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The Inbox: Battling Over Scope of Practice

The Inbox: Battling Over Scope of Practice

Editor's note: We work hard to write about issues that will help physicians run their practices in a manner that is both prosperous and efficient, while still delivering quality patient care. And we are delighted when our readers let us know what they are thinking. This month we are excerpting a blog by managing editor Gabriel Perna that was written about the VA's plan to expand scope of practice for advanced practice nurses to address long wait times for treatment. The article has been edited for space and is followed by comments made by readers at PhysiciansPractice.com.

This Battle Over APRNs Feels Familiar

… In case you were under a rock during the spring of 2014, a Veterans Affairs internal investigation revealed that more than 1,000 veterans had waited months to see a doctor to receive care at the Phoenix VHA facility. Of the 1,000-plus veterans, at least 40 had died while on the waiting list, CNN reported at the time. The number was later revised to 35, but the CNN report turned this issue into a full-blown scandal. You couldn't flip on cable news channels without someone weighing in about the VHA's failure to care for veterans.

… About one day after this latest snafu, the VHA announced a proposal that aims to quiet its doubters and fix the issue, once and for all. The proposal would expand the scope of practice for advanced practice registered nurses (APRNs), giving them full practice authority when they are acting within the scope of their VA employment.

Seeing as the VA is the country's largest health system, this move could have major ramifications. … The nation's largest doctor group, the AMA went on the attack: "While the AMA supports the VA in addressing the challenges that exist within the VA health system, we believe that providing physician-led, patient-centered, team-based patient care is the best approach to improving quality care for our country's veterans."

The American Association of Nurse Practitioners (AANP), on the other hand, applauded the move: "Veterans stand to significantly benefit from this essential VA policy update, which gives them unencumbered access to nurse practitioners and the excellent, compassionate, and patient-centered care they provide," said AANP President Cindy Cooke in a statement.

* Editor's note: The comment period closed July 25, 2016. The VA will make a decision in the next few months, according to The Washington Post.

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