VA Empowers Nurse Practitioners; Association of American Physicians and Surgeons (AAPS) Urges Caution

TUCSON, Ariz., Jan. 03, 2017 -- The U.S. Veterans Administration issued final regulations billed as a victory for nurse practitioners, who have doubled in number to more than 200,000 in the past decade, states the Association of American Physicians and Surgeons (AAPS). The VA will permit full practice authority for advanced practice registered nurses (APRNs) to provide primary care and related services to veterans without clinical supervision by physicians. APRNs will be permitted to make diagnoses and initiate and manage treatment plans, including prescribing medications.

The AAPS Board of Directors issued the following statement concerning non-physician clinicians:

“The medical world has become increasingly complex and confusing to patients. Non-physician clinicians who may be caring for them include physician assistants and advanced practice registered nurses, typically nurse practitioners, nurse anesthetists, nurse midwives, and clinical nurse specialists, as well as allied health professionals who have obtained a Doctor of Philosophy or other doctorate in their professions, including but not limited to pharmacists, audiologists, and physical therapists.

“In many instances, such medical personnel are mistaken for physicians, particularly if they introduce themselves as ‘doctor,’ or fail to correct the patient who mistakenly assumes the examiner is a physician. Busy medical settings such as emergency rooms, hospitals and clinics, lend themselves to such confusion.

“With several post-graduate years of medical training, physicians have broad authority and considerable latitude in the scope of their medical practice. Clinicians with less extensive and multi-faceted training need a clearly defined scope of practice in keeping with state statutes and the requirements of professional ethics.

“We believe that it is unprofessional conduct for medical professionals to use any letter, letters, word, words, term, or terms either as a prefix, affix, or suffix indicating that they are entitled to engage in a medical practice for which they are not licensed.”

• “We believe it is in patients’ best interest to be informed of the qualifications of the clinicians who will be providing their medical care.
• “We believe patients have the right to withhold consent to be treated by non-physicians.
• “We believe physicians should support their patients in exercising their rights regarding treatment by non-physician clinicians.
• “Suggestions for compliance:
  1. Personnel should wear clearly identifying nametags.
  2. A sign should be prominently posted in the office explaining the breakdown of the clinical personnel.
  3. When non-physician clinicians work under supervision, the supervisor should be identified in advance and should be skilled in performing the particular procedure.
  4. Business cards of physician assistants and nurse practitioners should explain the difference between MDs, PAs, RNs, or other relevant professionals on the back of the card.”

The Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties, was founded in 1943 to preserve the patient-physician relationship.

Contact: Jane M. Orient, M.D., (520) 323-3110, [email protected], or 
Marilyn M. Singleton, M.D., J.D., [email protected]