When Ciara Staunton popped into our virtual meeting, she seemed excited and energized, but our healthcare-worker readers will know she’s had some exhausting months. Frontline workers of all kinds are donning their P.P.E. and masks and continuing to serve their clients, but there are still so many unanswered questions as our world works to respond wisely to the rise of COVID-19.

Staunton, however, is no stranger to new directions. She created her own private practice, Staunton Primary Care, as a nurse practitioner aiming to offer affordable and approachable family primary care in the Walnut Hills neighborhood. It was a joy to talk to her about her passion for accessibility and comfort in a healthcare setting.

Interview by Laura Leavitt. Photography by Angie Lipscomb.

Women of Cincy currently adheres to social distancing guidelines during all interviews.

How did you develop a passion for healthcare?

I had several family members in the healthcare field, and – me being stubborn – I started off just doing everything but healthcare. I think you realize it’s in your heart to help people, and eventually I was drawn back to that. I ended up going to nursing school and it took over from there.

Do you remember anything about the moment when you realized nurse practitioner work was the path for you?

I do. Unfortunately, I had an aunt who passed away, and I remember those last moments when the nurses were so welcoming. They made her passing such a beautiful experience that I thought, “Okay, this is it, I’ve got to do this.” That did it for me.

Could you tell me about the training and role of a nurse practitioner?

A nurse practitioner is initially a Registered Nurse with a bachelor’s degree. After that, you go on to graduate school, where you receive another two years of education and you complete clinical hours in all different fields. Once you are finished with that, you sit for state boards, and you’re licensed to provide full-service primary care.

There are a lot of patients who aren’t familiar with what nurse practitioners can do. We can do just about everything your family doctor can do.

That’s caring for babies from 0 to 100; anything done in your primary care office, we do. That includes women’s health, pediatrics, mental health; it’s such a broad aspect of care that nurse practitioners can care for. We write prescriptions, we do procedures, we do minor surgeries, we order testing, we diagnose – there are tons of things we can do.

Once you had your training, what was the process to start your own practice?

There was no clear-cut path – I feel like I just fumbled through it! One of the things with nurse practitioners is that a lot of us don’t realize private practice is a possibility, an option. I didn’t really have a map, so I just looked at regular primary care physicians and how they modeled their practices, and that’s how I began navigating things.

That’s kind of the vibe in our practice: warm and welcoming and family-oriented. We try to make patients feel comfortable. We want to provide holistic care and not refer you out for everything if it’s not necessary.

I’m big on not reinventing the wheel in healthcare, and not making things more difficult than they need to be. They can be simple and basic; I’m following those guidelines, and I’m still learning every day.

Can you tell me more about your approach to primary care?

Absolutely – our model is a little bit different. It’s called direct primary care; when I’m describing direct primary care, I like to tell patients to think of it like old-school country doctoring, like back in the day when you’d have one doc who saw the whole family. Your doctor did everything in your house: They knew you as a kid and watched you grow up; they took care of mental health and women’s health. You felt really comfortable in the office; you felt really at home and enjoyed going there. That’s kind of the vibe in our practice: warm and welcoming and family-oriented. We try to make patients feel comfortable. We want to provide holistic care and not refer you out for everything if it’s not necessary.

Are you all located in Walnut Hills? Tell me a little bit about making your home there.

There’s so much about Walnut Hills I love; it’s so new and it’s so vibrant and so up-and-coming and there’s so much growth. That’s the premise and foundation for our practice: It’s new and different and fresh, and we wanted to be somewhere centrally located. We wanted to be in a community that was initially lacking in healthcare. We wanted it to be accessible and available, and Walnut Hills seemed like a perfect location.

Tell us how you’ve navigated the complex world of insurance to provide options for your patients.

Oh my gosh, the thing with direct primary care is that we want things to be convenient, affordable, accessible, and transparent. Direct primary care has been around for about 20 years, and in the past 8 years it has really become popular as a response to healthcare costs getting out of control.

The main premise is that we try to remove the things that hinder healthcare, and sometimes that is insurance. For most of our patients, they pay a small monthly fee – less than the price of a gym membership or cable. That gets you access to all of it: unlimited visits, everything done in the office is free, we discount medications 90%, we discount labs 90% off, and we partner with local companies to get you imaging at about 50 to 70% off.

Insurance is not working for many people; we’re so far from the patient-centered focus.

What we found is that a lot of our patients who come to us don’t even use their private insurance because it’s so much cheaper and beneficial for them just to pay outright.

