Last month I wrote that there was more to come concerning the new Department of Veterans Affairs Secretary Robert A. McDonald. At a press conference at the VA medical facility in North Las Vegas this past summer, I asked him how he planned to bring in new doctors when the government pays much less than the private sector. He said he was considering a plan to help pay off student loans if medical doctor interns would sign up with the VA, but he gave no details.
A few weeks later he spoke at the national convention of the Blinded Veterans Association in Sparks and did not address the topic of student loans. But when he was finished, I approached him and asked whether we could still see the VA pay off student loans for interns, and he said the program was still in the works. He then asked his press liaison to send me information about the program, which she did.
It’s no secret to anyone following recent news about the VA that its medical care has come under fire for numerous reasons. Some of the negative publicity can be traced to the agency having been shorthanded when it comes to doctors and other medical personnel to care for the influx of U.S. veterans who have served in the Middle East, and even many who served in Vietnam and who, in advancing age, are seeking additional care.
According to the information that was sent to me, McDonald told a group of Duke University students in August that to provide timely access to medical care, “we need to build capacity by hiring more clinicians. We need the best doctors and nurses serving veterans, and that is why I will be out recruiting, leveraging the existing relationships and affiliations VA has with many at academic institutions, and talking directly to medical professionals about joining us to fulfill our exceptional mission of caring for those who ‘shall have borne the battle.’”
But talking to medical students and urging them to sign on the dotted line is one thing. Real incentive programs are needed to induce graduates to become VA medical employees.
Those incentives include:
■ Expanding the loan repayment program, as included in the recently passed Veterans Access, Choice and Accountability Act.
■ Considering options to revise pay tables to offer more competitive salaries for VA providers in comparison to their academic and private practice colleagues.
■ Collaborating on a new nursing academic partnership focused on psychiatric and mental health care to build stronger, mutually beneficial relationships between nursing schools and VA facilities.
■ Partnering with the Department of Defense, Office of Health Affairs, Army, Navy and Air Force to improve recruitment of recently or soon-to-be discharged health care professionals.
■ Expansion of a pilot program that would bring combat medics and corpsmen to VA facilities as clinicians.
McDonald’s office pointed out that the actions are meant to build on existing recruitment tools, including the loan repayment programs and partnerships between local facilities and academic institutions. McDonald himself added, “We have the most inspiring mission and the greatest clients of any health care system in the world. That’s exactly the message I’m going to share as I speak with health care professionals and students about the value of serving at VA.”
Summer is when veterans service organizations hold their conventions, and McDonald took advantage of his being named VA secretary to take his message directly to thousands of veterans. He has generally been well-received, and his messages have been positive. Many of his plans are already being put into action.
Interim Under Secretary for Health Carolyn M. Clancy noted in the paper McDonald’s office supplied that, “To recruit and retain the highest quality medical professionals, VA needs to be competitive with other health care systems, and ultimately that is how we provide the best care to our veteran patients.”
But not everyone agrees that increasing pay schedules and paying off loans is all that is needed. Retention is a large part of the problem, statements from the American Federation of Government Employees suggest.
“VA Secretary Robert McDonald has taken a good first step toward improving veterans’ access to care by proposing to update the pay rates for physicians and dentists, who haven’t seen an increase since October 2009,” federation President J. David Cox Sr. said. “These rate increases will bring the VA closer to the salaries earned by private sector providers, enabling the VA to bolster its recruiting of top-notch providers.”
However, Cox said there are other systemic problems that must be corrected within the VA health care system. For starters, the VA suffers from alarmingly high turnover rates: More than 20 percent of doctors quit within the first two years of being hired, while nearly four in 10 quit within the first five years, Cox reported.
“While bringing on more physicians could help address some of the frustrations that our doctors experience, the VA needs to review all of the reasons for the high attrition rates and determine what more needs to be done to improve retention. Our doctors report having too little time to spend with patients, not enough support personnel, and too many layers of bureaucracy that hinder patient care.”
McDonald’s programs and other comments in his speeches indirectly address some of these topics, and pay increases (including paying off student loans) could go a long way in keeping doctors on staff.
In the meantime, if anyone reading this is interested in working for VA health care, or if they know if anyone who is, visit www.vacareers.va.gov.
Journalist and author Chuck N. Baker is an Army veteran of the Vietnam War and a recipient of the Purple Heart. He can be heard 8-9 p.m. Thursdays on “The Veterans Reporter Radio Show” on KLAV-AM (1230).