AASLD recently submitted formal comments to the U.S. Department of Education opposing a proposed rule that would exclude nurse practitioner (NP) and physician assistant (PA) degrees from classification as professional degrees for support from federal student loan programs.
While this proposal may appear administrative in nature, its implications for the hepatology workforce and for patients living with liver disease are significant.
Across the United States, demand for hepatology care is rising rapidly. Chronic liver diseases, such as ALD, MASLD, viral hepatitis, cirrhosis, and liver cancer, continue to rise in prevalence. At the same time, projections show the hepatology workforce will be unable to meet this demand in the coming decade.
Advanced practice providers (APPs) are essential members of hepatology care teams. Nurse practitioners and physician assistants provide specialized care across the full spectrum of liver disease by managing complex patients, performing procedures, coordinating transplant care, and expanding access to hepatology services in both academic and community settings.
Policies that limit access to the education pathways that prepare these professionals to care for patients risk worsening an already serious workforce shortage. If finalized, the Department’s proposal could discourage entry into NP and PA programs by limiting loan eligibility for these graduate degrees. Over time, this could reduce the number of clinicians entering hepatology and further strain patient access to care.
As we mark Women’s History Month, it is also important to recognize that policies affecting nurse practitioner and physician assistant education pathways disproportionately impact women in the field. Approximately 80% of nurse practitioners and nearly 70% of physician assistants in the United States are women. Women make up the vast majority of APPs, who are essential to expanding access to hepatology care. Ensuring that educational pathways remain accessible is essential not only for strengthening the hepatology workforce, but also for supporting the many women who are advancing patient care and leadership in our field.
AASLD’s advocacy on this issue reflects our commitment to advancing policies that strengthen the hepatology workforce and ensure patients receive timely, high-quality care. Our comments emphasize that APPs are highly trained professionals whose expertise is essential to delivering liver care across the nation, and particularly in communities where hepatologists are scarce.
We have seen firsthand how critical APPs are to caring for patients with complex liver disease. From managing chronic conditions to coordinating transplant care, APPs help ensure patients receive the specialized care they need when they need it.
AASLD will continue engaging with federal policymakers to ensure that workforce policies reflect the realities of hepatology practice and protect access to care for patients with liver disease.
We encourage members to stay informed about this issue and AASLD’s broader policy advocacy efforts by visiting the AASLD Policy Communications page, where you can follow ongoing developments.
Thank you for your continued commitment to advancing liver health and improving the lives of patients with liver disease.
Sincerely,
Saul J. Karpen, MD, PhD, FAASLD
President, AASLD
Dawn Drazek, MSN, NP, A-GPCNP-BC, AF-AASLD
Hepatology Nurse Practitioner
Former AASLD NP/PA Clinical Hepatology Fellowship Awardee
Chair of the Hepatology Associate SIG
To stay updated on AASLD policy updates and advocacy efforts, please visit the AASLD Policy Communications Page