Who cares about our turf wars? Patients don’t.


Recently a measure was proposed to allow APRNs full practice authority in the VA health care system.  With this measure, the embattled VA hopes to help optimize access to health care for our veterans. A measure to help with the firestorm of problems we witnessed unravel at the Phoenix VA system two years ago. Sounds great, right?

Nothing is ever that simple in American medicine. The professional organizations are, once again, at war. The AMA stands against increasing “mid-level” practice authority. It isn’t safe and isn’t the care America wants to deliver to their veterans.  In the same breath, the AMA is shaming the mistreatment of our Veterans due to delays at the VA, largely due to a lack of providers. The AANP and ANA take offense to the term “mid-level” and repeat well-established statistics about the safety of care provided by APRNs.  They also decry the mistreatment of veterans, and point out that safety is provider, not profession, dependent. Non-sanctioned voices on both sides take these arguments a step further and add anecdotal stories about the NP who or the physician who delivered substandard care. Thus sparking nasty commentary and bickering.  All the while, the lobbyists go back and forth, spewing statistics and talking points.

You would think the safety of humanity is at risk if you read through the debates, the comments and the rhetoric surrounding this issue.  All of the problems come out.  All of the trigger points.  They are all out on the table.  The lobbyist voices are loud. The only thing agreed upon is that our veterans deserve better.  Everything else, from the levels of training, to the ability to prescribe, to professional oversight, is at odds.  And it is all being debated, loudly and oftentimes unprofessionally.

The strangest thing is, the patients are largely silent.

The patients simply don’t care.  They don’t care what our initials are.  Realistically, it’s a bunch of egotistical alphabet soup to them.  They don’t remember what our title is once we walk out the door.  They definitely aren’t looking up the FACS, FAANP, or other fellowship designations following our names.  They don’t mean anything when a patient is sick and needs our help. Patients simply want high-quality care.  They remember the time we took to listen.  The time we spent investigating their symptoms to get to the right diagnosis.  The time we ordered the regimen that finally gave them relief.  The time we urged them to get the preventative screening that probably saved their life.  They remember the moments we spent in the hospital, late at night, fighting for their lives right alongside of them.  These are the moments we satisfy patients, and it doesn’t matter what your initials are to them. You can be an MD, a DO, a NP, or a CRNA, and it doesn’t matter as long as you are delivering the high-quality care patients deserve.

So why all this nonsensical squabbling?  Why are we fighting over things that don’t matter?  At the end of the day, we are all here for the same reason: to restore our fellow man to health.  Can we start acting like the team we say we are?  “Your health care team” who is here to meet the patient’s, our veterans, needs.  Why is “team-based care” still just a phrase?  We should be a unified health care front by now. Ready to step up, together, to serve those who have served us so unselfishly.  The ones who guarantee our ability to be free and to provide their care.

It is time to stop listening to the lobbyists; they only pit us against one another.  It is time to start listening to our veterans; they simply want care.

Amanda Dean is a nurse practitioner.

Image credit: Shutterstock.com


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