Thank you for the opportunity to comment. Reducing barriers to practice for Nurse Practitioners to practice is one way Virginia can increase accessibility to health care for Virginians. The requirement of five years full time practice to reach the goal of practice without a practice agreement with a patient care physician is already significantly out of line with what most states require and increases barriers to practice and care I Virginia.

  I would recommend that the process be a simple and straightforward as possible. I have worked seven years in primary care, then seven years in public health. During my time at public health I have had three medical directors. It would be difficult track down former physician team leaders. It would be uncomfortable to ask the person who worked the most consistently with me to sign a form, because I worked with him more than 7 years ago. While my physician team leaders will probably be willing to sign, the one I work with now, I have worked with less than two years. Should she sign and take my word? Wouldn’t it be better cutting out the middle man?

 Consider the individual physician team leaders. What if they personally disagree with nurse practitioners being granted the authority to practice to the full extent of their training? A Virginia Nurse practitioner should not have to stalk former physician team leaders or be at the mercy of a current physician team leader for permission to work to the full extent of her training and certification.

To prevent increased tensions and waste of time, I recommend that nurse practitioners be allowed to attest to their own work history. Nurses are consistently voted the most trusted profession and are no more likely to tell an untruth than a physician.

Thank you.

Rhonda Arthur DNP, CNM, 
WHNP-BC, FNP-BC