MSV believes that physician-led, team-based care is best for patients. Physicians are best equipped to practice medicine, independently and leading a care team, because of their extensive education and training. Some mid-level providers continue to advocate to practice outside of the care team in Virginia and nationwide; MSV opposes all efforts to end physician-led team-based care.

Autonomous Practice for Nurse Practitioners

In 2018, MSV opposed independent practice for nurse practitioners.

The bill, as introduced, would have allowed nurse practitioners to practice independently after 6 months of practice with either a nurse practitioner or a physician. The bill would have allowed NPs to practice in any specialty and with any patient population, without certification or experience.

Despite the thousands of messages sent to legislators, active lobbying, and compelling testimony by MSV members, the General Assembly continued to advance legislation. MSV pushed for the most stringent practice requirements to be included in the legislation, with the help of Del. Scott Garrett, MD.

MSV was successful at amending the bill. Virginia now has the toughest requirements designed to protect patients in the country. Virginia’s law includes:

Minimum of 5 years of clinical practice with a physician before an NP can practice without a practice agreement;

  • Clinical practice must be in the specialty for which the nurse practitioner was certified and licensed;
  • Regulation under the Joint Boards of Medicine and Nursing;
  • Requirement to obtain professional liability insurance; and
  • Report back to the General Assembly in 2021 on
    • The number and specialties of NPs practicing autonomously
    • The geographic areas where NPs are practicing autonomously
    • The number of complaint and/or disciplinary actions involving NPs practicing autonomously
  • Report must also include any recommended modifications to this law.


DMS for Physician Assistants

In 2018, MSV, in partnership with the Virginia Academy of Physician Assistants, opposed and defeated legislation that would have created a new Doctor of Medical Science (DMS) license which would establish an advanced level of physician assistants.


Optometrists Performing Eye Surgery

In 2018, MSV opposed and prevented an optometry scope bill that would have allowed optometrists to perform surgical procedures.

Get Involved

Help education your legislators about the importance of physician-led team-based care. Contact MSV's Government Affairs team to set up a legislator tour of your practice today!