Doctors, Dentists Should Be Consulted on Pay Law

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Dear Sgt. Shaft:

Congress passed an important law in 2004 that Veterans Affairs is implementing. This law, the Department of Veterans Affairs Personnel Enhancement Act, Public Law 108-445, is a dramatic reform in the way VA pays 15,000 physicians and dentists. In fact, this law is the first change of the basic system of pay since Congress passed the Organic Act of 1946, an act that established pay policies for VA physicians and dentists. Although Congress adjusted the actual rates of pay many times, the system of pay has remained the same.

In 2003, VA urged Congress to pass a new approach - VA's top health care legislative priority for the 108th Congress - because VA was "in a critical situation with increasing needs of veterans for health care while our current pay system leaves us in a very noncompetitive position for recruiting the staff we need today and into the future."

VA's legislative bill was supported by veterans organizations, federal unions and professional associations, all of whom expressed concern that VA be able to obtain the tools to attract and retain the best doctors and dentists for sick and disabled veterans.

VA met congressional intent in implementing this law. Some professional and labor organization stakeholders, including the American Medical Association and the American Dental Association, have indicated that VA did not consult with them after the law passed. These stakeholders were involved in creating a legal framework acceptable to their members, but then were denied further opportunity to advise VA in its application.

No VA physicians regularly caring for patients participated, and VA did not consult its largest employee union. VA leaders should have observed congressional intent and should have consulted VA physicians, dentists and their union representatives in establishing the new procedures that govern basic pay, market pay, performance elements and tiers of pay among specialties.

As you know, VA physicians, dentists and oral surgeons are caregivers, educators and researchers. They are the engines of VA health care. This act was intended for their benefit, to keep them providing outstanding care to veterans. VA should have involved representatives of professions in their establishment and implementation, as Congress directed.

Sgt. Shaft, I hope you will urge VA to engage both labor and professional associations, that remain concerned about the new pay and performance system. …