On
Newsstands
Now
Current Issue
Advertisement

The Doctor Is Out

Nurse-managed clinics are becoming an increasingly popular health care option. 

By |

In 2011, nurse practitioner Mary Riccelli opened the NeuroBehavioral Institute of Colorado, a behavioral health practice that operates without a physician. Even without a doc on-site, Riccelli’s patients number in the thousands. Beyond being in demand, Riccelli’s also on the cusp of a trend: There are more than 500 nurse-managed clinics in the country, and a 2012 report from the Rand Corporation predicted that the nurse practitioner workforce will nearly double by 2025. We talked with Riccelli about her doc-free environment.

____

Advertisement

5280 Health: What is the appeal of a practice like this for patients?

Mary Riccelli: We have nursing backgrounds, so our training stressed the importance of being present with the patient and not distracted. Nurse practitioners also generally like to prescribe fewer medications; we incorporate a more holistic approach to mental health care and advocate supplements. We don’t want people to expect a pill to cure everything. We also tend to be better listeners because nursing is naturally a more integrative approach. We ask about the whole body—your water intake, your sex life. Physicians are much more disease-focused. We’re person-focused.

Which disorders do you treat?

The full range—from Asperger’s and autism to eating disorders and post-traumatic stress disorder. My area of focus is family, and this practice is 60 percent children ages two to 18.

Did you always want to be a nurse?

Advertisement

I was looking for an industry where I’d be the most employable, so at 44, I decided to go back to school after 20 years in telecommunications sales. My sister said I should be a nurse—that I had that manner—but I wanted to be able to prescribe medication. When I went for a clinical rotation in family psychology at Syracuse University, I said, “This is for me.” I immediately started on a master’s in nursing at the University of Rochester in 1999.

How did you decide to do this?

When the Nurse Practice Act was enacted here in Colorado in July 2011, I saw it as an opportunity. Before the change, we had to have a collaborating relationship with a physician to prescribe medication. But since 2011, as long as we had the training hours, we could prescribe on our own. I am so proud of Colorado for making this huge step and giving us this freedom.

Has it ever bothered someone when they found out there is not a physician in your practice?

If people are calling and looking for care and they say they want to see a doctor, we are very clear with them. Most of the time, though, they end up booking the appointment anyway. If they really want to see a doctor we give referrals.

Advertisement

How will NP medicine fit into health-care reform?

In an overview of the psychiatry practices in Colorado, I found that 70 to 80 percent of the doctors are over 60. I think there will be an even bigger role for NPs in the near future, especially when more people are covered by the Affordable Care Act. Many primary-care doctors already refer patients to me; children’s hospitals, too.

How do more traditional practices feel about this type of medicine?

It was contentious with doctors for a while. We’re not doctors, and we don’t want to be. We want to be nurses.

Advertisement

Recommended for You

Newsletter Signup

Keep me up to date on the latest trends and happenings around Denver. 5280 has a newsletter for everyone. Sign Up