PRACTICING PRIMARY CARE
Nurse-led clinic sets the bar
One night in 1990, Dean Patricia L. Starck woke up with idea of starting a nurse-led clinic. So recalls Professor Thomas Mackey, PhD, FNP, FAAN, who would go on to lead UT Health Services for 24 years.
The nursing school was fortunate to have Mackey on faculty. He had previously helped establish rural nurse practitioner clinics in Appalachia and Illinois, and before his 20th birthday, he was helping priests care for patients in the Congo following civil war. Mackey joined the UTHealth Houston nursing school as an associate professor in 1989, teaching undergraduate courses.
University leaders traveled to Austin to make the case for establishing the new clinic, and approval came with the caveat that nurses would not charge for services.
“Everyone was worried, but I was not,” Mackey said. “I said, ‘We will hire a physician and bill through his name.’” That physician, George Delclos, MD, PhD, continues to serve as the medical director of UT Health Services to this day.
With an unrelenting focus on quality of care and patient safety, Mackey set out to build the clinic as a financially stable and sustainable business. “In about a year and a half, we became financially self-sustaining,” he said.
Employee and occupational health services became the foundation of future growth. Mackey’s early work with the Department of Family and Community Medicine at McGovern Medical School at UTHealth Houston, as well as providing physicals to patients for the medical school’s Faillace Department of Psychiatry and Behavioral Sciences, attracted the attention of Bob Bowman, then the assistant vice president for Auxiliary Enterprises for UTHealth Houston. This led to a contract for UT Health Services to provide employee and student health services for the entire university. Many employees began to choose the clinic as their primary care provider.
The arrangement worked out so well that Mackey sought out contracts with other large employers in the Houston area to provide occupational and primary care health services.
“Those people came in for pre-employment exams, and they turned around and become primary care patients,” Mackey explained. “UT Health Services became the model for academic nursing centers around the country because we were successful – we were financially self-sufficient and returned money to the school of nursing to further its academic mission.”
Mackey stepped down as the clinic’s director and the school’s associate dean for practice in 2015, but his retirement is only partial. He continues to serve the clinic’s largest occupational health contract with the Texas Commission on Environmental Quality. He travels all over the state from January to May each year providing annual health monitoring exams using a rented semitrailer with audiology, EKG, an exam table, and X-ray capabilities.
UT Health Services’ tradition of clinical excellence continues under the leadership of alumna and Director Joy Harrison, DNP, RN, and Associate Dean for Practice and Community Engagement Leissa Roberts, DNP, CNM, FACNM.
Harrison’s first task when joining Cizik School of Nursing in June 2021 was planning and implementing the clinic’s move from the 16th floor of the University Center Tower, 700 Fannin St., to the ground floor of the UT Health Science Center Professional Building at 6410 Fannin St., Suite 100. The new location, which opened in March 2022, offers added conveniences such as valet parking, telehealth services, a pharmacy across the hall, and a METRORail stop across the street.
Routine primary health care offerings include yearly well-woman exams, immunizations, and diabetes and cardiovascular disease risk assessments. Occupational health services for UTHealth Houston and other Houston employers include preplacement services, audiology and vision screening, chest X-rays, EKGs, and immunizations. The clinic also remains the employee health hub for UTHealth Houston’s 12,000+ employees.
“It is a great privilege to build on the innovative work of Dr. Mackey, Dr. Delclos, and the dedicated staff and nurse practitioners who established and grew UT Health Services over the years,” Roberts said. “In our new location, we look forward to serving as a health care home for more patients and a workplace partner for more employers while providing clinical opportunities to Cizik School of Nursing students and faculty.”
(Banner image: Thomas Mackey, PhD, FNP, (right) helped establish the UT Health Services clinic.)