The VA has proposed a new rule that would allow NPs to see patients without a physician's oversight; this could increase veterans’ access to healthcare.
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The VA has proposed a new rule that would allow NPs to see patients without the oversight of a physician. If the rule is put into effect, it could increase veterans’ access to healthcare.

There is little doubt that the Department of Veterans Affairs is struggling to keep up with the healthcare demands of former military members. In fact, some veterans wait over 100 days to see a physician at a VA facility. Despite some failed attempts at ameliorating the system, the VA has now proposed a new rule that could increase veterans’ access to healthcare across the country.

The Proposed Rule

Under this new rule, Nurse Practitioners (NP), a type of Advanced Practice Registered Nurse (APRN), would be granted full practice authority in VA clinics. In other words, NPs could see patients without the direct oversight of a physician.

For some NPs this is not a new idea. In fact, several states (including Washington, New York, and Montana) already allow NPs to work independently from doctors. Other states like Texas and Florida, however, still require physicians to oversee NPs. If granted, the proposed rule would allow NPs to practice independently in VA clinics regardless of state law.

If the rule becomes an official regulation, it would lay out the credentials that a NP must hold to work within the VA system. It would also fully define the scope of practice for NPs in each field of care. These systems would be put into place in order to ensure high quality healthcare for veterans.

Support of the Proposed Rule

The VA believes that giving NPs full practice authority would increase veterans’ access to healthcare. They argue that it would decrease wait time without compromising quality of care. Fortunately, research favors this argument. Several studies have shown that NPs provide services that are equal to or better than physicians when it comes to effectiveness, quality, safety, and patient satisfaction.

These findings are likely the result of the similar educational requirements for physicians and NPs. Typically, NPs must first complete a full academic program and pass a national standardized test to become a Registered Nurse (RN). From there, these individuals must earn a graduate degree and gain experience through hands-on clinical training. They then must go through further rounds of licensing and certification testing prior to earning the title of Nurse Practitioner. Subsequently, many NPs choose to continue their education in a particular field. While many NPs practice in family healthcare, others specialize in areas such as geriatrics or women’s health.

It is credentials like these that have many institutions supporting the proposed rule. In fact, the United States Federal Trade Commission even weighed in, stating that full authority for NPs would be beneficial to veteran patients who are seeking quick yet competent healthcare options.

The Debate Surrounding the Proposed Rule

While many are in favor of the proposed rule, others have spoken out strongly in contradiction. Specifically, physicians and the American Medical Association have come out against full authority for NPs. Those who disfavor the new rule do so from a standpoint of concern for patient care. These individuals and organizations believe that the true value of a physician is being overlooked. Furthermore, they argue that physicians’ extensive experience puts them in a better position to oversee patient care. Though the requirements are similar, physicians typically do complete more hours of education and training than NPs.

Fortunately, both sides were granted a public comment period, in which they could air their grievances or support of the proposed regulation. After this time period, which ended in late July, officials will decide whether to add the rule to the Federal Regulations.

Nurse Practitioners who are considering a specialty or who are interested in working with the Department of Veterans Affairs could greatly benefit from Locum Tenens work. Not only can they gain experience in a particular field, but they also can play a role in the changing face of the VA system. Physicians who would like the opportunity to work with America’s veterans should also consider Locum Tenens work. For more information, please contact the National Association of Locum Tenens Organizations.

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