VA has 41,500 unfilled medical jobs, forcing vets into costly private care

Meghan Hoyer and Gregg Zoroya | USA TODAY

The Veterans Health Administration has 41,500 job vacancies for doctors, nurses and other medical professionals across its sprawling health care system while it struggles to provide timely medical care for veterans, according to records obtained and analyzed by USA TODAY.

The failure to fully staff hospitals is one reason why the Department of Veterans Affairs paid for 1.5 million veterans to see doctors outside the agency in the past year, VA Deputy Secretary Sloan Gibson testified late last month. Those private visits have cost U.S. taxpayers more than $7.7 billion, the VA said.

The added expenses have left the VA with a $2.6 billion shortfall this year, prompting VA Secretary Bob McDonald to plead with lawmakers Thursday to quickly pass a bill that would give him flexibility to shift money within the VA budget to cover the gap.

Gibson testified before Congress June 26 that the shortfall would not have been so large "if we were fully staffed up."

Neither McDonald nor Gibson told Congress how many medical jobs are unfilled in its 150-hospital system, which funds roughly 210,000 full-time medical positions. Instead, both told lawmakers they have increased medical and non-medical staff by 12,000 in the past year.

In 2014, the VA was plunged into a scandal over delays in providing medical care, including systemic manipulation of appointment records to cover up those delays, according to findings by investigators. Then-secretary Eric Shinseki was forced to resign.

USA TODAY discovered the 41,500 vacancies as of late June in data obtained through a Freedom of Information Act request. The full- and part-time positions include openings for 5,000 physicians, nearly 12,000 nurses and more than 1,200 psychologists, according to the data.

Four locations were short at least 100 doctors: Orlando, Portland, Ore., Baltimore and Salt Lake City. Each of those locations also had at least 100 vacant nursing positions. Portland needed nearly 300 part-time and full-time nurses.

Asked this week about this omission from Gibson's testimony, Janet Murphy, deputy undersecretary for health operations and management, said, "I can't speak to the deputy's testimony."

She confirmed the 41,500 vacancies, saying the VA is working hard to recruit and hire more medical professionals. “I will say some of these facilities have too many vacancies and they need to get them filled and we need to help them fill them," she said.

In some places, more than one in five jobs appeared unfilled. For example, according to recent testimony at a House subcommittee meeting on VA hiring practices, 2,020 physician assistants worked for the VA earlier this year. The records show 639 openings for physician assistants — a vacancy rate of 25%.

Murphy said the VA was competing in a tough market to attract medical professionals, despite a widely publicized effort by McDonald to recruit doctors from medical schools. One reason she cited was President Obama's expanded health insurance program that has made medical professionals more in demand. Another factor is an annual 9% attrition rate.

In addition, pay for many positions is lower than in the private sector.

Others said the VA’s bureaucratic hiring procedures — and vacancies within its human resources department — made the process too cumbersome and slow.

“There are nurses out there who want to work with us,” said Joan Clifford, immediate past president of the Nurses Organization of Veterans Affairs. “But most people aren’t going to wait two months for a job when the hospital down the street is going to hire you in a few weeks.”

The VA's vacancy problem has gotten significantly worse over the past year. The Arizona Republic reported the VA had 31,000 unfilled medical job openings in July of 2014. Since then, Congress passed legislation increasing medical staffing by 10,000.