More physicians stand against VA’s proposed rule for APRNs


More physicians are opposing a proposed rule from the Department of Veterans Affairs (VA) that would give advanced practice registered nurses full practice authority, citing concerns that such a move would decrease the standard of care offered to veterans.

The proposal is intended to address staffing issues at VA hospitals, a system that has been embroiled in scandal over long wait times for veterans seeking care.

Robert Wergin, M.D., board chair of the American Academy of Family Physicians (AAFP), which represents more than 124,000 doctors, wrote a letter to the VA saying that the organization strongly opposes the rule, as it could impact patient safety and would undermine the rights of states to regulate practice authority. “Granting APRNs independent practice authority nationally would undermine a state’s authority and dismantle the process of team-based collaborative care, while further fragmenting an already disjointed U.S. healthcare system,” Wergin wrote in the letter.

AAFP is the latest profession organization to stand against the VA’s proposal. The American Medical Association and the American Society of Anesthesiologists have both previously released statements urging the VA to rescind the plan. ASA has been a particularly staunch opponent to the VA proposal, FierceHealthcare previously reported, even creating a campaign to encourage the public to stand against the rule during its public comment period.

Wergin also writes that allowing APRNs full practice authority within the VA would create two separate sets of rules for medical professionals--one within the VA system and one outside of it--which is guaranteed to confuse them. “The proposed rule claims that having a national license will simplify the system; however, it will instead create an even more complex system causing confusion for providers and veterans,” he writes.

The VA’s proposal is not without its advocates. The American Association of Nurse Anesthetists, the American Nurses Association, the Air Force Sergeants Association and the Military Officers of America united for a press conference at the end of June to encourage people to continue leaving positive comments and supporting the plan. Juan Quintana, president of the AANA, said that as of the end of last month the rule had already received more than 40,000 comments, and two-thirds were in favor, FierceHealthcare previously reported.

- read the AAFP letter (.pdf)