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House Passes Wenstrup Bill to Increase Access to Specialty Care Physicians at the VA

WASHINGTON, D.C. – Today, the U.S. House of Representatives passed the VA Provider Equity Act (H.R. 1058). Congressman Brad Wenstrup, who serves as the Chairman of the House Veterans’ Affairs Health Subcommittee, introduced H.R. 1058 to improve veterans’ access to specialty care physicians by enabling the VA to better recruit and retain experts in lower extremity conditions.

“From lower extremity injuries related to improvised explosive devices to foot and ankle ailments caused by aging, diabetes, or other service-connected disabilities, the veterans seeking care from the VA have uniquely complex medical needs,” said Chairman Wenstrup. “Our veterans deserve the highest quality treatment from the most experienced medical professionals. My legislation will give VA the tools it needs to hire and employ the best and the brightest, and help ensure timely access to care. I thank my colleagues in the House for the bipartisan passage of this legislation, and I urge the Senate to act swiftly as well, so these reforms can reach our veterans as soon as possible.”

“As a podiatrist himself, Rep. Wenstrup knows firsthand the valuable and increasingly necessary medical and surgical care that podiatrists provide our nation’s heroes,” said Chairman Roe. “I’m grateful to Rep. Wenstrup for his leadership on this legislation that would put podiatrists on a level playing field with their physician peers and improve recruitment and retention of experienced and high-quality podiatrists.”

Support of Veteran Service Organizations:

Paralyzed Veterans of America (PVA) Associate Executive Director of Government Relations Carl Blake: “Paralyzed Veterans of American is pleased to offer support for the amendment in the nature of a substitute to H.R. 1058, to clarify the role of podiatrists in the Department of Veterans Affairs. Podiatrists at VA are currently classified among optometrists and other allied health professionals, rather than among physicians and dentists. As a result, the VA pay scale incorrectly differentiates podiatrists from other physician providers. This legislation will appropriately correct that discrepancy.”

Disabled American Veterans (DAV) Commander Dave Riley: “VA podiatrists are highly specialized surgeons who play a critical role in managing the care and treatment of extremely common injuries and diseases both for acutely injured and ill veterans and those of advanced age. Podiatry is just one component of the overall comprehensive care of America’s veterans, but it is a critical one. Supported by a DAV national resolution approved by our nearly 1.3 million members to ensure VA provides that comprehensive care to its enrolled veterans, we believe these practitioners’ status should be commensurate with other physicians in VA. Therefore, DAV supports this legislation, and urges its passage.”

Veterans of Foreign Wars (VFW) Director of National Legislative Services Carlos Fuentes: “On behalf of the men and women of the Veterans of Foreign Wars and its Auxiliary, I am pleased to offer our support for the the VA Provider Equity Act. This is a common sense piece of legislation and the VFW thanks Congressman Brad Wenstrup for his work to improve access to podiatry for veterans, which is an area of medical specialty VA has traditionally struggled to adequately recruit and retain.”

American Podiatric Medical Association (APMA) President Ira H. Kraus: “As president of the American Podiatric Medical Association, the national organization representing the vast majority of America’s foot and ankle physicians and surgeons, one of my chief responsibilities is to protect and advance the practice of podiatric medicine and ensure timely and appropriate patient access to necessary and appropriate medical and surgical foot and ankle care. It is with this goal in mind that I write today to offer APMA’s strong support of your bipartisan legislation, the VA Provider Equity Act (HR 1058). This legislation will resolve the persistent problem of recruitment and retention of podiatrists employed by, or wishing to be employed by, the Veteran’s Administration. By resolving these issues, it will enhance access to high-quality health care for a most worthy patient population: America’s veterans. Doctors of podiatric medicine (DPMs) are podiatric physicians and surgeons, also known as podiatrists, qualified by their education, training, and experience to diagnose and treat conditions affecting the foot, ankle, and structures of the leg. The medical education and training of today’s podiatrist includes four years of undergraduate education, four years of graduate medical education at an accredited podiatric medical college, and a minimum three years of hospital-based residency training. Twenty-eight of the approved residency programs in podiatric medicine and surgery are conducted at VA facilities across the nation and provide graduate medical education for more than 200 podiatric residents annually. The VA currently employs less than 350 full-time equivalent podiatric physicians. APMA thanks you again for your leadership and dedication to this important issue and to this most deserving group of patients. We look forward to working with you and your colleagues to see its enactment into law.”

American Foot and Ankle Society President Thomas Lee: “On behalf of the American Association of Orthopaedic Surgeons (AAOS), which represents over 18,000 board-certified orthopaedic surgeons specializing in foot and ankle disorders, we would like to express support for your amendment to H.R. 1058, the VA Provider Equity Act. The Wenstrup amendment will increase access to food and ankle care for Veterans by improving recruitment and retention within the Department of Veterans Affairs (VA) of highly qualified podiatrists. The amendment accomplishes this by raising salaries for podiatrists and allowing podiatrists access to appropriate leadership positions at the VA. Podiatrists are an essential part of the care team at the VA and work alongside orthopaedic surgeons every day to provide excellent service to Veterans. Thank you and your staff for your commitment to our veterans and for working with us throughout this process. We are happy to support the resulting legislation.”

National Association of Veterans Affairs Physicians and Dentists (NAVAPD) President Samuel V. Spagnolo: “The National Association of Veterans Affairs Physicians and Dentists (NAVAPD) strongly supports your amendment to H.R. 1058 "Role of Podiatrists in Department of Veterans Affairs."  All the provisions of your amendment, which establishes clinical oversight standards, modification and clarification of pay grade by adding podiatrists to the Physician and Dentist Schedule are long overdue.  Over the years NAVAPD has been a leader in working with VA management to obtain equal pay, clinical oversight standards, and utilization of physicians and dentists skills in management positions.  I am heartened to see that VA, in their White Paper on Podiatry Pay, recognizes the importance of podiatrists in providing veterans’ healthcare and that the utilization of podiatric services has been increasing citing a 21% increase from 2015-2016.  At your suggestion, NAVAPD is pleased to include podiatrists in our membership and will be reaching out to the Department of Veterans Affairs podiatric community soon.  I also want to applaud your continuing efforts to improve hiring and retention problems in VHA and look forward to working with you and your staff during the 115th Congress.”

 

Background:

Veterans face increasing numbers of foot and ankle ailments, including diabetic-related complications, peripheral neuropathy often linked to Agent Orange exposure, orthopedic maladies, and vascular compromise, with 1.8 million veterans at risk of amputation. As of 2015, 93% of new podiatry patients wait more than 15 days for an appointment, and podiatry is the 4th most referred-out surgical service to community care.

This problem is self-imposed. VA lags behind the private sector in pay and leadership opportunities for podiatrists. VA's qualifications for podiatrists were developed in 1976 and have not been updated in the 39 years since. In that time, the practice of podiatry has evolved significantly. Today, podiatrists receive education and training comparable to that of other physicians and surgeons. Many podiatrists join the VA with less than 10 years’ experience and without board certification; they stay long enough to earn board certification and then leave the VA for greater career opportunities elsewhere. This means the VA is attracting less experienced podiatrists when they have a patient population that is more complex. H.R. 1058 will address these issues and improve veterans’ access to much needed podiatric care.

Congressman Wenstrup also introduced this legislation last Congress, which was included in H.R. 3016, the Veterans Employment, Education, and Healthcare Improvement Act, and passed the House on February 9, 2016.

 

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