NAVAPD’s activities include organizing scientific meetings, educating members of Congress so they can best exercise their oversight and budgeting responsibilities, growing working relationships with veterans’ service organizations, maintaining an active dialogue with official representatives of VA medical programs, and presenting and/or publishing position statements on critical issues. 

Congress cannot discharge its responsibilities to the Nation’s veterans and to the VA Health Care Delivery System unless it has accurate, timely, and unbiased information about the inner workings of the VA and the clinical accomplishments of VA healthcare professionals.  

It is the goal of NAVAPD to bring its members into direct contact with Members of the House and Senate Committees on Veterans Affairs.

NAVAPD has had many accomplishments over the decades since its founding. Some of those accomplishment may be known by its members, and some may be unknown, or taken for granted as always having been a benefit. Outlined below are some of the many accomplishments that NAVAPD has been proud to be part of.

Our Founding: 

NAVAP was formed in 1974 to improve patient care, strengthen communications at all levels, and foster better recruitment and retention of qualified physicians.  At that time 13% of the VA’s full-time physicians had resigned and another 35% of the VA’s physicians were part-timers creating serious concerns for quality patient care. At that time dentists were not members, so the acronym was NAVAP for The National Association of VA Physicians. 

Over the Years:

In 1975 NAVAP convinced Congress to create bonus-pay legislation. PL – 94-123 passed nearly unanimously in the House and Senate. The bill allowed for up to $15,000 bonus pay per physician and at an average of $7,500, this represented a 20% increase in the average VA physician salary.  NAVAP’s first pay impact is in effect.

In 1976 NAVAP successfully opposed Senate Bill 2908, section 4110. This bill would have allowed the transfer of physicians without full due process.

In 1977 NAVAP defeated Senate Bill 2908, section 4110 and successfully championed passage of a second bonus-pay bill (PL – 94-581). 

In 1977 NAVAP testified before the Senate regarding physician working conditions. Dr. Herbert Rose reported that the “full-time corps of VA physicians is deteriorating rapidly, and medical care at many hospitals is deteriorating with it.”  Noting noncompetitive salaries and benefits, restrictions on outside practice to supplement income, and other issues, Dr. Rose went on to say that [physician] career opportunities are becoming as “about as unattractive as any in American medicine today.”

In 1979 NAVAP successfully advanced PL 96 – 330, which established Special Pay for physicians and dentists.  This bill was vetoed by President Carter, but the House and Senate both soundly overrode the veto. The law enhanced physician and dentist pay and benefits opportunities in numerous ways:

• Authorizes the payment of special pay to physicians and dentists in the Department of Medicine and Surgery (DM&S) who are employed full-time intermittently, less than half-time, occupy internship or residency positions, or are retired annuitants.

• Authorized increased rates of pay for certain physicians and dentists in specified geographic areas where there are recruitment and retention difficulties.

• Provided that special pay (with limits) will be treated as basic pay for civil service retirement purposes and be included in the calculation of the amount of Federal life insurance physicians and dentists are eligible to purchase.

• Required VA to report biennially to the President on recommended amounts of special pay for VA physicians and dentists that are to be comparable with other such government and non-government personnel.

• Required the President to include in the budget recommendations on exact rates of such special pay.

• Directed the VA to report on each year to the congressional committees on Veterans' Affairs, on the implementation and administration of the special pay provisions of this Act.

• Exempts VA physicians and dentists from the Senior Executive Service.

In 1982 NAVAP Board filed suit against VA Administrator Robert Nimmo. Nimmo had ordered a reduction of special pay by $5,000 despite Public Law 96-330.  While the lawsuit was lost, the reduction was eventually reinstated.

In 1983 NAVAP successfully opposed proposed changes in M-2, Part I, Chapter 26, 26.07. These changes would have permitted supervision of surgical residents by absentee or “ghost” - surgeons. 

In 1984 NAVAP supported VA physicians, whose relationships with pharmaceutical companies were attacked by the VA Inspector General.  In the Fall of 1985 NAVAP President testified before the VA Congressional committee on the weakness of the cases against these physicians and pointed out the Department of Justice took no action on the few cases that were referred to it.

