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Virginia GA “Missing Opportunity" to Improve Rural Health Care

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Tuesday, February 23, 2016   

RICHMOND, Va. - The Virginia General Assembly is missing an opportunity to bring care to medically under-served parts of the state, nurse practitioners say.

Going into the session, several bills would have loosened regulations and let mid-level medical providers operate in the mostly rural areas without enough doctors.

But Mark Coles, a nurse practitioner and chairman of government relations for the Virginia Council of Nurse Practitioners, says all those bills have essentially been gutted.

Coles says now, they would do nothing to stop the common pattern in small towns, where a longtime practice with a doctor and two nurses could close its doors.

"The doc retires or becomes ill. They're having great difficulty in finding someone to buy that practice, and typically the practice would have to close," says Coles. "The community loses all three providers."

Senate Bill 369 would have permitted nurse practitioners in an under-served or high-unemployment area to see patients without the current requirement of a collaborative agreement with a doctor.

But the bill was changed to create a pilot project for doctors instead, to use telemedicine to see patients remotely. Coles calls that an empty promise, and says lawmakers are just helping doctors protect their professional turf.

"What's happened at the halfway point is these bills have been watered down or, in fact, the bills that are being voted upon now aren't the original language at all," he says. "That it's language that's been proposed by organized medicine."

He cites a Federal Trade Commission staff report that says within limits, nurse practitioners are "as safe and effective as independent health-care providers."

Coles thinks people in rural Virginia have gone long enough without easy access to primary medical care.

"It may be months before you can get your initial visit, and you might have to drive a long way," he says. "We're simply saying, 'Let's have the opportunity for a couple of NPs to start their own practices in these areas.'"

The Medical Society of Virginia argues that doctors are better suited to handle that care; Coles says studies have shown nurse practitioners do just as well. He adds one big problem is that doctors often don't want to practice in rural areas.


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