The physician community of Virginia needs to be the drum major when advocating for our patients, our profession, and our communities.

My daughter’s Band teacher would tell his students, “practice, show up, and bring your stuff; good advice for music and good advice for life.”  It’s no secret that medicine is changing, but do we lead the parade for change? Or do we choose to watch from the sidelines?

We know our practice and our patients better than anyone else. We see them at their most vulnerable and we use our knowledge and training to meet their medical needs, but sometimes that is not enough. We must take our practices to the legislative and policy arena to ensure that Virginia is the premier state to practice and receive medical care.  We must show up in the General Assembly and election campaigns, and we need to bring our stuff to these debates. We need to be on the forefront of any and all healthcare policies and change.

We have had multiple legislative successes in the past year when we have brought ourselves forward through MSV.  We know how our practices work and we worked to finally gain success on Balance Billing in spite of significant health plan resistance.  Our success further proves that legislators care about the voices of physicians, PA’s, and patients.

We showed up to advocate for the VMAP program and pushed the legislature to continue expansion of this program for pediatric mental health and added budget coverage. This is a huge step in the right direction for physicians, pediatric patients, and their families.

I am proud that MSV brought science and data to the legislative debate on violence prevention.  Science and data are “our stuff” and legislators were swayed by medical science as they debated these issues. We have that knowledge, lets use it to make positive change.

These successes prove that we can lead the parade on our issues, but a parade is only as strong as the sum of its parts.  In the past few years, the number of us who advocate in the General Assembly is dwindling.  Our year-round support for the MSVPAC is decreasing as well; last year saw the first increase since 2017.  Our profession is being challenged, policies and laws are put in place by non-physicians.  We need to be the leaders making decisions for healthcare.

What can you do?

• Practice by making advocacy a part of what medicine means for you.  Bring your issues and those of your patients forward.
• Show up by joining and getting your colleagues to join. Numbers count!
• Bring your stuff by donating and participating.  Make our legislative voice the strongest in Richmond.

As the leaders of the House of Medicine we need to always practice, show up, and bring our stuff!

Barbara Boardman, MD

The MSV Foundation was created to equip physicians and PAs with the tools and resources they need to best serve themselves, their patients, and the community at large.

No matter our specialty or how long we have practiced, we became leaders of healthcare teams to meet one common goal – help people. The MSV Foundation has played a pivotal role in bettering healthcare for our communities.

I believe in the mission of MSVF – “Caring for physicians, creating healthy communities.” It is a priority for physicians and PAs to have access to high quality programs which provide education for them and their staff. Leadership programs developed by MSVF are amazing. It is an honor to support these important Foundation programs as they ultimately benefit patient care, the entire healthcare team, and our communities.

I had an incredible experience with the Evolve Public Health program. MSVF initiated this exceptional program in 2013, I was very fortunate to be a member of the first class. These team-based sessions are very popular. Each team is unique. I vividly recall my team included an ophthalmology resident, a hospice physician and me – a heme/onc PA; quite a collaborative effort. Through this program, we were able to get back to the main focus of healthcare, patients. It also gave us occasions to focus on ourselves and our love for medicine.

The MSV and the Foundation are always here for us and our needs. They saw that physicians and PAs needed a resource for our well-being. Its new physician well-being program, SafeHaven™, is here to give us a place to get the behavioral health support we need. The healthcare team has always faced challenges, but the COVID-19 Pandemic has increased the need for support. SafeHaven™ is giving us the ability to ask for help without risk to our medical license.

Programs like SYNC, Evolve Public Health, Infuse, and SafeHaven™ bring us together. We are given the chance to concentrate on our leadership skills, team development, and our mental wellness. These opportunities make us better physicians and PAs. Through the Foundation, we are given the opportunity to self-reflect and return to the joy of our profession, helping patients through the practice of medicine.

The MSVF is the heart of MSV. Through my participation, I have developed lifelong friendships, I have learned about myself as a healthcare leader, and I have been given developmental opportunities that help me grow and change in my career. Through the MSVF, physicians, and PAs are able to get back to what truly matters – giving patients the care they deserve.

I am so happy to get to be a part of the Foundation’s first 35 years. Here’s to the next 35!

Kathy Scarbalis, PA-C, MPAS
MSVF Board President

MSV Statement

While hundreds of health care providers are on the frontlines of COVID-19 in Virginia, hundreds of other Virginia’s physicians, PAs, and nurses have been ordered to stay home or only provide limited health care to their patients. Rather than help and work with Virginia’s physicians and PAs, Governor Northam’s new executive order (EO 57) encourages the use of out of state providers and needlessly waives the statutory requirement for many nurse practitioners (other than CRNAs) to have a practice agreement with their patient care team physician during the scope of the disaster. The Medical Society of Virginia has learned that with the fast pace of dealing with the COVID pandemic, consulting with the Medical Society was inadvertently overlooked during drafting of the order.  We have shared our concern and we have been assured that heightened engagement with the Medical Society will resume.

