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The Shift in Recognition for VA Optometrists
The recent legislative change by the U.S. Department of Veterans Affairs (VA) marks a significant milestone for the field of optometry, especially within the VA healthcare system. On January 2, 2025, President Joe Biden signed the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act into law, paving the way for over 1,000 VA optometrists to receive recognition and compensation at the physician level. This change, years in the making, addresses an outdated pay structure that has hindered the recruitment and retention of skilled optometrists in the VA.
Why This Recognition Matters
DA doctors of optometry are vital to the health care services provided to veterans, delivering approximately 70% of essential primary and medical eye care services. Given the fact that many veterans depend solely on these services, recognizing optometrists as physicians will not only enhance their standing within the VA system but also ensure that veterans receive the quality care they deserve. For years, optometrists have been confined to the federal general schedule pay scale, which limited their pay and rendered them less competitive than their counterparts in private practice.
Understanding the Historical Context
For decades, optometrists have been pivotal providers of visual health care, particularly within the VA, where they perform an impressive range of procedures, including 73% of the 2.5 million selected ophthalmic procedures annually and virtually all care in low-vision clinics. However, a significant disparity in pay and recognition existed. The optometry profession was notably absent when allopathic and osteopathic physicians were afforded a physician-level classification in 2004. This oversight has led to increasing vacancies and job dissatisfaction among optometrists, especially as over 20% of the VA's optometry workforce is nearing retirement.
Endorsed by Key Advocates
The American Optometric Association (AOA) and the Association of Armed Forces and Federal Optometric Services (AFOS) championed this recognition, undertaking advocacy efforts that included over 300 meetings with congressional representatives. Their concerted efforts have underscored the essential role optometrists play within the VA, and finally, this advocacy work has culminated in legislative success. H. Lindsay Wright, executive director of AFOS, emphasizes that this law is crucial not only for recruiting optometrists but also for retaining those who are already making a difference in veterans' lives.
Future Implications for VA Healthcare and Patients
With the inclusion of optometrists in the physician pay scale, the VA can now offer competitive salaries, allowing them to attract and retain the top-tier talent necessary for maintaining high-quality vision care. The new law grants the VA authority to provide performance-based pay adjustments and bonuses, an initiative sought after by optometry advocates to ensure compensation reflects market conditions.
Yet challenges remain. Limited practice scopes and outdated regulatory frameworks can deter new optometrists from entering federal service. Continued advocacy for comprehensive optometry practice standards is crucial to ensure that the benefits of the new pay scale translate into better care options for veterans.
Conclusion and Call to Action
The elevation of optometrists to the physician pay scale is a substantial victory, echoing the ongoing commitment to improving healthcare for veterans. Advocates are urged to continue their support for the AOA and AFOS in the quest for enhanced practice standards. Participation in advocacy initiatives, such as the upcoming AOA on Capitol Hill event in 2025, will be critical in maintaining momentum for improvements in optometry’s role within the VA system. The significance of this change is not only in recognizing the essential services provided by optometrists but also in ensuring consistent quality care that our veterans deserve.
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