United States General Accounting Office

GAO Report to the Honorable

Constance A. Morella

House of Representatives

September 1997 PAY AND BENEFITS

Comparative Analyses

of Federal Physicians’

Compensation

GAO/GGD-97-170

GAO United States

General Accounting Office

Washington, D.C. 20548

General Government Division

B-276378 

September 15, 1997

The Honorable Constance A. Morella

House of Representatives

Dear Ms. Morella:

This report responds to your request for information on pay and benefits

of physicians employed by the federal government and in the private

sector to be used in considering reauthorization of the Federal Physicians

Comparability Allowance Act (5 U.S.C. 5948). The authority to enter

agreements to pay physicians comparability allowances (PCA) under this

act is currently due to expire on September 30, 1997. This act permits

federal agencies that are experiencing problems in recruiting and retaining

physicians to provide PCAs to physicians who are paid under title 5 of the

U.S. Code. On July 18, 1997, the Director of the Office of Personnel

Management (OPM) transmitted a report on PCAs to the President of the

Senate and the Speaker of the House of Representatives recommending a

3-year extension of agencies’ authority to enter into PCA agreements with

employees.

Background As of September 1996, there were over 25,000 full-time physicians

employed by the federal government. (See appendix IV.) Most of the

physicians paid under title 5 were with the Departments of Health and

Human Services (HHS) and Defense (DOD).1

 Physicians paid under title 37

were with HHS’ Public Health Service Commissioned Corps or on military

duty. Physicians paid under title 38 were with the Department of Veterans

Affairs (VA). Although not eligible to receive PCAs under title 5, physicians

paid under titles 37 and 38 are eligible to receive other types of special pay

for physicians. Also, under a delegation of authority from OPM, some HHS

physicians who receive basic pay under title 5 are eligible to receive

special pay under title 38.

Objectives, Scope,

and Methodology

As we agreed with you, our principal objectives were to (1) compare

amounts paid2

 to federal physicians under title 5 with amounts paid to

physicians under other sections of the U.S. Code and with physicians in

1

A small number of federal physicians work for such organizations as the Tennessee Valley Authority

or the Central Intelligence Agency or are in the Foreign Service. These physicians are paid under other

titles of the U.S. Code and are also eligible for PCAs.

2

For the purpose of this report, we defined amounts paid to physicians as “physicians’ pay,” which was

the total of basic pay plus any special pay or PCAs that were available only to physicians. Basic pay is

defined in appendix III.

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the private sector; (2) determine what other types of pay and benefits

federally employed physicians receive; and (3) identify ongoing efforts by

federal agencies that affect or have the potential to affect physicians’ pay.

In addition to the primary comparisons required by our objectives, we also

developed additional analyses of physicians’ compensation, which are

discussed in appendix I.

In our previous report on federal/private sector pay comparisons,3

 we

noted that experts in labor market analysis suggested that federal/private

compensation comparisons that focus exclusively on pay may be

misleading. A more complete analysis of total compensation would be

needed to consider factors such as differences in pay plans and job

responsibilities, federal restrictions limiting amounts of either basic or

special pay, working conditions, job satisfaction, and risks of being laid

off. This would apply to comparisons among federal positions as well.

Because much of this information was not available from studies of

physicians’ pay and because of the time constraints for completing this

review, we only obtained pay-type information for federal and private

sector physicians and did not assess these other factors. In addition, as

agreed, we did not evaluate the significance of recruitment or retention

problems upon which PCAs are based. Therefore, we did not attempt to

make conclusions or recommendations on the sufficiency, size, or

continued need for PCAs under title 5.

On the basis of our preliminary work, we agreed to obtain physicians’ pay

and benefit information for full-time federal physicians paid under titles 5,

37, and 38 of the U.S. Code. In doing our work, we interviewed officials

from HHS, DOD, VA, OPM, and the Office of Management and Budget (OMB) to

obtain descriptive information on the various types of pay and benefits

that physicians received and on recent actions that affect or have the

potential to affect physicians’ pay. HHS, VA, DOD, and the Commissioned

Corps provided us with payroll information, which we used to make our

comparisons. Unless otherwise stated, except for military physicians,

federal physicians’ pay data in this report are for calendar year 1996. We

did not verify the pay information we obtained. Our scope and

methodology are described in greater detail in appendix III.

3

Federal Personnel: Federal/Private Sector Pay Comparisons (GAO/OCE-95-1, Dec. 14, 1994).

