In the brief, the AUA pointed out that urologists are critical to providing care to veterans.
“It is imperative the AUA also begins to hear from its members in the field on how this rule may be impacting patient care,” the AUA noted, asking urologists to contact the AUA’s Government Relations & Advocacy Department at [email protected] or 202-403-8500.
The new rule permits three roles of APRNs to practice to the full extent of their education, training, and certification without the clinical supervision or mandatory collaboration of physicians. They are Certified Nurse Practitioner, Clinical Nurse Specialist, and Certified Nurse-Midwife.
“Standardization of APRN full practice authority, without regard for individual state practice regulations, helps to ensure a consistent delivery of health care” across the Veterans Health Administration by decreasing the variability in APRN practice that results from varying state practice regulations, the VA said in the rule. About half the states have their own scope-of-practice laws for nurse practitioners.
In addition, the new policy also helps make the most efficient use of APRN staff capabilities at its facilities, the VA said, thus increasing its capacity “to provide timely, efficient, and effective primary care services, as well as other services.”
The VA said it did not address the team-based care argument in its rule “because we consider it to be an integral part in addressing all of a veteran’s health care needs. Establishing full practice authority to VA APRNs, including CRNAs, would not eliminate any well-established team-based care.”
“This part of the VA’s final rule will rewind the clock to an outdated model of care delivery that is not consistent with the current direction of the healthcare system,” said AMA President Andrew Gurman, MD, who also said state laws should be followed.