Hiring new doctors can happen quickly because it is normally done at the facility level, said Dr. Maryann Hooker, a neurologist at Wilmington (Del.) VA Medical Center, and a local president for an American Federation of Government Employees chapter in Delaware. But “the question is whether the people exist,” Hooker said.
Those following the medical employment market say that, unlike in other countries where doctors are reported struggling to find work, unemployment is not a problem for U.S. physicians. So, with a limited pool of potential candidates, the VA will need to market to its strengths, namely flexibility and the ability to help new hires pay down their medical school debt.
Private hospitals tend to have clinicians sign noncompete clauses, which can make it difficult for a doctor to leave who wants to move on. But that's not the case within the VA, said Dr. Jane Orient, executive director of Association of American Physicians and Surgeons.
The VA also has a nearly unrivaled medical school loan repayment program for providers that private industry can't match, Hooker said. Clinician hours also tend to be more manageable, because most VA-facility procedures are outpatient-related.
But first and foremost, the VA needs to be willing to pay up, especially for specialists, according to Dr. Atul Grover, chief public policy officer at the Association of American Medical Colleges.
VA salary ranges generally don't match what doctors can make in the private sector. A doctor performing invasive cardiac surgery at the VA can expect to make $98,967 to $385,000 annually, for example, according to a January 2014 Office of Human Resources Management report. In the private sector, the salary range is $421,000 to $556,632, according to the firms responding to Modern Healthcare's 21st annual Physician Compensation Survey.
In most instances, the amount of the money the VA can offer specialty providers is capped at certain levels. But administrative procedures exist that allow facilities to override those caps, Grover said. The process to do so can be burdensome, he noted, but it may be one the VA needs to undertake to attract new physician talent.
The VA mission to serve those who have defended the nation could prove another recruitment tool, Hooker said.
Beyond recruitment, the VA has ongoing issues with staff retention. On average, 28.8% of all employees who were newly hired by the Veterans Health Administration between fiscal 2005 and fiscal 2007 quit within the first five years of their employment, according to a 2014 VA report. Of those losses, nearly half occurred within the first year, and 71.9% occurred within the first two years.
Follow Virgil Dickson on Twitter: @MHVDickson