Bob Donaldson is clinical director of emergency medicine and president of the medical staff at Ellenville Regional Hospital in New York. His current projects sound much like any medical staff president's goals.
What might surprise you is that Donaldson is not a physician but a nurse practitioner. He was elected to this influential position by his physician colleagues and enjoys great support from the hospital's medical staff.
I interviewed Donaldson to find out how a nurse practitioner broke down physician hierarchy and found an innovative hospital that could be a model for provider collegiality and meeting a community's healthcare needs.
Donaldson has a long background in emergency nursing and came to Ellenville Regional in 2004 when he was approached by the owners of an emergency medicine group that staffed providers for the ER, which at the time was staffed by all physicians, and asked to be the first non-physician provider for the ER.
He interviewed with the new CEO, with whom he immediately hit it off. The CEO convinced him that despite the hospital's financial difficulties those things would change, so Donaldson came on board.
"I passed muster, if you will, as the first non-physician, full-time, sole provider here as an NP working in the ER alongside the docs," he says. "It was so successful that we ultimately eliminated all the docs here and replaced them all with nurse practitioners or physician assistants."
In 2004, the ER saw 8,000 visits per year. Now, it sees 12,500 per year, a number it has maintained for the last two years. Donaldson notes that the non-physicians provider arrangement is unusual but explains that his CEO conducted extensive research on nurse practitioners and their practice as part of his graduate work.