Commentary

School Nurse Shortage? How About Bringing A Doctor To School?

The new school year has begun, so let’s talk about school nurses.

Used to be when you felt sick at school, you were sent to the school nurse and she, in turn, sent you home.

Of course, times have changed.

For one thing, you’re lucky if your kids’ school even has a nurse, a situation being compounded by America’s overall nursing shortage.

Just 40% of schools have a full-time registered nurse and 35% a part-time one, reports Frontline Education, a marketer of school administrative software.

You might think the problem would be worse in public schools, but 84% of them have full- or part-time nurses, compared to just 52% of charter schools and 35% of private schools.

Another thing that’s changed: Kids who feel sick at school may get examined by a doctor -- thanks to telehealth.

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We learned this from TytoCare, an eight-year-old primary care provider that works directly with nurses or other school employees in 2,500 schools across the country.

By using a dedicated FDA-cleared TytoCare device and tablet called the Pro Smart Clinic, they can connect students with doctors for medical-grade physical exams -- from listening to hearts and lungs to examining ears, throats, and skin.

TytoCare contracts with health systems or virtual providers who provide the service to individual schools or districts. Some examples include Guilford County, North Carolina schools, served by Cone Health, and Sioux Falls County, South Dakota schools, via Avel eCare.

Dedi Gilad, TytoCare’s CEO and co-founder, tells Pharma & Health Insider that this system has led to reduced emergency room and urgent care visits. “One partner health system in Texas surveyed parents and found that 27% would have gone to the ER, and 45% would have gone to an urgent care center if they did not have access to this care at school,” he relates.

An added advantage of TytoCare is that even kids without doctors can get to see a doctor, particularly apropos these days due to families losing Medicaid coverage, or immigrant children whose parents may fear bringing them to an in-person doctor.

And when we say they “see” a doctor, they actually do see him or her on-screen.

And oh yeah, remember how the school nurse would send you home? TytoCare says that 89% of students it sees return to class the same day.

TytoCare, which also has a home device called the Home Smart Clinic, works with 250 health systems and has 1.6 million patients registered for its platform.

1 comment about "School Nurse Shortage? How About Bringing A Doctor To School?".
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  1. Joe Mandese from MediaPost Inc., September 10, 2025 at 4:52 p.m.

    Editor Joe Mandese posting this "letter to the editor" sent by National Association of School Nurses President Lynn Nelson as a comment here:

    Letter to the Editor

    Your recent article, “School Nurse Shortage? How About Bringing a Doctor Into the Classroom” (Sept. 4, 2025), raises important questions about how we meet the health needs of students. However, framing may inadvertently misrepresent both the depth of the problem and the most practical solutions. I am concerned that framing telehealth as a replacement for school nurses risks misunderstanding both the challenges and the solutions.

    First, the shortage of school nurses is a critical issue that deserves urgent attention. The National Association of School Nurses (NASN) and other experts have long documented the risks to student health, safety, and academic achievement when schools are not adequately staffed with licensed registered nurses. School nurses are uniquely trained to manage chronic conditions, respond to emergencies, oversee immunization compliance, and connect families to community resources, all within the complex regulatory environment of education and health.

    Telehealth can be a powerful tool for improving access to health care. The National Association of School Nurses (NASN) supports telehealth as part of a comprehensive school health strategy, but only when it is integrated with the on-the-ground expertise of a school nurse.

    School nurses are uniquely positioned to ensure telehealth works in schools. They can assess when telehealth is appropriate, connect families with providers, manage technology and privacy requirements, and follow up on care plans. Without a licensed school nurse present, telehealth often fails to address real barriers such as consent, health equity, chronic disease management, and the need for immediate in-person assessment.

    Research confirms that school nurses are cost-effective and essential to student success. A JAMA study found that every dollar invested in school nursing yields more than two dollars in benefits to society. Telehealth can extend the reach of physicians and specialists, but it cannot replace the daily, comprehensive role of a school nurse who knows the students, understands the school environment, and bridges health and education.

    If we want telehealth to succeed in schools, the solution is not to substitute it for nurses, but to invest in school nurses as the cornerstone of student health—and build telehealth around them.

    Sincerely,

    Lynn Nelson MSN, RN, NCSN

    President

    National Association of School Nurses (NASN)



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