MEDICAL ADMINISTRATION

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80M00165A002100060009-7
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 14
• Document Creation Date: December 20, 2016
• Document Release Date: August 3, 2006
• Sequence Number: 9
• Publication Date: April 21, 1977
• Content Type: MF

Aepproved For Re kL~ WbrC J 'A01N1p~1?562W100060009-
Office of Legislative Counsel
2 0 APR 1977
Mr. James M. Frey
Assistant Director for Legislative Reference
Office of Management and Budget
Washington, D.C. 20503
Dear Mr. Frey:
Enclosed are proposed reports to Chairman Inouye, Senate
Select Committee on Intelligence, and Chairman Price, House
Armed Services Committee; expressing this Agency's concern
about certain inequities in the salary schedule for physicians
employed by the United States.
Advice is requested as to whether there is any objection
to the submission of these reports from the standpoint of the
Administration's program.
Sincerely,
SIGNED
George L. Cary
Legislative Counsel
Enclosures
Distribution:
Orig - Addressee
1 - OLC Subject
1 - OLC Chrono
V- OLC 0\IB Liaison, Wler-\cl
OLC:WPB:sm (19 Apr '77)
U -6
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MEMORANDUM FOR: Director of Central Intelligence
VIA
PROM
Deputy Director for Administration
Charles A. Bohrer, M.D.
Director of Medical Services
SUBJECT : Medical Administration
REFERENCES Ex Reg 6861, dtd 7Mar77; Ex Reg 6861/1,
undtd; Ex Reg 6861/2, undtd; Ex Reg
6861/3, dtd 15Apr77
1. Action Requested: None; for information only.
2. Background: Thank you for supporting and
forwarding the letters on Federal physicians comparability
pay to the Honorable Daniel K. Inouye and the Honorable
Melvin Price. While this office currently has no acute
staffing problem with physicians, I do have a staff that is
discontent with the inequities in the pay system. Physicians
applying for employment with the Agency likewise do not under-
stand the inequity.
It is apparent that the previous memorandum sent to you
on physicians in the Office of Medical Services gave you the
impression that there are nine physicians administering, a
total of twenty-five. The following information is provided
in order to clarify the use of OMS physicians.
The Director, Deputy Director and Chief of Professional
Services of OMS are the principal physicians involved in the
administration and management of physicians, nurses, technicians
and psychologists in the office. Their administrative respon-
sibilities, of necessity, involve professional judgments as
well. One physician is developing our ADP applications (CAMPS).
In addition, there are four psychiatrists whose primary respon-
sibilities include daily patient evaluation and consultation.
One additional psychiatrist (part-time) provides behavioral
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SUBJECT: Medical Administration
support to the Agency and the Intelligence Community on the
STAT
physicians are involved directly in the evaluation, examina-
tion and provision of emergency health care for employees and
dependents at the Headquarters Building and at Ames. One
physician is currently undergoing career development training
internally and at Johns Hopkins in order to provide him with
additional professional qualifications required by this office.
The Office of Medical Services, like any office, has
certain general administrative duties which are, not unique
in nature and do not require decisions by a physician. These
administrative activities are primarily delegated to medical
administrative officers, most of whom were trained as chief
corpsmen or their equivalent by the military services.
SIGNED
CHARLES A. BORRER. D.D.
Charles A. Bohrer, M.D.
Attachments
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Honorable Daniel K. Inouye, Chairman
Select Committee on Intelligence
United States Senate
Washington, D. C. 20510
I am writing to express my concern about the serious problem
faced by this Agency in recruiting and retaining qualified physicians.
This problem results, in large part, from certain inequities in the salary
schedule for physicians employed by the United States.
