By Mark Frost, Chronicle Editor
A year ago Kathleen Emerson was a nurse practitioner in the office of Dr. Donald Merrihew, Jr. on Bay Road in Queensbury.
“When Dr. Merrihew decided to retire, we realized that a lot of patients were having trouble trying to get into a primary care office. They were just having to wait months and months. So after hearing a month or two of people struggling with that, [her husband] Steve and I discussed the possibility of me opening up my own practice.”
It’s something the state now allows.
“A nurse practitioner, after having 3,600 patient hours, which is about two years if you work full-time…in New York State, you’re allowed to work on your own, open your own office, when you have a collaborating doctor,” Kathleen said.
“I have two, a cardiologist and an internal medicine doctor, that I call if I have questions.” She said they chose not to be identified for this article.
She said Dr. Merrihew provided most of the equipment with which they opened the office, which is situated on Bay Road above Quaker, several hundred yards north of where Dr. Merrihew’s office was, on Bay Road south of Quaker.
“We could not have done what we have done without the help of Dr. Merrihew — and all the staff stating that they wanted to stay with me until we did open up a new practice,” she said.
Kathleen says Dr. Merrihew’s practice closed on Dec. 30, 2022. Hers opened three months later on April 3.
It was a leap. Steve says they mortgaged their house. “I gotta be honest. We leveraged everything we had to do this.”
Had Kathleen yearned to open a practice of her own? “No, no, not at my age,” she says. “I just thought I would work until I retired.”
She said she’s 65 years old and that now “I think 65 is the new 45.”
“I enjoy the work,” she says. “I think you need to enjoy what you’re doing to stay in and go to work every day, and that keeps you young, keeps you going.”
Was it daunting? “I was daunted by it, but I just realized that there were so many people that would not have a primary care doctor, and they would fall through the cracks.
“A lot of these people that I’d known for [the] five years that I’d worked there are sick and really needed to continue on with the care that they needed.”
Husband Steve says, “A lot of those were suboxone patients. They have been switched off of opioids and other drugs and they’re on a suboxone program. Kathleen has an amazing success story with that right now.”
She says, “So many people are doing so well and are productive, have jobs, and are able to live their life, enjoy life.”
She says, “I just realized that it’s a huge hole in the community that would not just be absorbed by other primary care offices. I just wanted to do our part to try to help my little part of the world and help the people in it. It’s a broken system right now and I just wanted to do what we could.”
“We’re walk-in only,” Kathleen says of the practice. “We don’t have appointments.” When interviewed several weeks ago she said that she’s seeing “anywhere from 15 to 30” patients a day.
She says Dr. Merrihew’s practice had 7,000-to-8,000 patients on its roll.
Steve had his own health-related career. “I retired from EMS,” he says. “I ran Warrensburg EMS for 18 years. So I’m familiar with a little bit of the management side of that.”
In retirement, he says, “I’m a real estate agent with Berkshire Hathaway,” but he became Kathleen’s office manager “out of necessity” when the planned person became ill. “We couldn’t afford to pay anybody else at that point,” he says.
The Emersons said they’ve been married for 15 years. Steve had played a role already in Kathleen’s progression. “Steve introduced me to Dr. Merrithew,” she said. “He had been a patient of Dr. Merrihew, and Steve wanted to ask him if I could do some clinical time here…And Dr. Merrihew said, ‘Oh, I would love to train you or give you some clinical time.’
“So I actually worked with him [Dr. Merrihew] before I graduated, and he offered me a job after I got done with school. He taught me a lot.”
Kathleen’s route to becoming a nurse practitioner was long and unplanned.
She said she grew up in Gansevoort and went through South Glens Falls schools.
“What started me down the medical field, I actually used to work for Sherwood Medical in Argyle, made medical tubing and all kinds of medical products. I worked there for 21 years. And in 2004, they decided to move to Mexico.
“So at the time, they had to pay for your retraining. So I went to Hudson Valley Community College and did a two-year degree” to become a Health Information Technician “to either work in an office or in the emergency room as a tech.
“And one of my classes was only offered in the fall and we were graduating in the spring. So they allowed me to take an EMT class to substitute.
“I took that and passed, became an EMT, and started volunteering where I was living at the time.
“And I met somebody that worked in the ER as a tech. She talked me into going in and putting in for a position for tech in the ER and I did that. I got the job. After being a tech for a couple of years, I decided to go to nursing school up here at ACC, got my nursing degree and worked as a new RN in the ER.
“And then after working for a couple years as an RN, I decided to go back to school, went to Sage College, got my bachelor’s and then kept going [and] got my bachelor’s as a nurse practitioner.
“So it wasn’t anything I really had planned. And this we didn’t plan until things happened with Dr. Merrihew.”
Steve found the available multi-unit office space at 375 Bay Road, Suite 101. “I used to teach across the hall,” he said. “I was on the board for the [EMS] Council for nine years and we’d bring students in here to do training. So I knew the space. I got to thinking maybe we could fix it up.”
When The Chronicle remarked, “I don’t think I’ve ever been in this building,” Steve quipped, “Oh, that’s good, because the IRS [office] is here.”
As office manager, he says he’s had “a whole new learning thing about credentialing — getting the insurance companies on board and getting [State Senator] Dan Stec’s office involved, because they [insurance companies] were sending us patients but they weren’t paying us. It’s like, this was fraud as far as I’m concerned.”
Steve says the “reimbursement rate…has been very difficult. That’s why you’ll see a lot of places now are going without insurance. They’re doing cash only or concierge type medicine…because with the insurance companies and just jumping through all the hoops is crazy.
“It’s really not fair. You pay all you pay into it — and then just trying to get them to cover anything is like pulling teeth.”
Kathleen says her biggest surprise has been “just the insurance struggle.”
She is currently the practice’s sole provider. “Right now I’m handling it,” she says, but the plan is to “bring on another practitioner…now that the insurance part is starting to kick in…There was actually a geriatric nurse practitioner that also did some clinical time with Dr. Merrihew. She’s willing to start with us too.”
Kathleen says, “I enjoy Primary Care. I used to be an ER nurse, I was in Glens Falls Hospital for 11 years. And I always saw people at their worst. And then either they got better and were discharged home or they were admitted. And I never really got to follow up and see what happened after I saw them in the ER.
“I like primary care because they come back every month or every six months to get blood work or to get checked up. And I like that part of it, that continuation of care.”
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