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Brian Goodroad: Expand the role of nurse practitioners for veterans

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Brian Goodroad

Minnesota has a long heritage of protecting the needs of veterans. Our own Congressman Tim Walz, a veteran of the U.S. Army National Guard, serves on the bipartisan conference committee tasked with finalizing VA reform legislation. In this role, we hope he'll work to expand the role of nurse practitioners at VA facilities where veterans should have full and direct access to nurse practitioner care, similar to the access now enjoyed by patients in Minnesota.

Nurse practitioners are increasingly the health-care providers of choice across the country. Expertly educated and clinically trained to provide primary care services, they evaluate patients, make diagnoses, order and interpret diagnostic tests, write prescriptions and manage health conditions. Nurse practitioners are also more likely to serve in medically underserved and geographically remote communities that are in dire need of more clinicians.

Nearly 50 years of peer-reviewed, independent analyses show the outcomes of nurse practitioner patients are not only equivalent but sometimes better than those of physicians. The data also shows that patients are consistently more satisfied with the care of nurse practitioners, citing their holistic, patient-centered approach; the added health education and counseling; and the overall extra time spent with patients. More than 900 million visits were made to nurse practitioners in 2013.

These statistics illustrate the reality in Minnesota, where patients — men, women and children — now have had full and direct access to nurse practitioners thanks to the actions of our state lawmakers who this year made Minnesota the 19th state, plus the District of Columbia, to grant nurse practitioners full-practice authority. This step was a clear choice as easing regulations affecting nurse practitioners only has been shown to positively affect the health of patient populations. Meaningfully, no state that ever enhanced patient access to nurse practitioners has reversed this decision.

Unfortunately, other states and federal bodies, such as the VA, have yet to modernize and have needless nurse practitioner restrictions — regulations that create costly redundancies and delays, leading to lower quality care. These restrictive laws have been kept in place despite the recommendations of renowned national policy organizations and government bodies — the Federal Trade Commission, AARP, Institute of Medicine, National Governors Association and National Conference of State Legislatures — that all call for more independence for nurse practitioners across the country.

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In the past year, the VA itself began moving in this direction and proposed providing veterans with full and direct access to nurse practitioner care. It is crucial that the VA moves forward with this change — a step that will have an immediate and positive impact on the quality and timeliness of care that our veterans receive. This change would also assist the VA in its ability to recruit larger number of nurse practitioners, who are more likely to work where they can practice to the full scope of their preparation.

It is unconscionable that men and women who have served in uniform are not receiving timely health care when thousands of nurse practitioners are on hand at VA facilities, ready and fully prepared to improve and enhance care delivery. With help from Congressman Walz, we can do something about this. We can provide veterans with the same access to high-quality, safe nurse practitioner care that our friends and neighbors in Minnesota enjoy each and every day.

Brian Goodroad is the Minnesota state representative to the American Association of Nurse Practitioners

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