Those of you following the recently completed session of the Virginia General Assembly may have taken special notice of a bill having to do with nurse practitioners. Proposed by Del. Dawn M. Adams, herself a practicing nurse practitioner, H.B. 1737 – which passed by more than a three-to-one margin in the House – enables nurse practitioners with as few as two years of full-time clinical experience to practice without a practice agreement with a physician. Previously, nurse practitioners needed five years of experience to practice independently.
Nurse practitioners have found growing autonomy in their practices over the years. Beginning with an amendment to the Medical Practice Act in 1973, which first gave NPs the right to perform “medical practice acts” under the supervision of a physician, legislation in the decades to follow has given them the ability to dispense manufacturers’ samples, prescribe medications and order physical therapy services, among a list of expanded functions.
Reducing the requirement in Virginia, one of the most restrictive states, is an incremental step in the right direction, says Dr. Adams. But she notes that the issue of nurse practitioners practicing independently has never been about competence but more about power and control.
“Every medical provider I know, including nurse practitioners, welcomes partnerships, so it’s not about that; it’s not about safety and outcomes, as critics would have you believe,” she says. “We’ve proven we are competent. We have extensive education and are highly capable in our practice areas. These restrictions that limit our independence are about maintaining a patriarchal structure and limiting how much we can grow, both professionally and financially.”
The Senate enacted a provision that calls for more data to be collected on nurse practitioner practice areas and patient outcomes, statistics that will be reviewed early next year.
Meanwhile, many nurse practitioners are expanding their practices during the pandemic, including through the use of telemedicine.
“Telehealth has been pivotal to ensuring that people are connected and healthy over the past year,” Dr. Adams says. “The pandemic has accelerated its acceptability and patient comfort level, and that wasn’t going to happen on its own.”
Dr. Adams, who uses telehealth in her own practice, notes that telemedicine is not only a tool for reaching rural patients but also establishing new best practices for when a patient actually needs to come in physically. She also sees it as an effective tool on the preventive care front.
“People are so much more comfortable in their own homes, and you can get a more genuine sense of their condition – at least initially – without the anxiety that often comes with an in-person visit,” she says.
Key Takeaways:
- H.B. 1737 was recently passed by the Virginia General Assembly and enables nurse practitioners with as few as two years of full-time clinical experience to practice without a practice agreement with a physician.
- H.B. 1737 was proposed by Del. Dawn M. Adams, who shared her insights in this post. She says that reducing the requirement in Virginia, one of the most restrictive states, is an incremental step in the right direction, but the issue of nurse practitioners practicing independently has never been about competence but more about power and control.
Grant funds for this former VTN initiative have expired. For more information about connecting with or serving as a collaborating physician in Virginia, we suggest contacting Virginia Board of Nursing, Virginia Council of Nurse Practitioners, or Virginia Nurses Association.