Psychiatrists’ Pay to Rise at Veterans Health Administration

Beginning November 30, pay rates for physicians in the Veterans Health Administration (VHA)—including psychiatrists—will rise to more competitive levels, one of several measures intended to recruit and retain badly needed medical personnel to the giant health system.

The new pay scales bring the VHA, a part of the Department of Veterans Affairs, more closely in line with the private sector and other federal government agencies, said VHA psychiatrist Jenny Boyer, M.D., Ph.D., J.D., speaker of the APA Assembly and co-chair of the APA VA Caucus.

The range has moved up a notch from (in the VHA’s jargon) Pay Table 1 to Pay Table 2, which in turn has three “tiers.” Annual salaries begin at $98,967 and top out at $260,000.

“The VHA couldn’t compete with other federal entities that could pay more, like the Department of Defense or the Indian Health Service,” added Lizbet Boroughs, deputy director of APA’s Department of Government Affairs.

The increased pay, combined with new legislation that doubles the amount of medical school debt relief from a maximum of $60,000 to $120,000, is expected to help attract more psychiatrists to the VHA (see story on page 28).

“These changes are good not only for psychiatrists but for a population that deserves good care,” said Boyer, who noted that she was speaking as an individual and not as a representative of the VHA.

APA’s support for the changes derived in part from an action paper passed by the APA Assembly, Boyer noted.

“We looked at open positions for psychiatrists across the government and found 156 in the VHA and just one in the Department of Defense, because the DoD had a higher pay scale,” she said in an interview. “This shows that individual APA members can offer an idea and make significant changes.”

Psychiatry is considered together with other medical specialties like emergency medicine, pulmonology, and oncology in the VHA pay scheme.

Higher rates will apply to both newly recruited psychiatrists and those already serving in the VHA, said Boyer. “Boosting pay for new hires alone would actually have a reverse effect. People would leave one facility and apply at another one to get better pay.”

Actual pay within each tier is governed by the applicant’s credentials, experience, and assigned tasks within the system. For instance, supervisors and psychiatrists who choose to work in rural areas may earn more, said Boyer.

“Competitive compensation for psychiatrists serving in the VHA has been a top advocacy priority for APA,” said Boroughs. APA has worked on three tracks to that end. Official statements and letters to Congress and the VHA have addressed the subject. Advocacy by APA members has educated Congress, while APA’s Department of Government Relations has worked with veterans’ service organizations (like Vietnam Vets of America, Iraq and Afghanistan Veterans of America, and Disabled American Veterans) to amplify the need to improve the VHA’s retention and recruitment of psychiatrists.

Formerly, gaining higher pay was determined by a system of exceptions to salary caps or the use of hiring bonuses, both of which require often lengthy internal approval processes, said Boroughs. While that system will be replaced, the VHA will still take time to verify applicants’ credentials and experience and conduct background checks. Applicants must also pass physical examinations and have valid, up-to-date certifications. Those requirements will still take time to meet and verify, continuing to slow the hiring process. ■