VA standards for healthcare professionals threaten veteran care



As a physician and veteran, I firmly believe that those who put themselves at risk by serving in our country’s military deserve the highest quality health care we can provide. But a new initiative by the Department of Veterans Affairs (VA) to implement national standards of practice would jeopardize the care our veterans receive and would likely have far-reaching consequences by changing the license to practice. Status for healthcare professionals.

Simply put, the VA’s initiative, called “The Supremacy Project,” would create a single set of standards of practice for all physicians employed by the VA, a diverse group that includes 40 specialties and more than twice as many subspecialties. . Creating a standard for all physicians is both impractical and unnecessary.

National practice standards would also be created for 47 non-physician health professionals, with each standard being developed independently of the others and no possibility of meaningful input from other stakeholders. This siled approach is inconsistent with the way care is delivered today, with an emphasis on physician-led care teams.
Equally concerning is that this aggressive action by the VA, which was initiated by the Trump administration, is a maneuver to circumvent state laws and regulations by preventing state medical boards from overseeing physicians and non-physicians employed by the VA within their borders. . We know that in some circumstances and jurisdictions, this lack of oversight would allow non-physicians to provide care beyond what is permitted by state law.
Doctors, as a group, have been silent on The Supremacy Project so far because the VA was not transparent when it created the initiative. To date, there has been no significant opportunity for input or review from WADA or any state medical or specialty society. After the initiative was revealed, the AMA and 102 other physician organizations across the country sent a letter to VA Secretary Denis McDonough urging him to drop the proposal, which would negatively impact the overwhelming majority. 9 million veterans in the United States receiving their care. of the Veterans Health Administration.

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Why VA’s decision to nationalize the Standards of Practice is wrong

But this is only one of the many fatal flaws contained in the initiative that the VA advances. Extensive research has shown that physician leadership is widely recognized as essential to team-based medical care, and that the vast majority of patients prefer a physician to take primary responsibility for their diagnosis and treatment.

Each member of a patient-centered healthcare team brings valuable skills and experience to the task at hand, but none can match the skills and knowledge acquired by physicians over four years of study in medicine, three to seven years of residency, and over 10,000 hours of clinical experience and training.

Healthcare teams operate at the highest level when a physician orchestrates the integration and teamwork of multidisciplinary providers and leverages the strengths and talents of each team member for the benefit of the patient. We must reject any VA action that threatens patient safety by allowing non-physician providers to perform procedures and other functions that are beyond their knowledge, experience and licensing authority.

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Advocacy for Veterans’ Health

I am proud to recognize our AMA’s continued support for healthcare initiatives that directly benefit our country’s veterans. There are many examples.

Our contribution has helped create and shape the Community Veterans Care Program, which enables Veterans to seek medical care outside of the child care system when they cannot provide adequate care. or timely. This program helped address the issues of excessive wait times for the provision of veteran care that came to light in 2014, and has since grown in scope and size to provide expanded health care choices for those who have served our country.

Last spring, our AMA underscored its support for legislation pending in current Congress that would expand community maternity care options for pregnant and postpartum veterans.

The 150 medical centers and some 1,400 community outpatient clinics that make up the VA health system are a tremendous asset, providing comprehensive and in many cases highly specialized care to our veterans, many of whom welcome the opportunity to receive a treatment alongside others who have also served. We must reject any action that diminishes the quality of care our veterans receive.


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