AMA Issues Statement on VA’s Proposal on Advanced-practice Nurses

CHICAGO — Dr. Stephen Permut, board chair of the American Medical Assoc. (AMA), issued a statement this week blasting the Department of Veterans Affairs’ (VA) “unprecedented” proposal to allow advanced-practice nurses (APRNs) within the VA to practice independently of a physician’s clinical oversight, regardless of individual state law.

“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,” Permut said. “We feel this proposal will significantly undermine the delivery of care within the VA. With over 10,000 hours of education and training, physicians bring tremendous value to the healthcare team. All patients deserve access to physician expertise, whether for primary care, chronic health management, anesthesia, or pain medicine.

“There are many examples from across the nation demonstrating that physician-led, team-based care results in improved access to high-quality, cost-effective healthcare,” he went on. “From patient-centered medical homes to some of the nation’s largest healthcare systems, physician-led, interprofessional, team-based healthcare has proven to be a successful model in the delivery of healthcare. The nation’s top healthcare systems rely on physician-led teams to achieve improved care and patient health while reducing costs. We expect the same for our country’s veterans, and look to these systems as evidence that physician-led, team-based models of care are the future of American healthcare.

He concluded, “the AMA urges the VA to maintain the physician-led model within the VA health system to ensure greater integration and coordination of care for veterans and improve health outcomes.”