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Why can’t the St. Louis VA recruit a director who stays?

The John Cochran VA Medical Center in St. Louis.
Durrie Bouscaren | St. Louis Public Radio
The John Cochran VA Medical Center in St. Louis.

Next week, in-person interviews will begin for a new director of the Department of Veteran’s Affairs Health Care System in St. Louis -- for the ninth time in three years.

The challenges of finding a director who can make a long-term commitment aren't unique to St. Louis. Across the nation, the VA has had difficulty recruiting administrators, VA Under Secretary David Shulkin said Friday.

Shulkin and U.S. Sen. Claire McCaskill visited the John Cochran Medical Center in St. Louis to discuss ongoing recruitment challenges.

During a press conference, Shulkin listed several ways the VA has a tough time recruiting. Salaries for a VA director start at about $130,000, while executive pay at nonprofit hospitals can be two to three times higher. In St. Louis, the health system has been plagued by scandals over wait times, falsified recordsand a 2010 contamination incident that put hundreds of veterans at risk for hepatitis and HIV.

"I do think that much of the negative attention... has made it more difficult for us to recruit," Shulkin said. “Our applications to the VA are down 78 percent since the crisis happened in April of 2014, starting in Phoenix." 

Dr. Patrick Adegboyega, interim chief of staff of the St. Louis system, said he doesn’t believe patient care has been affected by the lack of permanent leadership. But he conceded that the past three years have been a challenge.
“You have one here for three months," Adegboyega said of the directors who have served short stints. "That doesn’t give us for stability in terms of long-term planning to know where things are going, because in three months this person is gone again." 

There are 34 openings for VA director positions nationwide, Shulkin said, and 4,400 openings for other staff.

U.S. Senator Claire McCaskill, D-Mo, speaks to reporters with Veterans Affairs Under Secretary David Shulkin.
Credit Durrie Bouscaren | St. Louis Public Radio
U.S. Senator Claire McCaskill, D-Mo, speaks to reporters with Veterans Affairs Under Secretary David Shulkin.

  “Running a healthcare operation in 2016 is a complex job anywhere, but running it in the VA system, which is under such scrutiny, is a very challenging job,” Shulkin said. “What we’re trying to do is get the message out that the VA is a fantastic place to work." 

Lawmakers are trying to address the issue. McCaskill, a Democrat, cited a 2015 bill she co-sponsored that would have given the VA more flexibility with the pay they can offer to potential directors.

“Believe me, the vast majority of people who work at the VA aren’t here because they want to make more money. They are here because they want to serve,” McCaskill said. “But still, when you’re that far below the market, it makes it even more difficult to find the kind of leadership that we all want.”

Follow Durrie on Twitter: @durrieB