NAVAPD Provides Comment to the Steering Committee on Physician and Dentist Pay
NAVAPD has as its highest priority, the preservation and strengthening of the VA Health Care Delivery System so that it is always able to give veterans the highest quality medical and dental care equal to or better than can be obtained elsewhere in our society. The fair and equitable treatment of physicians and dentists makes the delivery of high-quality care possible.
Based on our member survey sent out in August 2022, Physician and Dentist compensation was the number one concern of our membership where fair and equitable treatment is not standard.
The Department of Veterans Affairs Health Care Personnel Enhancement Act of 2004, Public Law (P.L.) 108-445, was signed by the President on December 3, 2004, and became effective on January 8, 2006. This law requires the Department of Veterans Affairs (VA) to review physician, dentist, and podiatrist pay ranges at least once every two years. As part of the review process, a VHA Physician, Dentist, and Podiatrist (PDP) Steering Committee evaluates current data and makes recommendations regarding changes in specialty alignment and pay ranges for VHA physicians, dentists, and podiatrists.
38 U.S.C. §7431 (e)(1)(A) states that at least once every two years, the Secretary shall prescribe for Department wide applicability the minimum and maximum amounts of annual pay that may be paid to physicians, dentists, and podiatrists. The Steering Committee last convened in November 2020 and is scheduled to reconvene December 6-7, 2022, to meet the two-year requirement prescribed in statute.
NAVAPD was asked to review the 2020 recommendations, determine their relevancy, and provide comments on those recommendations. Additionally, we were asked to answer the following three questions from the Steering Committee:
What suggestions do you have regarding the specialty alignment for any of the pay tables?
What suggestions do you have regarding other additional specialties or subspecialties that should be identified in the pay tables?
Are there any other comments or suggestions regarding the pay system you would like to share?
Our recommendations included not only the 2020 review but also for the 2022 review. In general, NAVAPD recommended changes to minimum and maximum pay levels, tiers, and physician and dentist alignment on pay tables. A summary of our 10 recommendations is below.
NAVAPD recommends re-evaluation of compensation for Pain Management physicians. There is a disparity between the pay table for anesthesiology and anesthesiology/pain management in the 2018 recommendations creating equal work for unequal pay as interventional pain physicians from primary specialties other than anesthesiology are expected to perform to the VA standards of anesthesiology pain management.
NAVAPD recommends Infectious Disease physicians be moved from Pay Table 1 to Pay Table 2. These physicians have shown resilience in the face of the COVID 19 pandemic, caring not only for our nation’s veterans, but also for VA employees.
NAVAPD recommends that General Practice Dentistry be moved from Pay Table 1 to Pay Table 2. There is no board certification for General Dentistry, but to be employed by VA, all general dentists must have completed additional residency training (not required for dentists to practice outside VA) or have completed 5 years of hospital dentistry. General Dentists make up >90% of the VA Dentist workforce.
NAVAPD recommends that Dental Specialists currently on Pay Table 1 be moved to Pay table 2. This includes Endodontists, Periodontists and Prosthodontists. We also recommend Oral Surgeons be moved to Pay Table 4 given the 4-6 years additional training and dual degrees that most oral surgeons hold. In larger facilities these surgeons are doing the same types of procedures in the orofacial complex and their ENT colleagues who are on Pay Table 4 creating an equal work for unequal pay scenario.
NAVAPD recommends the salary cap of $400,000 for Pay Table 4 physicians needs to be increased so that VA can recruit and retain those physicians. Younger physicians in the Pay Table 4 specialties can start out earning more than the VA maximum if they are at non-VA facilities so it makes it difficult to recruit and retain these physicians.
NAVAPD recommends that the Steering Committee add a new category for Transplant physicians. We also recommend that they be compensated at a level commiserate with their extensive training and not at the level of their organ specialty.
NAVAPD recommended a re-examination of the minimum and maximum salary ranges for each Pay table and recommended they be increased. They are obsolete and a barrier to VA attracting, recruiting, and retaining a vital, quality, trained, and educated workforce. We provided examples of the median salaries for various specialties that exceed the maximum VA is willing to pay.
NAVAPD recommended changes in the pay for Service Chiefs, especially in areas where they supervise other physicians and dentists who may be compensated at a high level than the Chief based on the Chief’s individual specialty.
NAVAPD recommends aggressive oversight of the pay system across the enterprise as it is known that different VISN’s and facilities within VISN’s compensate their physician and dentists differently. NAVAPD provided the Steering Committee with public domain websites showing how physicians and dentists are compensated differently across the country.
NAVAPD also called for transparency of the Steering Committee itself since we are unaware of who makes up this committee, how they are selected, how often the membership changes, what their specialties might be. We also called for immediate transparency of the proceedings.
NAVAPD is here to support our membership.
Feel free to reach out to your Regional Board member for any concerns. You can find your regional board member on our website under the Regional Chapters heading. The easiest and fastest way to contact us is by using the “Contact Us” feature on our website www.navapd.org.
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