Dive Brief:
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Nurse practitioners with five years of full-time clinical experience may soon be able to practice without a contract with a physician in Virginia after the commonwealth’s General Assembly overwhelmingly passed the measure HB 793, The Associated Press reported.
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While NPs are hoping Gov. Ralph Northam signs the bill as is, the Medical Society of Virginia is pushing the governor to add more requirements for them to meet.
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Bill supporters say requiring NPs to have collaborative practice agreements with physicians is unnecessary. Eliminating that requirement could expand healthcare access. Doctors argue patient safety and quality of care could be at risk with the change.
Dive Insight:
More than 248,000 NPs are licensed in the U.S. and the number has more than doubled over the past decade, according to the American Association of Nurse Practitioners. (AANP)
Virginia is one of a dozen states with restricted practice regulations. These regulations restrict NPs to “engage in at least one element of NP practice. State law requires career-long supervision, delegation or team-management by another health provider in order for the NP to provide patient care,” according to the AANP.
The governor has until April 9 to sign, amend or veto the bill. Northam, a Democrat, is a doctor and has yet to announce his decision.
Meanwhile, the Medical Society of Virginia offered an amendment that would require NPs to meet the five-year requirement while working with a physician in the same practice area. The society said it will not oppose the bill if it has that amendment. The Virginia Council of Nurse Practitioners opposes the change and wants the governor to sign the bill as is.
The debate pitting doctors against NPs is part of an ongoing feud.
The AANP slammed a resolution adopted by the American Medical Association last year that opposed independent practice for nonphysician practitioners. The AANP charged that the AMA was engaging in “fear-mongering” and putting physicians’ profits ahead of patients.
In some areas, nurses are seen as a way to help with an expected physician shortage in the coming years. NPs are expected to take on more of the patient workload as the population ages.
A 2017 report from the Healthforce Center at University of California, San Francisco predicted that California won’t have enough primary care physicians by 2030. It estimated nearly half of the state’s full-time equivalent primary care clinicians will be nurse practitioners and physician assistants by that time.
California is one of the 12 states with restricted practice regulations for NPs, according to the AANP.