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Outdated Processes Hamper VHA in Hiring Medical Staff

by U.S. Medicine

May 9, 2017

By Sandra Basu

WASHINGTON VHA is hampered by outdated human resources processes, as well as competition from the private sector, when it comes to hiring medical professionals, agency officials told lawmakers.

“We are striving to update not only internal hiring practices, but also open to legislative assistance to reform VHA’s recruitment, compensation, and accountability practices to stay competitive,” explained VHA Deputy Under Secretary for Health for Operations and Management Steve Young. Young made his comments at a hearing held by a House Committee on Veterans’ Affairs subcommittee on VA’s ability to recruit and retain quality providers.

Rep. Brad Wenstrup, (R-OH), DPM, who chaired the hearing, said his subcommittee continues to hear about prospective VA employees who accept jobs elsewhere because the hiring process is “too cumbersome and too lengthy.”

“We have opportunities here to bring excellent doctors in, if we are open-minded about how we go about what we are doing,” Wenstrup suggested.

When it comes to recruitment and retention of medical personnel, Young told the subcommittee that one of the challenges is that “VA has been faced with significant caps on awards for several years, resulting in a limited pool of funds for employee recognition.”

“While these caps were well-intentioned to increase accountability they also result in significant impediments to recruitment and retention in VHA,” he said.

The $230 million cap for fiscal years 2017 and 2018, he explained, “represents a significant decrease in available funding during a time when the market for clinicians is growing increasingly competitive.”

Young also told lawmakers that there is a need to make it easier for individuals to “come into government service.”

He, along with Partnership for Public Service President and CEO Max Stier, pointed out barriers to hiring, such as a lengthy Executive Core Qualification narrative that is required for Senior Executive Service (SES) positions.

Stier pointed out that no private sector employer asks applicants for executive-level positions to write lengthy essays to demonstrate their qualifications, yet this is what the government asks of most applicants for its executive positions.

“They don’t have to fill out huge long essays in any other organization besides the federal government,” he noted. “We have to normalize the process inside the government, if we expect great talent from outside the government to want to come in.”

Recruitment Challenges

Also testifying was Government Accountability Office (GAO) Strategic Issues Director Robert Goldenkoff, who cited findings from GAO’s 2015 and 2016 reports that described recruitment and retention challenges for VHA.

Goldenkoff said some of those issues are due to VHA’s limited “HR capacity, including attrition among its HR employees and weak-related HR functions.”

According to GAO, in fiscal year 2015 HR specialists transferred to other federal agencies at a rate six times higher than all VHA employees.

“According to the HR staff we interviewed, this has reduced HR employees’ ability to keep pace with work demands and has led to such issues as delays in the hiring process, problems with addressing important clinical hiring initiatives and an increased risk of personnel processing and coding errors,” a GAO report explained.

Young acknowledged that one reason that HR personnel are leaving is because the job is more difficult in VA than in other federal agencies.

“In VA, we have three HR systems, Title 5, Title 38 and Title 38 hybrid. It makes the HR professionals jobs very complex,” Young told the subcommittee.

 

Attracting Talent

The hearing was held days after the House passed a bill introduced by Wenstrup, who has encouraged the Senate to pass it to strengthen VA’s ability to identify staffing shortages, recruit employees to fill vacant positions and quickly on-board new hires, among other things.

Stier praised that bill but also suggested that Congress reconsider language that was not included but introduced during a previous Congress by Wenstrup, which would expand market pay to include VISN and medical center directors.

He said that, unless pay for these positions is closer to market, there will always be “too many vacancies.”

“Taking that out, I believe was penny wise and pound foolish,” Stier said. “At the end of the day, you are looking at the most important elements of success at VHA, which are the individuals running the medical centers, and they are being paid under $200,000 in a marketplace where their peers for the private sector are being paid $700,000 and plus.”

Meanwhile American Legion National Veterans Affairs and Rehabilitation Division Louis Celli suggested that one way to deal with shortages in medical professionals is for VA to establish its own medical school.

Students could have their tuition paid in full by VA and, upon graduation, the graduate would be required to accept an appointment at a federal health facility at a starting salary comparable to what a new medical graduate would be paid by VA based on their experience and specialty, Celli suggested.

“It’s within their statutory mission. They have the real estate. They have the expertise. They have the reputation and they have the resources,” he told lawmakers.

 


4 Comments

  • MS Lewis says:

    It is great to hear VA is willing to work on streamlining their hiring process. Another hindrance to hiring has been that the VA tries to use veteran-owned businesses for a lot of things, including hiring. Over the past few years this has truly hindered the hiring of physicians because the VA chose to drop an efficient and effective vendor for a veteran-owned business that has proven to not be prepared to manage the needs or volume effectively. This has resulted in areas being down many physicians and forced to send patients to CHOICE or NON VA Care physicians which has proven to be quite detrimental for continuum of care in meeting healthcare needs.

  • Steven Zeitzew says:

    There is another significant obstacle to recruiting physicians from private practice to the VA not mentioned here. The VA is self-insured for medical malpractice, and does not provide standard claims made coverage. A physician in private practice who moves to the VA must continue to pay private medical malpractice premiums, tens of thousands of dollars annually in many specialties. This is effectively a substantial salary decrease that makes take home pay much lower than the VA starting salary. This makes a VA salary offer less competitive to physicians in some specialties.

  • Steven Zeitzew says:

    There is another significant obstacle to recruiting physicians from private practice to the VA not mentioned here. The VA is self-insured for medical malpractice, and does not provide standard claims made coverage. A physician in private practice who moves to the VA must continue to pay private medical malpractice premiums, tens of thousands of dollars annually in many specialties. This is effectively a substantial salary decrease that makes take home pay much lower than the VA starting salary. This makes a VA salary offer less competitive to physicians in some specialties.

  • MS Lewis says:

    It is great to hear VA is willing to work on streamlining their hiring process. Another hindrance to hiring has been that the VA tries to use veteran-owned businesses for a lot of things, including hiring. Over the past few years this has truly hindered the hiring of physicians because the VA chose to drop an efficient and effective vendor for a veteran-owned business that has proven to not be prepared to manage the needs or volume effectively. This has resulted in areas being down many physicians and forced to send patients to CHOICE or NON VA Care physicians which has proven to be quite detrimental for continuum of care in meeting healthcare needs.


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