Attestations for NP Independent Practice in the Emergency Department
September 2024
The leadership at VACEP has long advocated to ensure physician-led teams of Emergency Physicians are the “gold standard” and the core of Emergency Medicine practice in Virginia and across the country.
It’s why we successfully introduced and passed legislation to ensure that a physician is always physically present and primarily responsible for every Virginia ED, a law that will go into effect in July 2025. We firmly believe the training and skills gained during an Emergency Medicine residency are essential to providing the best care to our patients and communities.
It’s also why we were greatly disappointed to see the requirement for independent nurse practitioner practice in Virginia recently reduced from five years to three, a law that went into effect in July 2024.
We fear independent practice by NPs without sufficient training runs the risk of endangering our patients and also putting these same practitioners in situations where they are not able to adequately manage a patient’s care.
We urge you to thoroughly evaluate any NP who comes forward asking you to sign paperwork to allow them to practice independently. Virginia law requires them to collaborate with a physician in the specialty in which they seek to practice independently for three years. It is best practice for any NP seeking independent practice to notify their collaborating physician of this intent prior to entering a collaborative practice agreement.
To that end, we have created a letter that outlines the six core competencies required of emergency medicine residents: patient care, medical knowledge, professionalism, system-based practice, practice-based learning and improvement, and interpersonal and communications skills. The requirements listed in sections A-D in the letter are based on these core competencies. Any provider seeking independent practice in emergency medicine should provide proof of these requirements.
