Dr. Mackey feels his outstanding contribution to nursing is the development of a model nurse practitioner faculty practice clinic at the University of Texas Health Science Center in Houston. This primary care and occupational health clinic is as a model academic nursing center (ANC) that is nationally known for its business systems, cost-effectiveness, clinical teaching, quality of care, and interdisciplinary approach to patient care by nurse practitioners. Building on his pioneering efforts in the mid 1970's to help develop the first rural clinic certified under the Rural Health Clinic Bill, he continued to work to ensure the viability and acceptability of advanced practice nursing in an interdisciplinary environment. Dr. Mackey's clinical and business leadership skills developed the most financially solvent faculty practice and ANC in the country in the areas of primary care and occupational health. Dr. Mackey served as the Associate Dean for Practice and Clinical Director until 2016 at which time he stepped down from those roles. Dr. Mackey continues as a part time faculty member providing clinical services at the University of Texas Health Services Clinic.