HL20: Robert D. Donaldson, NPC—The Nurse Practitioner-Run ED

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is the story of Robert D. Donaldson, NPC.

This profile was published in the December, 2011 issue of HealthLeaders magazine.

 "We've gotten past why a nurse practitioner is in charge in this community because I market myself. I am Bob Donaldson, a nurse practitioner."—Robert D. Donaldson, NPC

There are times when patients are ushered into the emergency department in tiny Ellenville Regional Hospital in upstate New York, and they ask: Is there a doc here?

"There are no doctors here in the ED, I'm the one you are going to see," says Robert D. Donaldson, NPC, in his well-worn refrain. And yes, there have been the occasional snickers, or even calls to the C-suite to complain.

Donaldson is no doctor, but he's a nurse practitioner, as is every member of the ED staff at the 25-bed critical access hospital. Not only does he often handle his own shift, he also has clout within the hospital. He's clinical director of emergency medicine and president of the hospital's medical staff, sharing ED leadership responsibilities with a medical director, Norman Chapin, MD. The hospital is in the Catskill Mountains about 40 miles from Kingston, NY.

So is this really working, a nurse practitioner in charge? And do the physicians really like what he's doing? "You'll have to ask them," he says. He pauses. "Yes, there is an answer to that. We are admitting patients, making money for the hospital, and the hospital is in the black year after year. What does that say? The hospital has received an award for its emergency department for patient care. What does that say?"