NCMS President’s Report from MSV Annual Meeting

One of the first official duties of NCMS’ new President, Michael P. Moulton, MD, was to represent our Society at the Medical Society of Virginia’s (MSV) Annual Meeting in Williamsburg the first weekend in November. He filed this report.

MSV’s membership approaches NCMS’ with total members at 10,895 including 7,211 actively practicing physicians. And the Virginia society grapples with many of the same legislative issues we face. Here is a brief summary of several legislative items our neighbors to the north have addressed. NCMS staff also will be working on somewhat similar legislation in the upcoming 2013  session.

Nurse Practitioners (NPs)

Passed HB 346:  Outlines a team-based care model designed to help improve access to physician and NP care and reduce paperwork. The changes emphasize a consultative and collaborative approach between physician and NP, with the physician providing leadership and management of the care team.  Provides NPs more flexibility to treat patients in nursing homes and free clinics, as well as  increases the physician to NP management ratio from 1:4 to 1:6.

Definition of Surgery

Passed HB 266, which is a measure to define “surgery” so that no person other than a licensed doctor of medicine, osteopathy, dentistry, a licensed nurse practitioner or a person who is acting pursuant to the orders and under the appropriate supervision of a licensed doctor of medicine, osteopathy or dentistry shall perform surgery.

Epinephrine in schools

Following the death of a Chesterfield elementary school child from anaphylaxis after she ate a peanut on the playground, the Virginia General Assembly will require all local school boards to adopt and implement policies for the possession and administration of epinephrine in every school. Under the policies, the epinephrine would be administered by a school nurse, a school board employee or a volunteer who is authorized and trained in the administration of epinephrine to any student believed to be having an anaphylactic reaction. .

Narcotic Prescriptions

A bill was defeated that proposed to have physicians check the narcotic database against every narcotic prescription they wrote.

House of Delegates Action

The MSV polled its membership on how they would cope with the proposed expansion of Medicaid under the Affordable Care Act (ACA). Of the 220 respondents, a third said they would have the capacity to care for additional Medicaid patients if the program was expanded. They also voiced concerns about continuing reimbursements after the Federal funding for the expansion expires.  Based on these survey results and citing a New England Journal of Medicine article from August 12, 2012, which offered evidence that the expansion of Medicaid coverage may reduce mortality among adults, particularly those between the ages of 35 and 64 years old, minorities and those living in poorer areas, the MSV House of Delegates passed a final resolution supporting the Virginia legislature to fully expand Medicaid under the limits set by the ACA.


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