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We also purchased and reviewed several studies on physicians’

compensation that were prepared by private consulting firms.4

 These

studies contained pay information for physicians in various medical

specialties who were employed primarily in group practices, health

maintenance organizations (HMO), and hospitals. Except for pay data for

physicians in various medical specialties, these studies did not contain

information that would allow us to compare the pay of the private sector

physicians with the pay received by federal physicians.

We requested comments on a draft of this report from the Secretaries of

HHS, Defense, and VA, and the Directors of OPM and OMB. The agencies’

comments are discussed at the end of this letter. We performed our review

from December 1996 to August 1997 in accordance with generally

accepted government auditing standards.

Results in Brief The average5

 annual pay for HHS physicians6 paid under title 5 was

(1) 17 percent less than the average for HHS physicians who received

special pay under title 38, (2) 21 percent less than the average for VA

physicians paid under title 38, (3) 4 percent greater than the average for

Commissioned Corps physicians, and (4) 23 percent greater than the

average for physicians in the military.

The average pay for title 5 HHS physicians was $101,660. For HHS physicians

who received PCAs, average pay was $104,730 compared with $79,485 for

those who did not receive a PCA or special pay under title 38. The average

pay for DOD physicians paid under title 5 was $86,760. For DOD physicians

receiving a PCA, average pay was $89,710. For VA physicians and HHS

4

We purchased studies prepared by Hospital & Healthcare Compensation Service (HHCS); Sullivan,

Cotter, and Associates, Incorporated (Sullivan); American Medical Group Association (AMGA); and

Medical Group Management Association (MGMA). Two of these organizations cautioned users of their

reports that the data provided by responding medical practices may not be representative of all

physicians or all medical groups because the data were not based on a random sample of medical

practices.

5

In this report, the word “average” refers to the mean. We recognize that the use of medians is

preferred because they are not subject to distortions that may occur in averages when extremely high

or low values are included in a data set. However, we used averages because they were only slightly

different from the medians and because the medians were not available for all federal physician groups

we compared. We also rounded all dollar amounts to the nearest 5 or 0.

6

For the purpose of this report, unless otherwise cited, information on physicians paid under title 5

was based on amounts paid by HHS and DOD to physicians who both did and did not receive PCAs.

According to OMB data, HHS employed approximately 1,363 of the 2,402 title 5 government physicians

in fiscal year 1996. Because of time constraints, other than selected data on title 5 physicians with

DOD, we elected not to obtain detailed pay data on physicians paid under title 5 who were with

non-HHS agencies.

Page 3 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
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physicians who received special pay under title 38, average pay was

$128,540 and $122,555, respectively. Average pay for physicians in the

military (Army and Air Force) and the Commissioned Corps, both of

whom were paid under title 37, was $78,250 and $97,770, respectively.

In general, physicians paid under titles 37 and 38 were eligible for and

received more types and higher amounts of special pay than HHS and DOD

physicians receiving PCAs under title 5. The average PCA for HHS physicians

was $15,760, and the average PCA for DOD physicians paid under title 5 was

$12,505. Average special pay amounts for VA and HHS physicians receiving

title 38 special pay were $39,585 and $38,950, respectively. Average special

pay amounts for physicians in the military and the Commissioned Corps

were $35,190 and $43,260, respectively.

For selected medical specialties, our comparisons of pay information from

studies of private sector physicians’ pay with the pay of federal physicians

who were paid under titles 37 and 38 showed that private sector

physicians were generally paid more. In some specialties, private sector

physicians were paid considerably more. Pay information for HHS

physicians paid under title 5 was not available by medical specialty. These

physicians were not eligible for specialty pay, per se, but were eligible for

PCAs based on determinations that significant recruitment and retention

problems existed.

In addition to basic pay and physicians’ special pay, federal and private

sector physicians were eligible for employer-provided nonwage

compensation (e.g., retirement and health and life insurance benefits).

Some federal physicians also received other types of pay based on factors

such as hours of duty, special skills, or places of work. Physicians in the

military and the Commissioned Corps were generally entitled to

supplements to basic pay in the form of tax-free allowances for

subsistence and housing. Appendix I contains information on these other

benefits.

Regarding ongoing efforts that affect or have the potential to affect

physicians’ pay, we identified two recent initiatives. Since November 1993,

OPM has delegated authority to HHS, DOD, and the Department of Justice

allowing them to provide title 38 special pay to their physicians. As of

May 1997, HHS was the only agency to have used this authority. Also, VA is

currently exploring the feasibility and appropriateness of linking

physicians’ pay with performance.

