When you hear the word clinic or phrase doctor's visit, you might think of waiting rooms with fish tanks and check-in stations with sliding glass windows. Maybe even a TV with scrolling messages about flu season and preventive measures to take, such as washing your hands and covering your cough. You wait for your name to be called and are then ushered back by a nurse who takes your vitals and asks some clarifying questions before the doctor enters. It's a routine many of us know well.
If that's your definition of a wellness visit, then you're in for a surprise at Seaside Family Medicine. Upon entering this nurse-managed clinic, you are greeted by dark wood floors, light blue walls with crisp, white shiplap paneling. Coastal inspired artwork constitutes much of the décor and restored, wood church pews are the only options for seating. To the right, guests are greeted at an open check-in station with opaque, hanging light fixtures — something you might find at a spa or over a kitchen bar; atypical in many medical practices.
Amanda McAllister, RN, DNP ’17, was intentional about each design element, holding to her vision of creating a peaceful and quiet, nonclinical feeling space where patients could receive their treatments.
"I know from personal experience that going to see a health care provider can be stressful, so I wanted to provide a serene environment for our patients,” Amanda said. “I want them to be as comfortable and relaxed as possible."
Amanda owns and manages Seaside Family Medicine alongside her mother, Donna McAllister. That's one of the notable reasons Seaside Family Medicine is not your average medical practice: it's nurse owned. Another reason: it's also a mother-daughter business venture.
Donna and her husband moved to Charleston from Massachusetts in 2013. After Amanda graduated from Regis College in Boston with a master's degree in nursing, she joined her parents in South Carolina and accepted a position at a Federally Qualified Health Center (FQHC) in Orangeburg.
In 2016, Amanda decided to pursue a doctoral degree at MUSC. Because she continued to practice in the health clinic while going to school, Amanda was able to participate in the Advanced Nursing Education Program, a grant program that provides tuition assistance in exchange for her continued work at the FQHC.
After Amanda graduated from MUSC with her Doctor of Nursing Practice, the mother-daughter duo decided to take a leap together by opening their own clinic. Amanda felt that her work in the health center not only reaffirmed her desire to own a health clinic but also showed her that she wanted to provide care in medically underserved communities.
"Throughout Amanda's college years we always talked about her dream of having her own practice and mine of owning my own business," Donna said.
Nurse-managed health centers are emerging across the country to meet the growing demand for quality and affordable health care in underserved communities. These clinics are operated by advanced practice registered nurses (APRNs), authorized under Title III of the Public Health Service Act. To put the need into perspective, parts of all 46 counties in South Carolina are considered medically underserved, making nurse-managed centers a great benefit to South Carolina residents.
With the passing of South Carolina's Nurse Practice Act in 2018, nurse practitioners now can practice without direct approval from a supervising physician, write and sign off on certain prescriptions, and open a clinic beyond the 45-mile limit from the supervisor. This new law increases the scope of practice for advanced nurse practitioners around the state, and in turn, grants more access to health care, especially for patients living in rural communities.
Though nurse-managed clinics are growing in number, nurse-owned clinics are uncharted territory. Amanda and Donna did their research before striking out on their joint venture only to find limited data and a minimal number of best practices when operating a nurse-owned clinic.
"There just wasn't a lot of literature to pull from," Amanda said. "We've done quite a bit of on the job learning."
They selected Berkeley County as the location for Seaside Family Medicine. Seaside Family Medicine uses the community health center model that Amanda knew would be effective in Berkeley's rural areas. The clinic has a family nurse practitioner (FNP) and a pediatric nurse practitioner (PNP), so all members of the family can be seen on the same day. The McAllisters also felt it was essential to expand and improve access to high-quality care, so the clinic offers extended evening and weekend hours.
It's been more than a year since the duo embarked on their business venture and Seaside Family Medicine is gaining more patients each month. Soon, Amanda will need to hire additional practitioners to meet the community's growing demand for quality health care. When asked if she would do anything differently, Amanda said she wouldn't. The support of her mother, the experience in Orangeburg, and the education she received from MUSC's College of Nursing are precisely what she needed to chase her dream.