Dear Secretary McDonough:
The undersigned physician organizations have recently learned of the Department of Veterans Affairs (VA) Supremacy Project. We are writing to express our serious concerns with the VA’s efforts to develop National Standards of Practice for physicians and other health professionals that supersede state scope of practice and licensure laws. In particular, we are dismayed that the VA has not provided a transparent process by which public stakeholders are provided an adequate opportunity to review and provide meaningful input into the standards of practice. Furthermore, based on what we have learned about the VA’s approach to developing the standards of practice for 48 categories of health professionals, we believe the VA has failed to consider that these health professionals do not operate in isolation but rather as a team. Yet, the
VA is creating and moving standards forward independent of one another. In order to provide the best care for our Veterans, the VA must engage in a systematic examination of how all these standards will fit together and affect the health professional team. The policies the VA is seeking to overhaul will have implications for standards of care beyond the VA. It is therefore vitally important that the VA initiate a meaningful process for the collection, dissemination, and inclusion of stakeholder input as early into the process as possible.