CHICAGO — The American Medical Association (AMA) and 102 other organizations are asking the Department of Veterans Affairs (VA) to jettison the development of standards that threaten to undermine confidence in the health care provided to our nation’s veterans by upending state-based licensure and oversight of health care professionals.

“These back-of-the-envelope standards will have the unintended consequence of reducing the quality of health care for veterans, many of whom suffer from complex symptoms that require expertise from trained medical professionals,” said AMA President Gerald E. Harmon, M.D. “These new standards of practice are unlikely to encompass the complexity of modern medicine. They will supersede longstanding state regulations and laws and create confusion. This is a solution in search of a problem.”

Initiated by the Trump Administration through an interim final rule, the standards could lead to patient safety issues and lower quality of veteran care by allowing health care providers to practice above their license and perform procedures for which they are not properly trained. The proposal would result in a national standard of practice for 48 categories of health professionals. The VA standards for each category will be independent of one another rather than emphasizing the role of each health care professional in a team-based approach.  The VA is developing the standards without transparency and adequate stakeholder input. 

More importantly, these new federal standards will supersede existing state laws. Such a move would prevent state boards from properly supervising the practitioners they license, making it all but impossible to discipline health care professionals who deliver inadequate or substandard care.

Health care professionals working for the VA would be exempt from state laws that are the result of years of legislative and stakeholder involvement.

“Had we been asked, we would have told the VA to pause and consider the breadth of what it is doing. This is a monumental undertaking, not one to rush through between administrations,” said Harmon, a former major general in the Air Force. “Physicians want to deliver superior care to veterans. These standards are likely to compromise care. That isn’t what the VA intends, but that’s the probable result.”

The AMA has long supported improved access for veterans, including changes that promoted community-based care. The AMA backed the Community Care Program that allows veterans to choose their preferred community provider or a VA staff member.