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Analyses of

Physicians’ Pay

We used several measures—averages, medians, and percentiles—to

portray and compare the pay federal physicians received under titles 5, 37,

and 38. Our principal analyses consisted of comparisons of (1) physicians’

pay—a combination of basic and special pay, (2) basic pay, (3) special pay,

and (4) federal and private sector physicians’ pay for selected medical

specialties.

Federal Physicians’ Pay

Comparisons

When measured by the average, physicians’ pay for HHS physicians who did

not receive title 38 special pay was less than physicians’ pay of HHS and VA

physicians who received special payments under title 38. In contrast,

average physicians’ pay of HHS physicians exceeded the average pay of

military and Commissioned Corps physicians who were paid under title 37.

Table 1 shows, for government physicians paid under titles 5, 37, and 38,

average amounts of basic and special pay combined. Where available, we

also included information on maximum pay, medians, and pay at the 25th

and 75th percentiles.

Table 1: Annual Physicians’ Pay for Federal Physicians in Selected Agencies

Groups of physicians by pay titles 25th percentile Median Average 75th percentile Maximum

HHS title 5 $89,540 $102,640 $101,660 $113,255 $148,400

HHS title 5 receiving PCAs 94,150 104,350 104,730 117,310 147,705

DOD title 5 N/A N/A 86,760 N/A N/A

DOD title 5 receiving PCAs N/A N/A 89,710 N/A N/A

HHS title 5 receiving title 38 special pay 111,290 133,200 122,555 145,645 167,440

VA title 38 118,845 128,910 128,540 139,090 186,700

Commissioned Corps title 37 N/A N/A 97,770 N/A N/A

Military physicians title 37 N/A N/A 78,250 N/A 151,230a

Note: N/A indicates that data were not available.

aFor military physicians, the maximum amount paid was not based on actual payroll information

but was based on DOD pay tables and information on special pay provided by a program official.

Source: GAO analysis of physicians’ pay data provided by federal agencies.

According to DOD officials, the majority of military physicians do not make

the military a career and usually leave active military duty after fulfilling

all required service obligations for education and training. Approximately

70 percent of the physician force is evenly distributed between the O-3

Page 5 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
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(entry level) and O-4 ranks.7 This skews the presentation of “average

salaries” of military physicians to relatively low amounts.

Federal Basic Pay

Comparisons

Similar to total physicians’ pay, basic pay—one component of physicians’

pay—was the highest for HHS and VA physicians and lowest for physicians

in the military. HHS physicians paid under title 5 and VA physicians paid

under title 38 had average basic pays of $87,815 and $89,350, respectively.

Average basic pay for physicians paid under title 37 was $43,110 for

physicians in the military and $54,510 for Commissioned Corps physicians.

Average basic pay received by physicians paid under titles 5, 37, and 38 of

the U.S. Code is shown in table 2. Where available, maximum basic pay

authorized or received by these physicians as well as median pay amounts

and amounts paid to physicians at the 25th and 75th percentile are also

shown.

Table 2: Annual Basic Pay for Federal Physicians in Selected Agencies

Groups of physicians by pay titles 25th percentile Median Average 75th percentile Maximum

HHS title 5 $79,005 $87,265 $87,815 $98,315 $148,400

HHS title 5 receiving PCAs 79,760 88,345 88,970 98,680 130,250

DOD title 5 N/A N/A 77,685 N/A 102,620

DOD title 5 receiving PCA N/A N/A 77,205 N/A 101,615

HHS title 5 receiving title 38 special pay 80,135 91,375 83,605 98,680 110,670

VA title 38 90,090 90,090 89,350 90,090 123,100

Commissioned Corps title 37 41,355 48,520 54,510 71,600 98,290

Military physicians title 37 N/A N/A 43,110 N/A 104,240a

Note: N/A indicates data were not available.

aFor military physicians, the maximum amount paid was not based on actual payroll information

but was based on DOD pay tables.

Source: GAO analysis of basic pay data provided by federal agencies.

Federal Special Pay

Comparisons

For physicians receiving special pay—the second component of

physicians’ pay—average PCAs received by physicians under title 5 were

lower than special pay received under titles 37 and 38. Large differences in

average special pay to physicians—over $20,000—existed between HHS

physicians who received PCAs ($15,760) and VA physicians and HHS

7

In the Army and the Air Force, the O-3 rank is a Captain and the O-4 rank is a Major. In the Navy, the

O-3 rank is a Lieutenant and the O-4 rank is a Lieutenant Commander.

