Publication / DecodeDC/ Scripps
May 21, 2014
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VA hospitals struggle to fill openings for much-needed doctors and nurses

Staff deals with more red tape while earning less

WASHINGTON, D.C. – Veterans Affairs hospitals and facilities across the country have almost 2,000 openings for health care professionals, but they’re struggling to fill the jobs because a lot of nurses and doctors aren’t interested.

It was recently reported that 40 people on waiting lists at the VA health care system in Phoenix, Ariz., later died, although it is unclear whether the deaths resulted from delayed treatment. There also have been reports of unauthorized waiting lists, often months-long, being used to deal with a deluge of patients. Despite the decreasing veteran population, the number of patient appointments is up – at about 85 million appointments a year, President Barack Obama said Wednesday in the White House press room.
Since the news of the Phoenix scandal broke in April, seven other facilities were found with similar waiting lists. Obama vowed to get to the bottom of the backlog, assigning his deputy chief of staff, Rob Nabors, to oversee a review of the VA. The House will also vote this week on a measure to give VA secretary Erick Shinseki the authority to remove employees who exhibit poor work performance.
The entire nation is experiencing a shortage of health care providers, but the VA’s issues are compounded because it must compete for those providers with non-government hospitals, which operate with half the red tape and offer higher wages.
Genevieve Billia, a VA spokesperson, sums up the situation this way: “Some factors include: the growing national shortage and availability of experienced, quality candidates who possess the competencies required for the position; the salaries typically paid by private industry for similar positions; employment trends and labor-market factors that may affect the ability to recruit candidates; and other supporting factors such as rural/highly rural locations that may be considered less desirable.”
But for health care professionals, the pitfalls of working for the VA come down to time and money.
“There are several challenges. The hiring process — it’s just too long… Then once you get in, there’s another piece of red tape for [registered nurses] to get licensing and verification and background checks,” says Irma Westmoreland, an RN at a VA medical center in Georgia and a representative of National Nurses United.
Westmoreland, who has worked at VA medical facilities for decades, says the positions offered by the VA are becoming less desirable especially for younger nurses entering the field. In addition to the prolonged application process, she says, they are turned off by an unreliable promotion schedule — things she says that make non-government hospitals more appealing.
An example of the VA’s disadvantage when hiring nurses, Westmoreland points out, is that the agency will not promote nurses with a two-year associate’s degree to a senior position, even if they have worked at the VA for years.

Nurses salaries at VA hospitals are competitive, according to 2012 BLS data. But it’s the red tape that makes the jobs less appealing, especially when the difference in wages is only a few thousand dollars a year.

For physicians, the difference in pay is a huge factor.

The average VA physician salary for FY14 is $213,229.40, according to Billia. Comparably,  physician salaries in 2012, according to the BLS,received median annual compensation of $220,942 for primary care, and physicians practicing in medical specialties received median annual compensation of $396,233.
In addition, government pay freezes are all too real. This year VA nurses and doctors received their first raise since 2011, when a three-year pay freeze was signed by Obama as part of an effort to balance the budget.
The VA operates 151 medical centers, 135 community living centers, 103 residential rehabilitation treatment programs, and 820 community based outpatient clinics. According to the most recent VA audit from 2012, there are about 7,000 specialty physicians at all VA medical facilities. Five percent of those positions are now open, according to
Although the population of veterans in the United States has peaked and will continue to fall, VA hospitals and outpatient facilities have experienced an intensified demand from aging baby boomer veterans and survivors of the wars in Iraq and Afghanistan, many of whom are coming home with wounds that soldiers wouldn’t have survived in earlier conflicts.
Source: Department of Veteran Affairs
“We do know that there’s a 45 percent increase in outpatient medical appointments since 2005,” said Debra Draper, director of health care at the Government Accountability Office. “People are surviving things that they never would have survived before and would need more specialty care and ongoing care needs.”
She added, “If you have a shortage of providers that certainly does limit your capacity.”
Lee Bowman, Scripps National Reporter, contributed to this report.