I am a Certified Nurse Midwife in the state of WV. I am required to have a signed collaborative agreement from an obstetrician in order to hold a license to practice in the state. All of the obstetricians in my local area have refused to even reply to my letters or phone calls asking for said collaboration. Because they are not required by law to collaborate on request, they are able to keep me from being able to practice. I am fully qualified and practice by my profesesional organization's standards (the American College of Nurse Midwives). However, my "competitors" have complete control over whether I can practice at all, much less to the full scope of my certification and licensure.