Dear Representative/Senator (Last name)
I am a Veteran, a constituent and a Physician Assistant (PA) in the Veterans Health Administration (VHA). I am deeply concerned about the current state of Veterans access to VA health care. Demand for health care providers is rapidly outpacing supply at every level. Nationwide physician shortages are expected to balloon to 62,900 doctors in five years and 91,500 by 2020, according to the Assn. of American Medical Colleges work force projections. The number of U.S. medical school students going into primary care has dropped 51.8% since 1997, according to the American Academy of Family Physicians (AAFP).
Physician Assistants can and should be a big part of the solution to this problem. The PA profession was born out of necessity to meet the increasing needs for primary health care providers during the late 1960’s. The PA profession has a special relationship with Veterans. The first PA graduates were Veterans. The VA hired one of the very first physician assistants to graduate in 1967. Today, there are over 2000 PAs employed by the Department of Veterans Affairs, making the VA the largest single employer of PAs. In the VA system about a quarter of all primary care patients treated are seen by a PA. Since the first graduating class at Duke University in 1967, PAs have been treating Veterans and providing many of the same services that physicians offer—filling a critical need.
PAs are recognized as the number five Critical occupation with in the VA; however the VA is simply not competitive with the private sector when recruiting and retaining PAs. The main reason for this is there are 30,000 PA job openings nationwide and the VA simply cannot compete with salaries when compared to the civilian sector. One easy solution, which is within the authority of Acting Secretary Sloan, is to including the PA occupation in the VHA Locality Pay System. This inclusion would enhance recruitment and retention by mandating an annual salary survey and adjust pay accordingly to ensure competitive salaries.
It is important to note that the Veteran Service Organizations Independent Budget FY2014 recommends that Congress request a specific VA plan on including PAs in the Locality Pay System or legislate specific pay provisions to address the long-standing problem with PA recruitment and retention. The VSO IB also recommends that VA should implement recruitment and retention tools targeting the Education Debt Reduction Program (EDRP) and the Employee Incentive Scholarship Program (EISP) to include PAs.
An additional constrain to recruitment and access is that many VA facilities only post midlevel provider positions for Nurse Practitioners (NP) which effectively eliminates 50% of eligible applicants. I urge you to mandate that the VA list all midlevel provider positions for both PAs and NPs.
As always we appreciate your ongoing support of Veteran’s issues and look forward to working with you
(name, title, home address)