Americans Speak Out in Overwhelming Opposition to VA Policy Risking Veterans’ Lives
Wed, Jul. 27, 2016

SCHAUMBURG, Ill. – Veterans and the public have spoken in overwhelming opposition against a U.S. Department of Veterans Affairs (VA) proposed policy that would lower the standard of care in VA medical facilities and jeopardize Veterans' lives by removing physician anesthesiologists from the operating room.

The comment period for the proposed policy, published in the Federal Register May 25 closed yesterday. Ninety percent of Veterans who commented said no to the proposed rule. Overall, the majority (an estimated two-thirds) of the more than 167,000 comments oppose the rule. VA's proposed policy attracted an unprecedented outpouring from the public, a record for VA-related issues as well as a record for the most comments posted to the Federal Register in 2016. 

The proposed policy would replace physician anesthesiologists with nurses, abandoning a proven model of care where physician anesthesiologists and nurse anesthetists work together as a team to provide Veterans high-quality and safe anesthesia.  

"Americans understand that it would be wrong to lower the standard of care provided to these men and women who have bravely served our country," said Daniel J. Cole, M.D., president of the American Society of Anesthesiologists. "We expect the VA will listen to the comments of Veterans, their families and the American public who care about the quality of health care in the VA system and abandon this dangerous proposal that runs counter to the VA's own strategy to deliver high-quality, Veteran-centered care."

The policy change is based on a shortage of some types of physicians in VA and would permit all advanced practice registered nurses (APRNs), including nurse anesthetists, to practice outside of the physician-led team-based model of care.  However, there is no shortage of physician anesthesiologists in VA and the change is not needed to improve access to anesthesia care in surgery.   

The VA's own Quality Enhancement Research Initiative (QUERI) could not discern "whether more complex surgeries can be safely managed by CRNAs." In fact, there are no independent studies that show nurses can ensure the same outcomes as physician anesthesiologists. 

"The fact is, surgery and anesthesia are inherently risky requiring physician involvement, particularly for Veterans who are sicker and often have multiple medical conditions that put them at greater risk for complications," Dr. Cole said.

The leading experts on anesthesia care in the VA, the Chiefs of Anesthesiology, have twice expressed concern that the new policy "would directly compromise patient safety and limit our ability to provide quality care to Veterans."  

The policy also conflicts with 46 state laws that recognize the importance of physician involvement in the delivery of anesthesia. 

The VA now will read and consider all submitted public comments before publishing a final rule. Stay informed about the proposed policy and continue to advocate for the health of Veterans by visiting


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