VA's Failure to Use Its New Authority to Boost Pay for Doctors Draws Bipartisan Criticism

Why It Matters

Without implementing the Dole Act, the VA risks worsening physician shortages, which could degrade care quality for millions of veterans and undermine congressional efforts to modernize federal healthcare staffing.

Key Takeaways

• VA doctors still limited to $400,000 salary cap
• Dole Act permits 300 pay‑waiver exceptions for critical physicians
• VA has not issued guidance since law took effect July 2023
• 3,300 physicians left VA in 15 months, outpacing 2,200 hires
• Bipartisan lawmakers demand immediate implementation to retain veteran care staff

Pulse Analysis

The Dole Act, enacted just before President Biden left office, was designed to give the Veterans Health Administration flexibility to compete with private‑sector salaries. By allowing up to 300 waivers on the $400,000 cap and retroactive pay for previously capped earnings, the law aimed to address a chronic recruitment bottleneck in specialty care. Yet the VA’s internal disagreements over waiver allocation have stalled any rollout, leaving a sizable portion of its physician workforce stuck under outdated compensation limits.

Physician attrition at the VA has accelerated in recent years, with data from the Office of Personnel Management showing a net loss of roughly 3,300 doctors in the last 15 months, while only 2,200 new physicians have joined. This imbalance mirrors earlier staffing challenges that the 2022 PACT Act helped alleviate for nurses, resulting in 10,000 wage increases. The contrast highlights how the VA’s failure to act on the Dole Act could reverse gains made in other clinical categories, potentially driving more clinicians to the private market and leaving veterans with longer wait times and reduced access to specialty services.

Bipartisan pressure is mounting as both Democratic and Republican members of the Veterans Affairs Committees have publicly urged VA Secretary Doug Collins to issue the needed regulations. Their letters stress that timely implementation is essential not only for recruitment but also for retaining the talent already within the system. If the VA moves forward with the waivers, it could stabilize staffing, improve care continuity, and signal a broader federal commitment to modernizing compensation structures for critical public‑sector roles.