AAFP Blasts VA Decision Granting APRNs Full Practice Authority

Final Rule Shortsighted, Harmful to Veterans

December 16, 2016 01:19 pm News Staff

Today AAFP President John Meigs, M.D., of Centreville, Ala., slammed a final rule(www.gpo.gov) released earlier this week by the Department of Veterans Affairs (VA) that grants advanced practice registered nurses in VA facilities independent practice authority.

The final rule is effective on Jan. 13, 2017, and applies to all states regardless of an individual state's laws.

"There is no doubt that this action taken by the VA could undermine the quality of health care provided to the very Americans who deserve nothing but the best. Shame on the VA," said Meigs in an interview with AAFP News. "Our veterans put their lives on the line for this country and should be guaranteed access to family physicians."

"The AAFP understands the VA's concerns about long wait times for veterans. However, it's quite clear that in their haste to find a quick and easy solution to a very public problem, the VA has taken a sharp turn in the wrong direction. This regulation is no solution," said Meigs.

He noted that the rule effectively supersedes state laws and regulations regarding the authority of nurse practitioners. He pointed out that a majority of states have steadfastly refused to grant NPs independent practice authority, and for good reason -- doing so would put patients at risk.

"We know that the safest and highest-quality health care is delivered by a health care team led by a physician," said Meigs. "All members of that team play an important role, but the leadership role of the physician is indisputable given the extent of the training, knowledge and experience each physician brings to the health care table."

The AAFP strongly opposed the VA's plan from the start and fought against it at every opportunity.

For example, VA officials were informed of the Academy's grave concerns in a July 13 letter(2 page PDF) to the VA Undersecretary for Health David Shulkin, M.D.

Unfortunately, VA leadership overruled the AAFP's solid arguments against the proposal.

Despite the Academy's deep disappointment with the VA's shortsighted decision, Meigs vowed that the AAFP would continue the fight for high-quality team-based care built around a health care system that values the expertise and compassion that family physicians bring to their role as team leaders.

"All of our patients, and especially our veterans, should expect nothing less," said Meigs.

Related AAFP News Coverage
AAFP Decries VA Plan to Expand Nurses' Scope of Practice
(7/15/2016)

More From AAFP
Joint letter from physician groups to the VA opposing proposed expansion(7 page PDF)