The Department of Veterans Affairs is the country’s largest health care system, providing care to more than 9 million veterans at more than 1,200 facilities across the country. Despite its vital mission and massive responsibility, the agency has been struggling to fill nearly 50,000 vacancies nationwide.
The VA’s chronic vacancies pose a real danger to veterans who have to wait longer for care. As a union representing front-line workers such as doctors, nurses, and other health care professionals, AFGE has a front row seat on how the department operates and why, after all these years, it still struggles to fill positions.
1. Low pay
The VA has many recruitment and retention tools to make its pay competitive with local markets, but it has not fully or correctly used them. Some VA facilities are doing better than others in paying employees market rate, but department-wide efforts to hold medical center directors accountable and ensure that all facilities comply with pay laws and policies hasn’t happened because VA senior leadership is not on board. Making matters worse, Congress in 2016 removed pay transparency for physicians and dentists by eliminating the “panels of peers” – committees formed to allow other providers who work in the same practice area to review local market data for new hires and current employees – making it impossible for providers to know whether they are paid fairly. As a result, many senior physicians get paid significantly less than new hires while others get paid far below market rates.
The VA’s promotion process for registered nurses is also plagued by favoritism and inefficiency, resulting in little or no opportunity for advancement for registered nurses. In addition, many managers are slow to conduct local market surveys of registered nurse and physician assistant pay, leaving both groups’ pay well below rates offered outside the VA.
2. Anti-worker policies
Medical personnel covered under Title 38 have very limited collective bargaining rights that make it nearly impossible for them to challenge VA’s violations of pay laws and its own policies. Unequal application of pay laws severely hurts its ability to recruit and retain doctors, nurses, and other health care providers.
This is on top of the VA’s repeated attempts to take away employees’ workplace rights and voice at work. The VA recently attacked Title 38 employees – nurses, doctors, and other medical staff – by removing all their ‘official time’ – the hours they use to make sure employees have the resources and training to do their work and to combat workplace discrimination and retaliation. This action took away the statutory right of 100,000 VA health care workers to representation in the workplace.
Under the Trump administration, the VA has also increasingly sent veterans to for-profit hospitals and have refused to adequately invest in VA facilities and workforce.
3. Lack of transparency in data reporting
The VA is required by law to report by facility how many vacancies exist for each occupation, but the agency has concealed data to prevent stakeholders from holding it accountable.
According to the VA’s inspector general’s report issued in June, the VA “used alternative aggregation methods and lacked sufficient transparency to permit stakeholders to use this information to track VA’s progress toward meeting full staffing capacity.”
Indeed, VA Secretary Robert Wilkie told members of Congress that filling positions is not his priority.
If the VA were concerned about its own mission of providing health care to veterans, it would address the colossal number of vacancies throughout the system. Instead, the VA has shamefully abandoned its mission, instead following the Trump administration’s push to privatize and dismantle the VA’s healthcare system.
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