The Uniformed Services Medical Officers Revised Pay Structure Act
of 1974 (P. L. 93-274) and the Veterans Administration Physician and
Dentist Pay Comparability Act of 1975 (P. L. 94-123) provided special
pay and incentive pay to physicians and dentists in the uniformed services
and the Veterans Administration, a total of approximately 92.5 percent
of the physicians employed by the Federal Government. As a result, the
remaining 7. 5 percent of the physicians employed by the Federal
Government receive compensation at a significantly lower rate than their
counterparts. Physicians employed by the Central Intelligence Agency are
among this group of civilian physicians adversely affected by the imbalance
in pay scales.
This inequitable situation, coupled with the availability of higher
salaries in the private sector, has placed this Agency in a poor competi-
tive position with respect to other Federal agencies with regard to the
recruitment and retention of physicians. I believe that if this Agency were
able to pay competitive salaries the problem would be solved. Data from
the Department of Defense indicates that the Uniformed Services
Physicians Pay Act stopped the net outflow of military physicians
Legislation was introduced in the 94th Congress that would extend the
benefits of P.L. 93-274 and P. L. 94-123 to physicians in other Federal
agencies and departments; in my view this would be a proper method to
extend these benefits .to physicians employed by the Central Intelligence
Agency. Similar legislation already has been introduced this session
in both Houses, by Representatives Lott (FI. R. 1.519) and Fisher (H. R. 4620)
and by Senator Mathias (S. 990). Since only a relatively small number
of Federal physicians are not covered by existing laws and would therefore
be affected by this legislation, swift action in the Congress is far from
certain. My Office of Legislative Counsel will follow the progress of
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this legislation but, if necessary in light of this Agency's pressing need for
remedial legislation, may offer a legislative proposal specifically drawn
to insure that physicians employed by the CIA are placed on a par with
those in the uniformed services and the Veterans Administration.
I feel it is appropriate to raise this legislative matter with the
Committee and urge your support for remedial language as introduced
already or, if necessary, as may be proposed by this Agency. I
welcome the opportunity to discuss the matter at greater length.
The Office of Management and Budget has advised there is no
objection to the submission of this report from the standpoint of the
Administration's program.
Yours sincerely,
/s/ Stai1Si ~e1d Turner 1 _ APR 1977
STANSFIELD TURNER
Admiral, U. S. Navy
Distribution:
Orig - Addressee
4:f DCI
1 - DDCI
1-ER
I - DDA
I - OHMS
I - OLC Subject
I - OLC 0MB Liaison
I - OLC Chrono
OLC:RLB:sm (retyped 28 Liar 77)
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Honorable Melvin Price, Chairman
Committee on Armed Services
House of Representatives
Washington, D. C. 20515
Dear Mr. Chairman:
I am writing to express my concern about the serious problem
faced by this Agency in recruiting and retaining qualified physicians.
This problem results, in large part, from certain inequities in the salary
schedule for physicians employed by the United States.
The Uniformed Services Medical Officers Revised Pay Structure Act
of 1974 (P. L. 93-274) and the Veterans Administration Physician and
Dentist Pay Comparability Act of 1975 (P. L. 94--123) provided special
pay and incentive pay to physicians and dentists in the uniformed services
and the Veterans Administration, a total of approximately 92.5 percent
of the physicians employed by the Federal Government. As a result, the
remaining 7. 5 percent of the physicians employed by the Federal
Government receive compensation at a significantly lower rate than their
counterparts. Physicians employed by the Central Intelligence Agency are
among this group of civilian physicians adversely affected by the imbalance
in pay scales.
This inequitable situation, coupled with the availability of higher
salaries in the private sector, has placed this Agency in a poor competi-
tive position with respect to other Federal agencies with regard to the
recruitment and retention of physicians. I believe that if this Agency were
able to pay competitive salaries the problem would be solved. Data from
the Department of Defense indicates that the Uniformed Services
Physicians Pay Act stopped the net outflow of military physicians.
