VA Provider Equity Act for Policymakers

Support the VA Provider Equity Act (S 1871 / HR 1058), Legislation to Improve the Recognition of DPMs under the Veterans Health Administration

Recent Activity
  • September 27, 2017 - Sen. Bill Cassidy (R-LA), introduced the VA Provider Equity Act (S 1871). 
  • July 24, 2017 - The House passed the VA Provider Equity Act (HR 1058) as part of the House consent agenda. (Watch the video of Rep. Wenstrup's passionate floor speech given in advance of the vote.)
  • July 24, 2017 - CBO score released for HR 1058, estimated increase in direct spending of $106 million over the next decade. 
  • July 19, 2017 - The American Academy of Orthopaedic Surgeons (AAOS) and the American Orthopaedic Foot and Ankle Society (AOFAS) sent a letter of support for the bill to primary sponsor Rep. Brad Wenstrup, DPM (R-OH), after negotiations between among AAOS, AOFAS, Dr. Wenstrup's office, and APMA leadership. The bill was passed unanimously out of the House Committee on Veterans Affairs. 
  • May 2, 2017 - APMA Trustee Dr. Seth Rubenstein; APMA member and president of the American Board of Podiatric Medicine Dr. Steven Goldman; and APMA member and Director of Podiatry Services for the VA Dr. Jeffrey Robbins were invited to provide testimony on behalf of the VA Provider Equity Act before the US House Veterans Affairs Health Subcommittee. 
  • February 14, 2017 - Rep. Brad Wenstrup, DPM (R-OH), introduced the VA Provider Equity Act (HR 1058). The original sponsors of this legislation include VA committee members Dr. Wenstrup, Rep. Ralph Abraham, MD (R-LA), Rep. Julia Brownley (D-CA), and Rep. Raul Ruiz, MD (D-CA).
Cosponsor Information

Review this up-to-date list of House and Senate cosponsors of the bill (PDF).

Request

APMA requests your assistance to resolve ongoing recruitment and retention issues for podiatric physicians employed under the Veterans Health Administration (VHA). These recruitment and retention issues are directly related to the definition of "physician" used by VHA, and as part of APMA's Path to Parity and goal for DPM recognition as physicians under all federal statutes, we need APMA members to contact their senators and representatives to address this issue for our nation's veterans.

Problem

As Congress continues to address health-care reform, there is an impending shortage of physicians and other health-care professionals to meet the needs of the nation’s veterans. Podiatric physicians play a key role in delivering the same, or better, medical and surgical foot and ankle services as medical doctors (MD) and osteopathic doctors (DO) provide. Yet, podiatric physicians are frequently excluded from programs that provide such workforce development incentives as performance bonuses, loan repayment, and scholarship opportunities. This exclusion ultimately results in ever-decreasing enrollment and increasing attrition rates at VHA facilities among willing residents and experienced podiatric physicians as they pursue opportunities for advancement not available to them through service to VHA.

If Congress fails to act to correct this recruitment and retention issue for podiatric physicians, the net effect will be the lowering of the quality of foot and ankle care available for the nation’s veterans.

Several VHA workforce enhancement bills introduced in both the House and Senate last session failed to recognize doctors of podiatric medicine—in the physician definition used, in the recognition of hospital-based podiatric residencies, or in the recognition of institutions that train podiatric physicians.

Background

The VHA podiatric physician compensation package has remained unchanged since 1976, except for those changes reflected in the Title 38, USC Section 7404 Clinical Podiatrist and Optometrist Salary Tables, that include basic pay and locality rate adjustments. Senior clinical podiatric physicians in 55 percent of the regions receiving locality pay have reached the legislatively capped rate of pay for the Level IV Executive Schedule limit. The compensation package for VHA podiatric physicians has become less attractive than what is offered in other practice settings, especially the private sector, which has resulted in recruitment and retention problems within VHA.

A significant proportion of the VHA podiatric physician workforce is composed of senior practitioners eligible for retirement, and difficulties have been documented in recruiting and retaining qualified providers in anticipation of these retirements and to meet current and future podiatric physician needs. VHA has acknowledged the need to develop strategic succession plans and initiatives to ensure knowledge transfer, continuity of services, and to replace the numerous clinicians and administrators across the system who are eligible to retire.

To remain competitive, VHA needs to initiate proactively appropriate recognition of podiatric physicians similar, if not identical, to what has been established for medicine and dentistry. Because this pool of providers is a very small percentage of the total physician providers in VHA (less than five percent, or approximately 330 podiatrists system-wide), both the costs and the savings will have little impact on the overall budget. However, if VHA were to include podiatric physicians under the Physician and Dentist Pay Schedule, it would give the facility directors the flexibility to help resolve retention and recruitment obstacles.

Response to AAOS Opposition

The American Association of Orthopedic Surgeons delivered a letter in opposition to this legislation in the last session of Congress (2015–2016). Download the response letters from APMA, the American Board of Podiatric Medicine, and the Academy of Physicians in Wound Healing. During the 115th Congress (2017-2018) the American Association of Orthopedic Surgeons delivered a letter of endorsement for this legislation. 

Download this issue/policy brief: VA Recruitment & Retention Issue Brief (PDF)


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