Editorial: Pay for VA doctors not competitive

Tuesday, Dec. 23, 2003 | 8:45 a.m.

One way out of the medical malpractice insurance crisis for medical doctors is to sign up with the Veterans Affairs Department. There are no medical malpractice premiums to pay and the hours are more hospitable than those worked by doctors in private practice. There are also many bonuses, including those for working full time and for staying with the VA for more than two years, for the nature of a doctor's specialty, for the area in which a VA doctor works and for being board-certified. Unfortunately for Southern Nevada veterans, the incentives are not working well enough for the VA to have an adequate number of doctors on staff.

It's been our observation that the local VA provides excellent care for veterans. There are logistical problems, largely because the VA is now leasing three buildings due to the June closure of the Addeliar D. Guy III clinic because of structural deficiencies. Also, the VA's 12 satellite clinics are staffed by different specialists, meaning veterans with multiple conditions sometimes have to travel from clinic to clinic for their complete care. And there are the occasional administrative problems common to all health-care organizations. But medical care at the area VA clinics is strong.

Our concern is that care may begin to slip if the issue involving the availability of specialists and even primary-care doctors is not soon addressed. The local VA doctor roster is understaffed by 10 percent. John Hempel, director of the local VA system that treats 32,000 patients a year, told Sun reporter Ed Koch that the problem is a noncompetitive pay schedule. Even with the bonuses, a doctor working for the VA will earn far less in a year than doctors in private practice. The base pay for VA doctors is $110,000, while privately employed specialists can earn in the $250,000 to $500,000 range and higher.

We would like to see the VA conduct a formal salary survey, as private businesses do before setting salaries for their top executives. The survey would show the going rate for all doctors and could act as glaring proof for Congress that salaries for VA doctors are below par. Boosting the pay for VA doctors would not break the budget, as already the department is paying millions to private specialists to make up for their staff shortage. This year, the local VA spent $17 million on outside specialists -- a 40 percent increase over last year. Because the cost of turning to the private sector will continue to climb, the VA would be better off spending that money internally, in the form of higher medical salaries. This would likely attract more doctors and end the staff shortages.