Nurse-led clinics: No doctors required

Nurse practitioner Susan Thaller and her patient, 10-year-old Earron Davis, at the new Children's Primary Care Clinic on Milwaukee's north side.

Millions of Americans now have health coverage thanks to the Affordable Care Act. But some are getting stuck on Step 2 – that is, finding a doctor.

Already, nearly a fifth of Americans live in areas with too few primary care physicians, and the shortage will only get worse as more people become insured. So, in some places, nurses are taking on the job of keeping people healthy.

In Milwaukee, a young boy named Earron Davis hops up on the exam table and swings his legs back and forth as a nurse takes his temperature and blood pressure. It’s the 10 year-old’s first visit to this new primary care clinic. It’s an area of Milwaukee with great healthcare needs, but few doctors. Physicians don’t want to be here because most people are on Medicaid, and doctors don’t make money off those patients. So Earron’s mom, Jessica Peterson, is happy there’s a new healthcare option so close to home.

"Cause there’s so many kids in the neighborhood that I’m sure has to go far out to see a doctor, so this is very, very, very convenient," Peterson says.

But the clinic hasn’t brought in any new doctors. Instead, nurse practitioners run it. They can handle the majority of primary care, and prescribe drugs. The clinic will still lose money on its Medicaid patients. But nurse practitioners cost a lot less than doctors. It’s a model that’s spreading.

"There has been tremendous growth in the nurse-managed health clinics, especially prior to the Affordable Care Act implementation, but certainly also now," says Tine Hansen-Turton, CEO of the National Nursing Centers Consortium. She says there are now 500 nurse-led clinics around the country, and the number will expand as providers look for less pricey ways to provide health care.

"I would go as far to say that we won’t have a successful implementation of the Affordable Care Act if we don’t utilize nurse practitioners in primary care roles," Hansen-Turton says.

Back at the new clinic in Milwaukee, nurse practitioner Susan Thaller is getting Earron Davis’ medications in order.

The boy has asthma, just like many of the young patients in this neighborhood. Thaller also treats a lot of diabetes, hypertension and obesity.

"As a family nurse practitioner, I offer a holistic assessment and then primary care. In that assessment, mental health issues, growth and development issues," she says.

This clinic, and another new one in town, are operated by Children’s Hospital of Wisconsin and Marquette University. Director Kerry Yamat says the clinics came about because neighbors lobbied for better health care options.

"Children’s listened to the residents and realized that there was a need to provide closer access to health care in this community, so here we are today," Yamat says.

The response has been so good that one of the clinics has already expanded its hours. And there are plans to add even more nurses in the coming months. 

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