The VA Is Smart to Give Nurses More Power

No need for micromanagement.

Photographer: Joe Raedle/Getty Images

The U.S. Department of Veterans Affairs hasn’t exactly been a model of efficient health care in recent years. But its new proposal to expand the role of nurses is a good idea that should be widely copied.

The VA wants to let its most highly educated nurses -- so-called advanced-practice registered nurses, who have master’s degrees or higher in medicine -- treat patients without a doctor’s supervision. That would authorize nurse practitioners, anesthetists, specialists and midwives to do the jobs they’re trained for: diagnosing problems, interpreting test results and prescribing treatments.

The change would mean faster treatment for the almost 6 million veterans the VA cares for, who continue to face long wait times for appointments. It would also free up the system’s doctors to spend more time treating patients directly, rather than supervising nurses who don’t need to be supervised. And it would be a better allocation of scarce resources; even the best nurses generally cost less than physicians.

Doctors’ groups resist giving nurses more responsibility, arguing that letting even the best-trained nurses practice without supervision will undermine care -- a charge the American Medical Association repeated in response to the VA’s proposal. That argument, which the AMA hasn’t offered evidence to support, seems more like a cover for a more parochial desire to protect doctors’ turf.

In overruling it, the VA can encourage a rethink by the 29 states that still don’t let nurse practitioners work without a doctor’s oversight. After all, the problems facing the VA aren’t that different from what ails the rest of the health-care system: Growing demands from an aging population are colliding with a doctor shortage and rising costs. In the complex world of health care, this is something rare: an easy fix.

To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at davidshipley@bloomberg.net.