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  • ASA "Fudges" Veterans Numbers: Overwhelming Support is FOR Full Practice Authority for APRNs at the VA



    Intellectual dishonestly is something one would not expect from a well respected Physician Society such as a the American Society of Anesthesiologist or the well respected anesthesia magazine Anesthesiology News. Unfortunately it has become all too common and the most recent example is in the press release by the ASA in Anesthesiology News found here only further throws into question their integrity.

    Anesthesiology News posted the article which they salaciously titled "Comments Slam VA Proposal" and went on to make this unqualified and evidence-free statement:

    There were more than 167,000 comments posted to the Federal Register on the U.S. Department of Veterans Affairs (VA) proposal to remove physician anesthesiologists from the OR. And, as was reported in a press release from the American Society of Anesthesiologists (ASA), dated July 26, 2016, the public was not impressed with the idea.


    Indeed, fully 90% of veterans rejected the proposed rule, and an estimated two-thirds of all comments opposed it.
    However the American Association of Nurse Anesthetist decided to take a different approach. In their press release found here entitled "7 Facts About Record-Breaking Response to VA Proposal to Improve Veterans' Access to Care" they make it clear the ASA and Anesthesiology news are misleading the public and their readers in their press release.

    The AANA listed the unprecedented support for APRN full practice authority at the VA from leading veterans’ service organizations collectively representing more than 1 million veterans have supported the proposed rule, including:

    Military Officers Association of America (390,000 members), AMVETS (250,000 members), Iraq and Afghanistan Veterans of America (200,000 members), Air Force Sergeants Association (100,000 members), Vietnam Veterans of America (75,000 members), and Paralyzed Veterans of America (60,000 members). On its website, the Iraq and Afghanistan Veterans of American bills itself as “The voice for 2.5 million post-9/11 veterans.” AMVETS, which opposed the rule early in the comment period, quickly changed direction and became a supporter of the VA’s proposal to grant full practice authority for APRNs.

    There were also letters of support from:



    1. AARP, whose membership includes more than 3.7 million veteran households, supports the rule.
    2. The American Hospital Association (AHA), which lists more than 130 VA hospitals among its members, supports the rule.
    3. The professional staff of the Federal Trade Commission (FTC) came out in support of the rule.


    However, what the AANA also did was prove the ASA and Anesthesiology News statements were not born out in the numbers on the federal register comments site by performing searches showing the ASA's numbers are impossible. Here is what they found:


    A search of the regulations.gov database of letters to the VA after the comment period closed revealed the following numbers: 86,381 letters used the phrase “veteran support,” nearly three times more than the 31,802 letters that used the phrase “veteran oppose.”

    With 167,000 total comments registered if 86 381 were in support it is impossible for there to be 90% opposed. In fact if every other letter was opposed besides the 86K that would only leave 80K opposed which would be at best 48%. The search itself only showed 31,802 letters which used the word opposed which is 19%.

    Clearly many letters may not use the words "support" or "opposed" as the AANAs data only accounts for 118,183 of the 167,000 total letters which is 70%. However it is not unreasonable to assume that the remaining 48,817 are mixed between both sides.

    Either way the fact that 86,381 letters are clearly FOR full practice authority for APRNs at the VA makes the ASA and Anesthesiology News statement that "90% are opposed" a total impossibility. It appears that the ASA has now dragged the reputation of Anesthesiology News down with it in their attempt to fool, scare and intimidate the public, legislators and anesthesia providers. Intellectual dishonestly and Cognitive Dissonance rules apparently.

    It is clear that Upton Sinclair's famous quote very much applies to the ASA and their cheerleaders.


    “It is difficult to get a man to understand something, when his salary depends on his not understanding it.”

    The ASA's opposition to this is nothing more than guild protectionism in an attempt to unfairly maintain market share and limit competition to do so. Their fear being this will spill into the private sector and end their monopoly.
    Comments 2 Comments
    1. nurserebecca's Avatar
      nurserebecca -
      Not trying to be a negative "Nelly", but I read the comments and many of them had phrasing about "I support our veterans, and they deserve "physician-led care".

      I think just searching support or oppose is not going to give accurate results. Every comment must be scored.
    1. ADMIN's Avatar
      ADMIN -
      Hey Becca

      There were multiple searches done however and all came out the same way, pro-APRN was way ahead in every metric. Not to mention the numbers of comments submitted by AANC, AANP, CRNA and other orgs (which they reported) were all PRO and clearly they were nearly 3/4 of the comments by number.
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