Legislation was introduced in the 94th Congress that would extend the
benefits of P. L. 93-274 and P.L. 94-123 to physicians in other Federal
agencies and departments; in my view this would be a proper method to
extend these benefits to physicians employed by the Central Intelligence
Agency. Similar legislation already has been introduced this session
in both Houses, by Representatives Lott (H. R. 1519) and Fisher (H. R. 4620)
and by Senator Mathias (S. 990). Since only a relatively small number
of Federal physicians are not covered by existing laws and would therefore
be affected by this legislation, swift action in the Congress is far from
certain. My Office of Legislative Counsel will follow the progress of
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this legislation but, if necessary in light of this Agency's pressing need for
remedial legislation, may offer a legislative proposal specifically drawn
to insure that physicians employed by the CIA are placed on- a par with
those in the uniformed services and the Veterans Administration.
I feel it is appropriate to raise this legislative matter with the
Committee and urge your support for remedial language as introduced
already or, if necessary, as may h:} proposed by this Agency. I
welcome the opportunity to discuss the matter at greater length.
The Office of Management and Budget has advised there is no
objection to the submission of this report from the standpoint of the
Administration's program.
Yours sincerely,
%s/ Stansfield Turnez
STANSFIELD TURNER
Admiral, U. S. Navy
Distribution:
Or.ig - Addressee
'J- DCI
1 - DDCI
1 - ER
.1-DDA
1 - OMS
1 - OLC Subject
1 - OLC 0MB Liaison
1 - OLC Chrono
OLC:RLB:sm (retyped 28 Mar 77)
i5' APB
1977
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MEMORANDUM FOR: Deputy Director of Medical Services
PROM
M.D.J. M.P.H.
Medical Systems Development Officer,
Office of Medical Services
SUBJECT Summary of the-Inequitable Pay Status for
Federal Civilian Physicians
1. Following the termination of the Doctors Draft
in June 1973, the Uniformed Services began to have difficulty
in recruiting and retaining physicians to provide quality
medical services for military personnel and their dependents.
By the spring of 19-74-a critical shortage of physicians
had. developed in the Uniformed Services. In evaluating this
situation, it was determined one of the principle reasons
for the shortage was the-inability of the military to pay
salaries that were competitive with the income. physicians
could attain in private practice and industry. In an
attempt to correct this difficulty, the 93rd Congress enacted
PL 93-274 (Uniformed Services Medical Officers Revised Pay
Structure) dated 6 May 1974. This Law enabled the Uniformed
Services to provide up to $13,500 per annum in special pay
over and above the prevailing levels of ordinary compensation.
2. By the summer of 1975 the Veterans Administration
(VA) began to recognize it was having great difficulties in
0 C, recruiting and retaining physicians. In analyzing the causes
for this, it was determined the principle reason for the
problem was the inability to pay salaries competitive with
the Uniformed Services and the income physicians could earn
in industry and private practice. To assist the VA in
rectifying these difficulties, the 94th Congress passed
PL 94-123 (Veterans Administration Physician and Dentist
Comparability Act of 1975). This Law permitted the VA to
pay physicians up to $13,500 per annum in special pay over
and above regular pay. This Law further directed the
Comptroller General and the Director of the Office of
Management and Budget (OMB) to study the problem of
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SUBJECT: Summary of the Inequitable Pay Status for Federal
Civilian Physicians
recruitment and retention of physicians and dentists in the
Federal Services and to develop recommended alternative
courses of action that could solve documented recruitment,
:retention and pay problems.
3. Because of the difficulties in recruiting and
retaining physicians in the Federal Services, as documented
by the Uniformed Services, the VA and some civilian agencies,
a Joint Agency. Work Group (JAWG) was convened by OMB and
chaired by the Civil Service Commission. (CSC) to study
compensation and personnel systems for physicians. and. other
Federal health professionals. The JAWG completed a report
to OMB in December 1976 on Compensation and Personnel
Systems for Physicians and Other Health Professionals. The
Executive Summary of this report is presented in Attachment A.