In 1985 NAVAP successfully supported VA physicians challenged by a Washington Post article. The article was regarding an American Medical Association survey that stated that the licenses of 87 VA physicians were questionable. In Congressional testimony, John Ditzler, MD, then chief medical officer of the VA and a member of NAVAP, clarified that 50 of the physicians cited were not employees of the VA but other federal agencies, and that only 12 of the remaining 37 physicians’ credentials required further review.

In 1987 NAVAP filed National Association of VA Physicians v. Thomas K. Turnage, Administrator of Veterans Affairs. The lawsuit alleged that the VA had not adhered to its own personnel policies concerning the appointment, conditions of employment, and discipline of VA physicians and dentists.  The VA motion to dismiss was rejected and the judge granted the NAVAP motion that the VA provide NAVAP with all VA personnel regulations, rules, policies, and interpretations – published or not.

In 1988 NAVAP voted to include dentists in the organization, and NAVAP officially becomes the National Association of Veterans Affairs Physicians and Dentists or NAVAPD.

In 1989 NAVAPD successfully supported having more physicians and dentists selected as Medical Center Directors. 

Other more recent accomplishments include the following:

NAVAPD successfully supported Pay bill of 2005 which created the 3-pronged pay approach including market pay and Pay for Performance which passed both House and Senate nearly unanimously.

In 2011 NAVAPD successfully opposes elimination of CME support for physicians and dentists.  With less than 24 hours’ notice, the NAVAPD Board drafted and submitted a letter of opposition and explanation to the House and Senate Committee Chairs and all committee members.  NAVAPD provided additional information requested by the staff of Congressman Jim McNerney, who successfully amended the bill to preserve the CME provision.

In 2013 NAVAPD provided Congressional input regarding issues of physician staffing and timeliness of care. Former President Samuel V. Spagnolo, MD, and Director of Communications Larry Conway met with Congressman Dan Benishek, Chairman of the House of Representatives’ VA Subcommittee on Health to discuss medical practice variance in VA facilities.  The discussions focused on staffing for specialty physicians, limitations on physician availability that required extensive travel by Veterans for care, and the then recent OIG report on staffing and productivity in the VA. 

NAVAPD testified before the House VA Subcommittee on Health. At the invitation of Chairman Dan Benishek, NAVAPD Director of Communications Larry Conway testified regarding the Inspector General’s December 2012 report on the lack of a system for determining required staffing and productivity for specialty physicians, and the flaws in, and effects of, the current and proposed systems for assessing staffing needs and productivity.

In 2013 a NAVAPD Board member was named to represent NAVAPD on special team Chartered by Under Secretary Petzel to investigate inconsistencies in the use of Performance Pay and to recommend strategies for improvement of the pay for performance process.

In 2015 NAVAPD successfully ended the practice of physicians and dentists being 100% committed to VA preventing employment elsewhere even on their own time and in non-physician capacity. 

In 2018 NAVAPD successfully opposed VA’s transfer of control of anesthesia from anesthesiologists to CRNA’s.

In 2019 NAVAPD leadership voted to include podiatrists into the organization. 

NAVAPD is asked to provide recommendations on Federal Budget issues and Caregiver support and every two years NAVAPD submits recommendations on pay panels and  pay tiers to members of Congress.

January 2022: The first Dentist is named as President of NAVAPD.

As you can see, NAVAPD has had numerous accomplishments over the decades since its inception. The future of medical and dental care in the VA has been enhanced by our efforts. In the future, one of my goals is to have regular contact with Congressional and VA leaders, to provide them the input and firsthand knowledge of what is experienced daily by VA physicians and dentists. I seek to provide input on the impact of the MISSION Act, the impact of COVID, or the fact that many physicians and dentists are working with less-than-optimal ratio of supporting staff while the number of veterans choosing VA is increasing. My goal is to make our Congressional Leaders aware that they must change the process for recruiting, hiring, onboarding, and retaining qualified staff, and give them new ideas on how to accomplish that goal. NAVAPD is here working for not only our members but for all VA Physicians and Dentists. 

If you would like to learn more about becoming involved in a local chapter of NAVAPD at your medical center, please contact us at opscoord@navapd.org