Opportunities:
• Africa: Partner with nursing schools and dermatology programs in Nigeria, Ghana, South Africa, and Kenya to develop culturally relevant curricula
• Caribbean: Collaborate on skin cancer prevention and keloid management education
• Latin America: Build partnerships around aesthetic nursing education and practice standards
Models for global work:
• Guest lecturing (virtual or in-person) at international nursing programs
• Co-authoring research with international colleagues
• Consulting on curriculum development for countries building aesthetic nursing specialties
• Creating open-access educational content that serves practitioners globally
Why this matters strategically:
When one healthcare system restricts access, nurse practitioners who can demonstrate impact across multiple contexts become more valuable, more visible, and more influential.
Entrepreneurship: Building Businesses That Serve Regardless of Policy
Founder-level nurse practitioners don't just react to policy. They build business models that work regardless of what policymakers decide.
Business Model Innovations:
• Membership-based dermatology: Monthly subscription model that covers routine visits, education, and basic treatments
• Hybrid cash-pay + insurance practices: Serving multiple payer types so your business isn't dependent on Medicaid reimbursement rates
• Concierge aesthetic NP services: Premium pricing for aesthetic services that fund sliding-scale or pro-bono medical dermatology
• Educational product lines: Digital courses, guides, and resources that generate revenue while serving your mission
What to build now:
• A payment structure that allows patients to access care during coverage gaps
• Partnerships with community organizations that can refer patients and provide space
• Telehealth infrastructure that reduces overhead and expands reach
• Educational content that positions you as the authority and builds trust before patients even book
Why this matters:
Because when Medicaid reimbursement drops and facilities close, the NPs who surviv and thrive, are the ones who built businesses designed to serve patients regardless of insurance status.
The Bottom Line: This Is Our Moment to Lead
H.R. 1 isn't just policy. It's a signal.
It's a signal that the systems we've relied on are shifting. That the patients we serve are going to need us more, not less. That the gaps are widening, and somebody needs to step into them.
And that somebody is us.
Because here's what I know about doctorally-prepared nurses, about founder-level nurse practitioners, about the educators and researchers and entrepreneurs reading this:
We don't wait for permission. We don't wait for systems to fix themselves. We design the interventions, publish the evidence, train the next generation, build the businesses, and lead.
So let's lead.
Let's publish the research that documents what's happening and what works. Let's build the curricula that prepares the next generation for this reality. Let's shape the media narrative so people understand what's at stake. Let's create the community programs that reach patients when traditional systems can't. Let's build the global partnerships that expand our impact beyond U.S. policy. And let's build the businesses that serve patients regardless of what policymakers decide next.
This is what it means to train founders, not followers.
This is how we turn policy challenges into leadership opportunities.
And this is how we make sure that when patients need us most, we're still here, still open, still serving.
Dr. Kimberly Madison, DNP, AGPCNP-BC, WCC, is a Board-Certified, Doctorally-prepared Nurse Practitioner, educator, and author dedicated to advancing dermatology nursing education and research with an emphasis on skin of color. As the founder of Mahogany Dermatology Nursing | Education | Research™ and the Alliance of Cosmetic Nurse Practitioners™, she expands access to dermatology research, business acumen, and innovation while also leading professional groups and mentoring clinicians. Through her engaging and informative social media content and peer-reviewed research, Dr. Madison empowers nurses and healthcare professionals to excel in dermatology and improve patient care.
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