A lot of our patients struggle because they have a high deductible plan, they pay thousands of dollars a year, and they never get the true benefits of their healthcare because no one can hit that deductible. So they love it because they can keep things affordable, lower their premiums on their insurance, and still get great care.

Could you describe a challenge that appeared when launching a private practice and how you overcame it?

Initially, interacting with patients was a challenge. Although nurse practitioners have been around since the early 1900s, there are a lot of patients who aren’t familiar with what nurse practitioners can do. We can do just about everything your family doctor can do.

Then, we were trying to get the word out to patients that we’re here, we’re a different model of care, and it’s just as effective. We offer quality care just like your family doctor would, so trying to get the word out and changing that mindset for patients has been challenging. I think the best way for me is to just consistently provide good quality care and [now] patients are starting to spread the word.

Has there been a particular bright moment in launching the practice?

Starting to get referrals from doctors and actual physicians. It makes you feel validated: You think, “They respect us as nurse practitioners; they are starting to see us as equal partners.”

Do you think there are any lessons about public health that can be taken from these past few weeks of coronavirus?

This has definitely been a learning curve for all of us. Initially, many weeks ago when this hit, the message all of us Americans received was to contact your primary care doctor; don’t go to the E.R. or urgent care. That message sheds light on a huge issue: Not a lot of Americans have primary care providers. They are left scrambling, thinking “What do I do? Where do I go? Who do I call?” We clearly need more access to primary care providers. That’s where nurse practitioners can really fill in that gap.

Have you seen an uptick in people contacting you for this information?

Absolutely; we’ve had tons of new patients come in. For whatever reason, they’ve kind of been out of the healthcare system for a while. It’s been great to get people back into healthcare and get them tuned back up again.

It’s terrifying for people, not knowing where to go or who to call. I’ve been honored that we’ve been a resource for people and helped them get the care they need.

Any advice or encouragement for other frontline workers on how to get self-care and rest?

For me, it’s to not shut down. I think we come home after long, hard days and it’s really hard and you don’t want to talk or interact since you’ve been interacting all day. It’s important to recognize that family is here: That’s your support, your backbone. Use it! Let people know what is going on with you. Reach out to friends.

One of the cool things about all this is that everyone is “Zooming” and it’s awesome. It helps you reconnect to see smiling faces. You breathe and relax and recharge. A lot of my older patients are pretty tech savvy. They really love interacting with family and grandkids; it’s really surprisingly increased their moods. Just that connection with family we don’t have when we’re so busy and don’t have the family focus.

Getting active has also been very helpful for me. Just going out to walk and clear my head has been very helpful.

What else should we know about your practice and the growth of direct primary care?

It’s definitely serving a niche. I’ve seen people coming to my practice who haven’t been able to afford healthcare, so they’ve let themselves go, been neglected for 15 or 20 years. I’m excited that these practices are making healthcare affordable and making patients comfortable getting back into the system. They get to take their power back!

These practices are making healthcare affordable and making patients comfortable getting back into the system. They get to take their power back!

Insurance is not working for many people; we’re so far from the patient-centered focus. We want to be saving insurance for the big stuff; think of it like car insurance for the big stuff, and everything else is affordable and preventative.

I want readers to know that they don’t have to accept the status quo of healthcare. There are options and different approaches, and you don’t have to accept anything less than customized care for you. Don’t just be a number in someone’s practice; work to find that home.

In Walnut Hills or elsewhere, do you have a favorite place in Cincinnati?

I like O.T.R. – I’ve been in Cincinnati now for almost 20 years and I can recall 20 years ago, how it was just such a different experience down there. Watching that grow over the past couple of years, it’s still very integrated, and I just love the diversity of O.T.R. It’s fun, and there’s always something different and new and cultural. There’s something really great going on all the time.

Is there an influential woman in your life you’d like to give a shoutout to?

I have to give a shoutout to my momma. She is a healthcare worker as well, and she’s also on the front lines. I think it’s a different level of commitment you have to have when you are near retirement and you could say, “You know what? I’m going to wrap this up now.” But she’s been so committed and dedicated, and seeing her compassion renews my own commitment to healthcare when I’m feeling flustered and burnt out. Still seeing her commitment after all these years is so inspiring as a nurse.

Do you know an awesome woman of Cincy? Nominate her here! New features launch on Mondays.

Re-Envisioning and Re-Energizing Healthcare with Ciara Staunton of Staunton Primary Care