Bill Overview
Title: To amend title 38, United States Code, to clarify the role of doctors of podiatric medicine in the Department of Veterans Affairs, and for other purposes.
Description: This bill generally aligns the position of podiatrists with that of physicians for pay and grade purposes within the Veterans Health Administration (VHA). Additionally, the bill replaces the Director of Podiatric Service position with a Podiatric Medical Director to be responsible for the operation of the podiatric service at the VHA. Such director must be a qualified doctor of podiatric medicine.
Sponsors: Rep. Wenstrup, Brad R. [R-OH-2]
Target Audience
Population: Podiatrists and veterans receiving podiatric care in the VA system
Estimated Size: 20000
- The bill affects doctors of podiatric medicine within the Department of Veterans Affairs by aligning their pay and grade with physicians.
- The target population primarily includes podiatrists working or planning to work within the Veterans Health Administration (VHA).
- This may indirectly impact veterans receiving podiatric care at VA facilities by potentially improving the quality and availability of such care.
- Aligning pay and grade with physicians can improve job satisfaction and retention among podiatrists, potentially affecting the staffing and availability of podiatric services.
- The establishment of a Podiatric Medical Director could lead to changes or improvements in how podiatric services are managed within the VHA, impacting overall service provision.
Reasoning
- The policy primarily affects podiatrists within the Veterans Health Administration, which means potential immediate impact on job satisfaction, salary, and professional standing for this group.
- Veterans receiving care from the VHA may experience indirect benefits through potentially improved services arising from better staff retention and morale, though the effects might be more pronounced over a longer term as service management changes are put in place.
- Given the financial constraints and budget limitations, the policy's effects will likely be incremental, affecting people gradually over years.
- The importance of understanding indirect impacts, such as on veterans, is crucial, as they represent a much larger group who receive care from the VHA.
Simulated Interviews
Podiatrist at VHA (California)
Age: 45 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- Aligning podiatrist pay and grade with physicians helps address long-standing inequities.
- I hope it’ll make our department more attractive, reducing turnover.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 5 |
Veteran, receiving podiatric care from VHA (Texas)
Age: 36 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- Any improvement in the podiatric department is welcome—current wait times are too long.
- I’m cautious but hopeful this leads to better care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
Podiatrist interested in VHA opportunities (Illinois)
Age: 50 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- This policy makes a VHA role more attractive due to improved pay and status.
- It could be the push I need to join the VHA.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 6 |
Recent podiatry graduate (New York)
Age: 29 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 7.0 years
Commonness: 8/20
Statement of Opinion:
- This change could accelerate my career—aligning with physician pay grades provides financial security.
- My decision to join the VHA might pivot based on this policy’s implications.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Retired veteran (Florida)
Age: 63 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 12/20
Statement of Opinion:
- Improvements in VHA services might make my care more consistent.
- Let's see if policy translates to real world benefits—I remain hopeful.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
Podiatric Medical Director, aspirant (Virginia)
Age: 40 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- Transitioning to Director could enhance our department immensely, improving service and operational standards.
- Leadership positions often lead to positive systemic changes.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 9 | 7 |
| Year 3 | 9 | 7 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
Physician at VHA (Ohio)
Age: 52 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- Equitable compensation should motivate and stabilize staff across practices.
- A stronger podiatric department complements general care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
VHA Administrator (Washington)
Age: 47 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 8.0 years
Commonness: 4/20
Statement of Opinion:
- Enacting this policy requires careful balancing—budget constraints are a real concern.
- Potentially beneficial, but needs to be coupled with other strategic measures.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Private practice podiatrist (Michigan)
Age: 34 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- This policy might lead me to pursue VHA roles due to improved pay and alignment with my career goals.
- More balanced work conditions could be appealing.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 6 |
VHA attendant, caregiver for veteran spouse (New Mexico)
Age: 60 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 13/20
Statement of Opinion:
- Positive policy shift, but it has to trickle down to service level fast.
- Hope for immediate improvements due to frequent visits to the podiatry department.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 4 |
Cost Estimates
Year 1: $15000000 (Low: $10000000, High: $20000000)
Year 2: $15000000 (Low: $10000000, High: $20000000)
Year 3: $15000000 (Low: $10000000, High: $20000000)
Year 5: $15000000 (Low: $10000000, High: $20000000)
Year 10: $15000000 (Low: $10000000, High: $20000000)
Year 100: $15000000 (Low: $10000000, High: $20000000)
Key Considerations
- The realignment of podiatrist salaries to those of physicians may address workforce retention and satisfaction challenges.
- Setting up a Podiatric Medical Director could lead to improved management and strategic planning for podiatric services within the VHA.
- Potentially increases the financial burden on the VHA unless offset by other efficiencies or budget reallocations.