Dr. Lora Vece – Virginia Council of Nurse Practitioners, HB 793

(Feb. 5, 2018)

Catherine Read interviews Dr. Lora Vece, Nurse Practitioner and member of the Virginia Council of Nurse Practitioners (VCNP) to talk about the House Bill 793 which would allow Nurse Practitioners to be on the path to having full practice authority in the state of Virginia. Today, a Nurse Practitioner (NP) is required to have a Collaborative Practice agreement with a designated physician, meaning that an NP cannot practice independently even though they are trained and nationally board certified to do so. While 22 states and the District of Columbia allow Nurse Practitioners to have full practice authority, Virginia is one of only 12 states in the nation that require physician oversight.   This burdensome requirement can adversely impact access to care, especially in rural and underserved communities, while also driving up the cost of health care.

In America today there is a shortage of primary care doctors , as many physicians choose to focus on areas of specialty. Dr. Vece indicates that Nurse Practitioners are uniquely qualified to fill the gap in primary care. Quality studies show that patient care management is as good, if not better, under Nurse Practitioners. NP’s take a holistic approach to medicine, looking at wellness, screenings, diet and exercise, family history, chronic disease management and acute medical problems to name just a few. Patients who work with Nurse Practitioners indicate higher satisfaction with their NP than with their physician, as they believe that their NP is a good listener and that they pay closer attention to their individual needs. Over 100 studies have proven that NP’s provide safe, high quality healthcare.

Under current Virginia law, an NP must secure a business contract with a physician in order to practice, and each physician can collaborate with no more than 6 Nurse Practitioners at a time. According to Dr. Vece this is a costly and burdensome requirement that can have adverse affects on access to care. For example, if a NP works with a doctor, and that doctor goes out of practice or gets ill and cannot practice medicine, then the NP can lose access to seeing their patients. This is a significant problem in underserved rural communities where NP’s outnumber doctors. Dr. Vece shared that additional challenges include NP’s who cannot find a physician who will enter into a collaborative relationship, a physician may charge a fee so excessive that the NP cannot maintain a sustainable business model, or the physician’s malpractice insurance carrier may prevent collaboration with an outside provider.  For these reasons, and many more, Dr. Vece and the VCNP are advocating to do away with this burdonsome requirement.

The proposed legislation is designed to put NP’s on the path to full practice authority in Virginia. It requires that NP’s have a practice agreement with a collaborating physician or Nurse Practitioner for a specified number of hours (1040) during the transition to practice period. After the NP has met this requirement, the practice agreement would be removed. The removal of the Practice Agreement would break down barriers, and allow for better access to care for patients. VCNP is hopeful the legislature will see this as a good faith compromise and an incremental step forward. Dr. Vece shared that VCNP would welcome support from any Virginia voter who thinks this legislation is a good idea.   If you support Nurse Practitioners and would like to expand access to more affordable care across the commonwealth, contact your legislator directly to voice your opinion.   Every Senator and Delegate keeps track of constituent requests, will take feedback into account when voting on legislation.