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Becky Compton and Molly Sandel column: Nurse practitioners increase access to health care in Virginia
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Becky Compton and Molly Sandel column: Nurse practitioners increase access to health care in Virginia

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By Becky Compton and Molly Sandel

The COVID-19 pandemic has highlighted the dedication of our nation’s health care heroes — the incredible men and women who have been working tirelessly since March to prevent community spread while continuing to provide primary and specialty care to patients of all ages and from all walks of life.

Among these heroes are more than 290,000 nurse practitioners (NPs), including more than 13,000 in Virginia. This week, Nov. 8-14, is National Nurse Practitioner Week, a time dedicated to recognizing these special health care professionals and the valuable work they do every day.

NPs are advanced practice registered nurses who have master’s, and often doctorate, degrees as well as extensive clinical training in the diagnosis and management of common and complex medical conditions. NPs provide a full range of health care services, guide patients in making educated health care decisions and promote healthy lifestyle choices every day.

Many of these providers work in rural and underserved areas to expand access to care to Virginia’s most vulnerable citizens. NPs also work to end health disparities and combat systemic racism in health care.

Throughout Virginia, NPs consult and collaborate using a patient care team approach and work everywhere from large hospital settings and medical offices to free and mobile health clinics, where they focus on adult and pediatric care, women’s health, mental health and other specialties.

They treat physical and mental ailments by diagnosing and treating acute and chronic conditions; ordering, performing and interpreting diagnostic tests; prescribing medications and other treatments; and counseling and educating patients about smart lifestyle choices.

Recent estimates from the Association of American Medical Colleges indicate the U.S. could experience a shortage of between 21,000 and 55,000 primary care physicians by 2023.

With nearly 90% of NPs certified in an area of primary care, according to the American Association of Nurse Practitioners, NPs can help bridge this gap by serving as a patient’s primary care provider.

Studies show that patients whose primary care providers are NPs have fewer emergency room visits and shorter hospital stays, resulting in lower out-of-pocket costs.

Current Virginia law allows NPs with five or more years of clinical experience to apply for autonomous practice licensure. Earlier this year, Gov. Ralph Northam signed Executive Order 57, which allowed NPs with two or more years of clinical experience to autonomously practice during the COVID-19 state of emergency.

Autonomous practice allows NPs to practice in rural and underserved areas where physician shortages are even greater than those in urban areas.

It also encourages NPs to develop innovative practice models, volunteer in free or mobile clinics without the restriction of a mandated collaborating physician, and expand access to care in all specialties including mental health and substance abuse treatment.

Unfortunately Anthem, one of Virginia’s largest insurers, does not share Northam’s confidence in NP care as demonstrated by the company’s recent reduction in reimbursement rates for NPs in Virginia from 100% to 85%. This change indicates that Anthem views the value of care provided by NPs as not equal to care by physicians since Anthem is continuing to reimburse physicians at 100%.

Interestingly, the confidence patients have in NP-delivered care is evidenced by the more than 1 billion visits to NPs every year. At a time when the need for health care is increasing and the number of physicians is decreasing, Anthem’s decision will have a devastating effect on access to health care in Virginia.

This year, U.S. News & World Report’s Best Jobs rankings listed nurse practitioner as the fifth best job (up from seventh in 2019) and fourth best health care job (up from fifth this past year). The Bureau of Labor Statistics is projecting 45% employment growth for NPs between 2019 and 2029, primarily because of an increased focus on preventive care and demand for health care services as the population ages.

We hope you’ll join us this week and throughout the year in thanking Virginia’s nurse practitioners for their dedication to enhancing the health of all citizens in the commonwealth.

Becky Compton, DNP, RN, FNP-BC, is president of the Virginia Council of Nurse Practitioners. Contact her at:

Molly Sandel, AGACNP, is Richmond region president of the Virginia Council of Nurse Practitioners. Contact her at:


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