Skip to main content
Skip to navigation

The Nurse is 'In': Bringing Health Care to Rural Areas

June 26, 2007

Story Contact:  Jennifer Faddis, 573-882-6217,

COLUMBIA, Mo. — Accessible health care is a major concern for rural Missourians. In many situations, people have to travel long distances to see a doctor. In order to address this concern, some nurse practitioners in the state are opening their own health clinics, and the University of Missouri-Columbia is helping them get the skills they need.

"Nurse practitioners were not trained as business people but were trained as clinicians," said Shirley Farrah, assistant dean for outreach and distance education for the MU Sinclair School of Nursing. "It's important to help them get the business skills that they need, provide networking opportunities and know the regulations that go along with owning your own clinic."

According to Farrah, there are fewer than 15 health clinics in Missouri that are owned and operated by nurse practitioners. MU Extension nursing programs show nurse practitioners in rural communities what it takes to start and operate a successful health clinic.

"The patient care aspect is probably the easiest. It's the business aspect that a lot of nurses aren't taught," said Laura Thiem, a nurse practitioner who owns a health clinic in Adrian, which is located 50 miles south of Kansas City.

With the help of her family, Thiem turned an empty storefront on Main Street into the Adrian Clinic. In her first year, her practice has served 1,800 people with more than 4,000 patient visits.

"That's pretty busy, and it's enough to keep the doors open. That tells me that there¿s a need here," Thiem said.

According to the American Association of Colleges of Nursing, health planners increasingly rely on nurse practitioners as the providers of choice for a range of front-line health services due to the growing pressure to balance quality and cost. Studies show that the quality of nurse practitioner care is equal to, and at times better than, comparable services by physicians and often lower in cost.

"About 80 to 90 percent of the patient issues that are seen in offices can be dealt with by nurse practitioners," Farrah said.

Since the mid-90s, the number of nurse practitioners has grown every year. In 1996, there were fewer than 40,000 nurse practitioners nationwide, but nine years later the number had increased to 141,000, according to the U.S. Department of Health and Human Services.

According to the Missouri State Board of Nursing, there are 3,026 nurse practitioners in the state. With the spiraling cost of health care, these professionals are playing a significant role by providing an affordable alternative for those who need it most. Farrah adds that rural health care in Missouri could benefit from the increasing number of nurse practitioners if they decide to own their own clinics. Currently, there are only a handful of clinics owned by nurse practitioners.
"That number has got to more than double," Thiem said. "If we have 10 to 20 now, 20 to 40 are not going to be enough. We need to have those in the hundreds. We have communities out there that could easily support a nurse practitioner."

Note: Television b-roll and sound bites are available on tape by contacting Kent Faddis, or 573-882-5361