Optometrists (ODs) employed by the Department of Veterans Affairs (VA) are celebrating more than just the start of a new year following last month’s passing of a sweeping bipartisan reform bill by Congress that included granting optometry physician-level recognition.
Let’s start with optometry at the VA.
We’ll take you back to 1976, when the Veterans Health Administration (VHA) Optometry Service was first established under the VA’s Office of Specialty Care Services (which includes both optometry and ophthalmology).
Since then, the following vision services have been provided and covered by the VA for veterans with VA health care benefits:
- Routine eye exams
- Preventative vision testing
- Eyeglasses/ blind or low-vision rehabilitation (in some cases)
Give me some vision stats.
Fun fact: Vision / eye health care is reported to be the third-most (behind primary and mental health care) requested service by veterans.
Focusing on optometry: The American Optometric Association (AOA) also reported that:
- 70% of essential primary and medical eyecare services at the VA are provided by ODs
- 95% of ODs practice at VA locations where eyecare is offered
- 73% of 2.5 million selected procedures at the VA are provided by ODs
- 99% of services in low-vision clinics and blind rehabilitation centers are provided by ODs
Now to this OD pay scale.
In announcing this legislative win for ODs, the AOA noted that, despite the critical role ODs play in providing healthcare services for veterans, the pay scale for these physicians—which was classified as a “general schedule (GS)” pay scale (more on that below)—has gone largely unchanged since the establishment of the VHA Optometry Services.
- Keep in mind: That was 49 years ago.
About the GS pay scale: This is one of 15 pay systems within the federal government that score from GS-1 (lowest) to GS-15 (highest) and are based on the level of work, difficulty, responsibility, and qualifications.
So you’re saying ODs weren’t being paid at a physician level?
Basically. While a 2004 legislation resulted in a new pay scale for allopathic and osteopathic physicians—followed by dentists and podiatrists in 2019—ODs “remained in the GS pay scale with a pay cap far below that of the private sector in many regions,” according to the AOA.
The repercussion of this: The AOA noted two major issues for the VA:
- A number of unfilled optometry positions at facilities
- Over 20% of the VA optometry workforce is at or near retirement
- Of that number, many have already reached the legislative pay cap
Sounds like this has been a long-standing issue …
Indeed. In recent years, the AOA has been joined by veteran service organizations such as American Veterans (AMVETS) and Disabled American Veterans (DAV) in advocating for adding optometry to the physician pay scale.
See here to learn more about the AOA’s recent efforts to prioritize the VA optometry pay scale discrepancy.
Yikes … now to this reform bill.
Initially introduced in the U.S. House in May 2024, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement (H.R. 8371) addresses various programs, benefits, and services provided by the Department of VA that apply to health care (which is where ODs are impacted) as well as:
- Educational assistance
- Home loans
- Homelessness
- Disability and memorial affairs
Get a highlights version here.
And the section applying to ODs?
Section 142 (titled “Modification of pay limitation for physicians, podiatrists, optometrists, and dentists of Department of Veterans Affairs”) amends the current pay scale limitation to add the +1,000 ODs employed by the VA to the physician-level pay scale.
- About this scale: At the VA, this pay system includes base, market, and performance pay—with market pay based on the needs of a physician’s specialty or assignment, experience, board certification, and accomplishments.
So what does this mean?
According to Jeanette Carbone Varanelli, OD, former chief of Optometry at the John D. Dingell VA Medical Center: major positive changes for the VA optometric profession.
“Raising the entry-level salary and earning potential as a career VA optometrist provides the opportunity to offer a more competitive compensation package to retain providers that understand how to support and care for the unique needs of our nation’s veterans,” Dr. Varanelli stated.
As a long-time advocate for this legislation, Association of Armed Forces and Federal Optometric Services (AFOS) Executive Director H. Lindsay Wright, OD, FAAO, expressed similar sentiments, calling the bill a “critical step forward” for ODs and an appropriate recognition of the “essential role optometrists play as frontline providers of eye and vision care within the VA health care system.”