EO57 Letter to Governor From Health Care Stakeholders

Executive Order 57

Importance of the Issue

The COVID-19 disease, caused by a virus that spreads easily from person to person that may result in serious illness or death and has been classified by the World Health Organization as a worldwide pandemic, has spread throughout the Commonwealth. The number of cases of COVID-19 continues to increase within the Commonwealth and in neighboring states. It is anticipated that COVID-19 will result in increased demands on the Commonwealth’s health professional workforce that will require additional personnel. Authorizing out-of-state licensed professionals, as well as residents, interns, and certain senior students to practice in the Commonwealth will assist in meeting that demand. In addition, permitting experienced nurse practitioners to practice without a practice agreement will increase the availability of primary care and hospital providers. Finally, expanding the use of telehealth will assist in the provision of needed health care services to the citizens of the Commonwealth.

Directive

Therefore, by virtue of the authority vested in me by the Constitution of Virginia and §44-146.17 of the Code of Virginia, during the state of emergency declared in Executive Order 51, I hereby order the following:

1. During the state of emergency declared by Executive Order 51, a license in good standing issued to a health care practitioner by another state shall be deemed to be an active license issued by the Commonwealth to provide health care or professional services as a health care practitioner of the same type for which such license is issued in another state, provided such health care practitioner is engaged by a hospital or an affiliate of such hospital where both share the same corporate parent, licensed nursing facility, dialysis facility, physicians’ office, or other health care facility in the Commonwealth for the purpose of assisting that office or facility with public health and medical disaster response operations. Hospitals, licensed nursing facilities, dialysis facilities, physicians’ offices, and other health care facilities must submit to the applicable licensing board each out-of-state health care practitioner’s name, license type, state of license, and license identification number within a reasonable time of such healthcare practitioner providing services for the health care facility or office in the Commonwealth. A health care facility includes assisted living facilities, congregate care settings, and any alternate care facility established in response to the COVID-19 emergency.
2. A clinical psychologist, professional counselor, marriage and family therapist, and clinical social worker with an active license issued by another state may be issued a temporary license by endorsement as a health care practitioner of the same type for which such license is issued in another state upon submission of an application and information requested by the applicable licensing board and the board’s verification that the applicant’s license issued by another state is active in good standing and there are no current reports in the United States Department of Health and Human Services National Practitioner Data Bank. Such temporary license shall expire ninety (90) days after the state of emergency ends. During such time the practitioner may seek a full Virginia license or transition patients to Virginia-licensed practitioners.
3. Health care practitioners with an active license issued by another state may provide continuity of care to their current patients who are Virginia residents through telehealth services. Establishment of a relationship with a new patient requires a Virginia license unless pursuant to paragraphs 1 or 2 above.
4. A healthcare practitioner may use any non-public facing audio or remote communication product that is available to communicate with patients. This exercise of discretion applies to telehealth provided for any reason regardless of whether the telehealth service is related to the diagnosis and treatment of COVID-19.
5. Nurse practitioners licensed in the Commonwealth of Virginia, except those licensed in the category of certified registered nurse anesthetists, with two or more years of clinical experience may practice in the practice category in which they are certified and licensed and prescribe without a written or electronic practice agreement.
6. Interns, residents, and fellows with active temporary training licenses to practice medicine issued by the Virginia Board of Medicine may practice in a hospital, including a clinic or alternate care facility operated by a hospital. without the supervision of a licensed physician or fully licensed member of the applicable faculty program at all times. The level of supervision required for each intern, resident, and fellow shall be established by the training program in coordination with the hospital where practice is occurring.
7. Senior fourth year medical students may practice in a hospital, including a clinic or alternate care facility operated by a hospital. without the direct tutorial supervision by a licensed physician member of the hospital staff. The level of supervision required for each student shall be established by the institution in coordination with the hospital where practice is occurring.
8. Individuals who have completed an accredited respiratory care program may practice respiratory therapy and for ninety (90) days thereafter or until the individual has passed the National Board on Respiratory Care licensure examination and been issued a license or has failed the examination, whichever occurs first.

Nothing in this order designates the healthcare practitioners above as agents of the Commonwealth.

These actions are in concert with, and further the provisions of Executive Order 51 in marshalling all resources and appropriate preparedness, response, and recovery measures to respond to the emergency.

Effective Date of this Executive Order

This Executive Order shall be effective April 17, 2020, and shall remain in full force and in effect until June 10, 2020 unless sooner amended or rescinded by further executive order. Given under my hand and under the Seal of the Commonwealth of Virginia, this 17th day of April, 2020.

Download A Copy of Executive Order 57