Texas Physicians Ask VA Health Official Tough Questions

In a frank and occasionally testy exchange, members of the Texas Delegation to the American Medical Association and a senior health care official at the U.S. Department of Veterans Affairs (VA) presented two very different pictures of VA's proposed scope-of-practice rule for advanced practice registered nurses (APRNs). "Veterans deserve the highest and best care," said Beaumont anesthesiologist Ray Callas, MD, a decorated U.S. Navy veteran of Operation Desert Storm. "In the most complicated cases, anesthesiologists should be in the lead."  

Last month, VA published a proposed rule that would allow APRNs — nurse anesthetists, nurse practitioners, nurse midwives, and clinical nurse specialists — to practice independently within the VA health system. While this doesn't change state scope-of-practice laws for APRNs working outside the VA system, it overrides those laws for care being provided inside VA.

"When we say independent practice for nurse practitioners, that's in the context of team-based care," the official told the Texans. "I don’t even know what an independent practitioner in the VA system would mean." 

Fort Worth pediatrician Gary Floyd, MD, said an important phrase is missing in VA's draft rule. "It needs to be 'physician-led,'" he said." Please put that language back in." 

Take a few minutes to tell VA officials what you think of the plan. Send comments via TMA's Grassroots Action Center or through the American Society of Anesthesiologists' Safe VA Care website. TMA and the Coalition of State Medical Societies already submitted a hard-hitting official comment letter.

Action, July 1, 2016

Last Updated On

October 11, 2016

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