The Wisconsin Medical Society, the American Medical Association (AMA) and other organizations expressed concerns this week about the draft Veterans Health Affairs (VHA) Nursing Handbook which mandates that all advanced practice nurses (APRNs) within the VHA be designated as independent providers, without regard to state practice acts. In a letter to the U.S. Department of Veteran Affairs, the organizations encouraged the VHA to embrace the use of new health care delivery and payment models that require integration and teamwork among physicians and other health care professionals to improve outcomes and reduce costs.
“In lieu of team-based care, the draft handbook requires APRNs to attain independent practice and penalizes those who do not wish to attain this status by prohibiting such APRNs from practicing as APRNs within the VHA,” the letter said. “Similarly, local facilities that wish to continue to provide physician-led, team-based care will be prohibited from doing so.”
The letter acknowledges that the United States faces growing shortages of both physicians and nurses along with an increasing need for primary care. However, the Society and others signing the letter say the independent practice model in the draft VHA Handbook would further compartmentalize and fragment health care delivery.
“We believe greater coordination through the use of more flexible collaborative practice agreements and protocols between VHA and physicians and APRNs, taking a team-based approach to care, can address much of the primary care demand within the VHA,” the letter said.
Back to October 31, 2013 Medigram