Allison Couture: Physican, student, advocate

Allison Couture checks the heartbeat of an infant using a stethoscope.

Like everyone across the globe, Dr. Allison Couture (MPA ’20) had her world turned upside down when COVID-19 struck. However, Couture had a unique vantage point: as a master’s degree student at the La Follette School of Public Affairs and as a practicing doctor.

A family medicine physician, Couture especially enjoys the preventive medicine aspect of her role as a primary care provider. “I have my feet in many different ponds,” she said. “In one day (before COVID-19), I could have gone to three or four healthcare settings, which I love.”

That came to a halt March 17, when she was scheduled to work a week on the mother-baby service at Meriter Hospital in Madison. To reduce the chances of being a vector of disease spread, she instead spent the next five weeks taking day and night OB shifts only.

Most disappointing, “I didn’t get to see my patients at my home clinic in Verona,” said Couture, who provided some care via telemedicine.

This topic prompts Couture to put on her advocacy hat in addition to her stethoscope.

“For some insurance to cover CPAP machines, the patient must have an in-person office visit to verify the diagnosis,” she said about the devices for treating obstructive sleep apnea. “But there’s nothing I do in that visit that I couldn’t do over the phone. We bring patients into the clinic because that’s how the payment system is set up.”

In the early weeks of COVID-19, Couture found herself telling patients more frequently that she wasn’t sure if insurance would cover the cost of their visit or their treatment.

“COVID-19 certainly is revealing a lot of the flaws in our healthcare system,” she said.

Because health systems like UW Health had to limit non-essential services, many cut physicians’ pay. “The pandemic is really highlighting how our insurance and healthcare systems are poorly optimized,” Couture said.

That’s where her master’s degree in public affairs (MPA) comes in. “Without my La Follette School classes, I would have a harder time understanding why this was happening and would not feel able to have an informed conversation,” said Couture, who received the 2018 Brenton Scholarship.

So how did this graduate of Xavier High School in Appleton, Wisconsin, and the University of Notre Dame find her way to the La Follette School’s master’s program?

During medical school at Chicago College of Osteopathic Medicine of Midwestern University, Couture said, one of her closest friends was “a wonderful activist. She opened my eyes to other ways of participating as a citizen.”

The medical school supported students’ involvement with state and national advocacy events, and Couture took advantage of every opportunity she was given. DO Day on the Hill in Washington, D.C., for doctors of Osteopathic Medicine (DO) and students like Couture, got her hooked.

“Organizers with the American Osteopathic Association made it very easy to step in, even for those of us who were trepidatious about dealing face-to-face with politicians,” Couture recalled, adding that she participated all four years of medical school.

Fast forward to her residency in the Department of Family Medicine and Community Health (FMCH) at UW–Madison’s School of Medicine and Public Health (SMPH), when she continued her advocacy efforts through the American Academy of Family Physicians and Wisconsin Medical Society.

Dr. Kathy Oriel, the Family Medicine Residency Program’s director at the time, asked Couture if she had ever considered an MPA degree. Couture’s response: “What do those letters mean”?

“I looked at a master’s degree in public health (MPH), but I really felt supported by our residency program with many aspects around public and community health,” Couture said. “The classes and training that you get in an MPA offered more opportunities for new ideas, for where I see myself as a physician and a citizen.”

The flexibility of the La Follette School’s curriculum allowed Couture to take courses in several UW–Madison departments, including the School of Journalism and Mass Communication and the Department of Economics. The La Follette School’s core courses laid the groundwork for her to thrive in these courses.

“I think I’m a very good communicator; that’s why primary care is a good fit for me,” Couture said. “But healthcare is a capitalist system, so if you want to sit at the table, you have to know how to talk about dollars and cents.”

Notably, Couture said the La Follette Forum on health policy and dinner with keynote speaker Mia Keeys of the American Medical Association were highlights of her La Follette School experience.

Listening to the panelists and talking with Keeys, Couture realized that she could make a difference. It also gave her several opportunities for self-praise, which she said is critical for women in medicine.

“I have worked really hard and have gone through a lot of training to get to this point,” she said. “It’s paid off. I’m informed, but I’m still itching to learn.”

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