"We have been saying in nurse practitioner circles for years that nurse practitioners can do most of the things that docs have been doing," says Donaldson. "[The CEO] felt we could do a comparable job. So we've been doing it—and people like it."
As an admitting provider in the ER, the hospital's medical staff got to know Donaldson well and in 2008 he was invited to be on the team to review and revise the medical staff bylaws.
"The medical staff, all physicians, voted to give equal rights to nurse practitioners on the medical staff," says Donaldson. "Which means if you have a practice here and you are involved in admissions to this hospital, that you are equal to a doctor as far as privileges at the facility and within the medical staff."
In another unusual move, Donaldson's work in the ER means he admits patients to the hospital and its various providers every day, so the hospital decided to give him attending status.
Donaldson says that in 2009 the hospital needed to fill the position of medical staff president and was having difficulty attracting volunteers. So he put his name in the hat.
"I look at that as like anything else nurse practitioners have done," he says. "There's a void and we step in and we do the job. So that's what I did."
Donaldson notes with a laugh that once a nurse practitioner's name was in the running, other physicians stepped up to add their names. After three rounds of voting, he was elected with more than 50% of the all-physician vote. Since his election, he has enjoyed success and support from his colleagues