AAFP Against Nurses’ Scope of Practice?


Oooh boy, someone is going to get it.  The AAFP, amazingly enough, got into the fray when they made a statement against the Department of Veterans Affairs (VA) who was trying to unilaterally expand the scope of practice for advanced practice registered nurses (APRNs).  The rule removes provisions that require nurses to work in patient-centered care teams supervised by a physician. The AAFP Board Chair, Robert Wergin, M.D., argues that “such action could jeopardize patient safety and would certainly override states’ authority to regulate medical and nursing practice”. Watch the claws come out by the nurses now.  And I guarantee the AAFP will backtrack. My question is where has the AAFP been?  They let the FNPs make claims that they are the same as doctors and said nothing.  They capitulated at every turn and now family doctors are losing jobs to them.  They have hid in the corner instead of pointing out that training and education do, in fact, matter. And now they grow a pair to protect anesthesiologists?  WTF?  Well, I guess better late than never.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  6 comments for “AAFP Against Nurses’ Scope of Practice?

  1. Peggy Gnehm
    July 21, 2016 at 2:56 pm

    Whew, a bit slanted there folks. There’s nothing in the new VA guidelines that expands the scope of practice for AP RN’S. They simply standardize the current scope of practice throughout the VA system (so it’s the same in every state) and allow AP RN’S to actually work as AP RN’S in the VA system, like they do everywhere else. Considering the wait times vets endure when trying to receive ANY care, and the complaints of the physicians that they’re overworked due to staff shortages, one would think the help would be welcome.

    • Doug Farrago
      July 21, 2016 at 3:11 pm

      I think you are on the wrong site. I don’t want you to get offended but this site truly treasures education and training. We believe it means something and we are offended when those of lesser education and training try to claim they are the same. It demeans us as doctors and it is disrespectful. If you truly believe an APRN is more than an RN then you must agree that an MD is more than an APRN, PA or NP. If you want to push back on that then you will not like it here. At least your tone is nice but we boot all militant NPs/PAs off the site.

      • Peggy
        July 25, 2016 at 10:45 pm

        Doesn’t it trouble you that family practice docs have less training than specialists?

        • Doug Farrago
          July 26, 2016 at 2:23 am

          Sounds like you’re baiting me but no. At least we both had medical school. I refer to them because they have more intensive training in an area that I need help. By the way, if you come back with some militant NP or PA stuff then I will just delete your rant.

  2. RSW
    July 19, 2016 at 12:00 pm

    Under marching orders from their corporate masters, the AAFP has spent the better part of a decade destroying the physician-patient relationship – the medical home, population health, team-based care – they’re all based on eliminating the role of the M.D.

    And now they pretend to be surprised that someone takes them at their word?

    Criminally corrupt, or stupid to a degree not consistent with life? I can never make up my mind.

  3. Pat
    July 19, 2016 at 7:51 am

    “Forceful letter…sharply criticizing”? Gimme a break. Trying to base the argument on state jurisdiction within a federal facility is flimsy enough, and already proves your point: the AAFP cowards will not name the LELT’s for exactly what they are, and what path they promise. Even within this letter, Wergin has already marked out his path of retreat. Pathetic.

    I’ll bet there is a backlog of prostate cases within the VA – wouldn’t it make sense to train up some urology ARNP’s to take up the slack in the simpler cases?

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