I'm writing this comment to clarify why I would like to see this law updated.  First, I want to thank the Board for taking time out of their valuable time to review this matter.  Secondly, I would like to tell the Board how professional Dr. Harp was in handling this request.  He contacted me personally and made me feel like what I had to say was important.  

I am Sue Cressel, a family nurse practitioner that lives in Bristol, TN, a border state to Bristol, VA.  I have worked independently as a NP for many years.  From 1998-2006 I managed the day to day operations and practiced as a NP in a small rural town, Mendota, Virginia.  I saw any type of patient that walked through my door, ages newborn to  96.  I saw these patients without a physician being present.  I

diagnosed, and treated as necessary, including prescribing any medication I felt was needed.  The physician would come weekly, to see any patient I felt needed more than I could offer, and also to sign charts as required.  As I understand it, with the proper protocols, practice agreement, etc. this is in the scope of practice for a NP.  

In 2006 I opened a small business in Bristol TN and later one in Abingdon VA and Cedar Bluff , VA.  One aspects of this small business is weight management.  On occasions, if a client meets criteria the drug Phentermine may be prescribed.  As you know this is a schedule IV drug.  NPs can write schedule II-VI drugs.

 Last fall it was brought to my attention that there was a law still on the books stating that  a weight loss client prescribed Phentermine had to be seen by a physician first. (This law was written before NPs had the authority to prescribe this schedule drug)  I've had discussions with several of my NP and Physician colleagues and we feel it should no longer state physician but, instead state provider, since this is in the scope of practice for an NP.   In our day to day practice we are allowed to see much sicker patients and prescribe much more serious drugs than Phentermine without the physician ever seeing the patient.  The law is confusing.  In fact, when I spoke to the Executive Director of the Board of Nursing she assured me that seeing this type of client and prescribing this medication was in the NP's scope of practice.  

I would appreciate you considering this matter.  If you need any additional information please feel free to call me.  

Thank you for your attention to this matter.