4. By January 1976 The Council... of Federal. Medical
Directors had become aware that a number of Federal civilian
agencies were having difficulties in recruiting. and retaining
physicians and ascertained that 1800-1900 Federal civilian
physicians (circa 7.5% of the total number of Federal physicians)
were not being provided any of the special pay benefits authorized
for their peers in the Uniformed Services by PL 23-274 and
the VA by PL 94-123. In an effort to correct this inequity
the Council worked to secure introduction of bills entitled
the Federal Physicians Comparability Allowance Act of 1976.
These Bills were introduced in the House by Congressman
Joseph Fisher on 20 May 1976 and in the Senate by Senator
Charles McC. Mathias on 8 September 1976. These Bills were
to provide up to $10,000 per annum in special pay over regular
salary levels. These Bills were referred to the Committees
on Post Office and Civil Service in the House and Senate,
respectively. These Committees requested the views of the
CSC, General Accounting Office (GAO), and OMB on these Bills.
The CSC did not take a position on HR 13933 because it felt
the reports directed of GAO and OMB by PL 94-123 should serve
as a basis for further action by Congress. The GAO advised
on 7 September 1977 it had sent its report to Congress which
was recommending a uniformed compensation plan for all.-Federal
physicians and dentists, which should help correct the
inequity being experienced by Federal civilian physicians.
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SUBJECT: Summary of the Inequitable Pay Status for Federal
Civilian Physicians
The 0MB did not formulate a position on HR 13933 because
hearings were not held on this Bill. Unfortunately, there
was not enough time in the 94th Congress to permit enactment
of these Bills into law. Thus, there still exists. an
'inequitable-pay status for the Federal civilian physicians
compared with that provided physician. peers in the VA and
the Uniformed Services.
5. By the summer of 1976, the Uniformed Service.s and
the VA had compiled statistics that demonstrated an improvement
in the recruitment and retention of physicians. The Uniformed.
Services had stopped its net outflow of physicians and had
been able to attain an equilibrium in the number of physicians
for the first time since the termination of the Doctors Draft.
Both the Uniformed Services and the VA thought their improved
experience was definitely related to their ability to provide
the special allowances authorized by PL 93-274 and PL 94-123.
In view of this experience, Congress was convinced to extend
these Laws, which were due to expire 30 September 1976, to
30 September 1977.
6. On 30 August 1976 the Comptroller General published
the report entitled "Recruiting and Retaining Federal Physicians
and Dentists: Problems, Progress, and Actions Needed for the
Future" as their response to the Congressional directive on
this subject in PL 94-123. The significant conclusion and
recommendations of this report are exhibited in Attachment B.
7. In December 1976 the 0MB published the report
entitled "Recruitment and Retention of Federally Employed
Physicians and Dentists" as its response to the Congressional
directive on this subject in PL 94-123. An executive summary
of this report is provided in Attachment C.
8. The current status of pay for Federal physicians is
that the Uniformed Services physicians in the Department of
Defense and Public Health.Service and physicians in the VA
are entitled to, and receive, special allowances of up to
$13,500 above their regular salaries, while the 1800 to 1900
Federal civilian physicians (circa 7.5% of all Federal
physicians) are not authorized to receive any of these-special
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SUBJECT: Summary of the Inequitable Pay Status for Federal
Civilian Physicians
allowances. The Council of Federal Medical Directors is
continuing its activities to secure passage of legislation
that will correct this inequity. Congressman Trent Lott
introduced. HR 1519 on.6 January 1977 to provide pay
.comparability for Federal civilian-physicians. The Council
has commitments from Congressman Joseph Fisher to reintroduce
HR 13933 in the House and from Senator Charles McC. Mathias
to reintroduce S. 3798 in the Senate to provide pay equity
for Federal civilian. physicians. Once the Bills have been
introduced by Messrs. Fisher and Mathias, the Council will
follow the Bills through their legislation process.
M.D., M.P.H.
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INFORMATION
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SIGNATURE
Att-L!Q~ 77-2167
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