New Brand of Nurse-Led Health Clinics Target Milwaukee's Underserved

Jan 13, 2014

A new brand of health clinic is cropping up more frequently across the country - clinics run by nurses.

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.

The clinics are serving low-income communities, where doctors are scarce. Two such clinics recently opened on Milwaukee’s north side, thanks to Children’s Hospital and Marquette University.

Today, 10-year-old Earron Davis is at the clinic on 23rd and Burleigh for his first visit. A nurse takes his height and weight, temperature and blood pressure, and checks his vision.

As Earron reads the letters, his mom, Jessica Peterson, says she's thrilled.

“I actually like it because it’s within walking distance and it’s convenient, being able to have a neighborhood clinic 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.

After a few minutes, nurse practitioner Susan Thaller walks into the exam room to begins to go over the medications Earron is taking. He has asthma, just like many of Thaller’s young patients.

She says a good number also have chronic bronchitis and increasingly, obesity. Among her adult patients – the clinic sees them too – common issues are diabetes and hypertension. But Thaller says typically an urgent care need first brings all ages, through the door.

“An illness issue, a sports physical, needing immunizations. Nurse practitioners as a family nurse practitioner I offer a holistic assessment and then primary care. In that assessment, mental health issues, growth and development issues,” Thaller says.

In poor neighborhoods like this one, you find great healthcare needs, but few primary care doctors. That’s because many residents are on Medicaid. Since the government program doesn’t fully reimburse physicians for the cost of services, few are willing to take on a large Medicaid population. So poor people often have to travel miles for a medical appointment, and many don’t have transportation.

It was a concern neighbors shared with Children’s Hospital during focus groups a few years ago.

“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,” says Kerry Yamat, who oversees the clinic on Burleigh and the other new one at the Northside YMCA.

Donations covered set-up costs, while a foundation has pledged to cover the clinics’ projected losses for at least three years. When it comes to staffing, Children’s Hospital provides administrative services. Marquette supplies nurse practitioners who have advanced training and the ability to prescribe drugs.

Nurses are more affordable than physicians. The model is spreading, especially in underserved areas.

Tine Hansen-Turton is chief executive officer of the National Nursing Centers Consortium. She says there are about 250 nurse-managed clinics throughout the country, and the number is growing.

“With Obamacare, there was for the time ever a definition in federal law around what a nurse-managed health clinic is, so now they are recognized, federally,” says Hansen-Turton.

She says the Affordable Care Act also set aside $15 million to support new clinics. As for the quality of care, Hansen-Turton says the nurses can capably manage much of the care doctors normally provide.

“It’s comparable to physician care. In some cases, better, and that has a lot to do with the relationship, and when you’re embedded in the community and have a strong relationship with people that live in a community, you also build up a different kind of trust and are able to see patients more often,” Hansen-Turton says.

Back on Milwaukee’s north side, nurse practitioner Susan Thaller says there’s been a great response to the new clinic so far, and even though it’s targeted for people who live nearby, patients are coming in from all over the city.

Children’s Hospital and Marquette hope to eventually hire more staff and extend the clinics’ evening hours. Eventually nursing students may become involved.