Page 6 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
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physicians who received special pay under title 38 ($39,585 and $38,950,

respectively). The average PCA of HHS physicians ($15,760) was also lower

than the average special pay received by military and Commissioned

Corps physicians, $35,190 and $43,260, respectively. Table 3 shows special

pay averages for federal physicians. Where available, maximum special

pay received by these physicians as well as the medians and amounts paid

to physicians at the 25th and 75th percentile are also shown.

Table 3: Annual Special Pay for Federal Physicians in Selected Agencies

Groups of physicians by pay titles 25th percentile Median Average 75th percentile Maximum

HHS title 5 receiving PCAs $12,065 $16,615 $15,760 $20,000a $20,000a

DOD title 5 receiving PCAs N/A N/A 12,505 N/A 20,000

HHS title 5 receiving title 38 special pay 30,060 44,075 38,950 50,365 63,000

VA title 38 29,500 39,000 39,585 48,295 84,485

Commissioned Corps title 37 N/A N/A 43,260 N/A N/A

Military physicians title 37 N/A N/A 35,190 N/A 79,500b

Note: N/A indicates that data were not available.

aThe maximum authorized annual PCA amount is shown. In several cases, payroll records

included PCA payments for an additional pay period in 1996, thereby showing PCA payments in

excess of the maximum.

bBased on DOD program information.

Sources: GAO analysis of information provided by federal agencies.

Unlike HHS and DOD physicians who received only PCAs, physicians paid

under title 37 and 38 were eligible to receive several types of special pay.

However, not all physicians can receive each type of special pay. Table 4

shows, for the five different types of special pay paid under title 37, the

number of Commissioned Corps and military physicians that received

each type of special pay, the average amount of special pay received, and

authorized maximum special pay amounts. Table 5 shows the authorized

maximum amounts for each of the seven types of special pay paid under

title 38 as the actual data were not readily available. Each type of special

pay is described in more detail in appendix II.

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Table 4: Types and Amounts of Special

Pay Received by Military and

Commissioned Corps Physicians

Type of special pay Agency

Number

receiving

Average

amount

received

Authorized

maximum

special pay

amount

Board certified Militarya 5,071 $3,595 $6,000

Corps 1,171 4,300

Variable Military 8,872 7,860 12,000

Corps 1,458 8,735

Additional Military 6,593 15,000 15,000

Corps 1,309 14,930

Incentive Military 5,790 17,385 36,000

Corps 1,128 14,805

Multiyear Military 2,011 9,745 14,000

Corps 879 10,310

aNumbers and amounts reported for military physicians are based on Army and Air Force payroll

information.

Sources: GAO analysis of special pay data provided by the Commissioned Corps and the Army

and Air Force.

Table 5: Authorized Maximum Special

Pay Amounts Under Title 38

Types of special pay

Authorized maximum

special pay amounts

Length of service $25,000

Scarce specialty 40,000

Board certified 2,500

Geographic location 17,000

Exceptional qualifications 15,000

Responsibility 45,000

Full time 9,000

Note: In a draft of this report, we presented information provided to us by VA on the number of

physicians receiving each type of special pay and the average amounts received. At VA’s

request, we deleted these data by specific type of special pay because, upon further review, VA

noted that automated pay system records do not contain complete information for individual

special pay components.

Source: VA.

Special pay received by individual physicians paid under titles 37 and 38

could differ significantly because not all physicians received the same

types or amounts of special pay. PCAs received by title 5 physicians varied

less because PCAs may not exceed $20,000. In 1996, of the 1,193 full-time

Page 8 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
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HHS physicians8 who had a full year of service, 830 received only PCA pay;

113 received only physicians’ special pay under title 38; and 135 received

both types of special pay, but not at the same time during the year. Of the

full-time physicians, 115, or less than 10 percent, did not receive PCAs or

title 38 special pay.

Comparison of

Federal and Private

Sector Physicians’ Pay

for Selected Medical

Specialties

HHS and DOD physicians paid under title 5 were not eligible for specialty

pay per se. Instead, these physicians could be eligible for PCAs based on

agencies’ determinations that significant recruitment and retention

problems existed for categories of physicians. According to PCA

regulations (5 C.F.R. 595.103(b)), categories of physicians include those

doing direct care, research, physical examinations, and administration of

medical or health programs.9

 Federal physicians paid under titles 37 and

38 and some HHS physicians eligible for title 38 special pay could receive

special pay based on their certifications as specialists by one of the

recognized American Medical or Osteopathic Specialty Examining Boards.

Such special payments included board-certified pay, incentive and

scarce-specialty pay, and multiyear special pay.

In selected medical specialties in which large numbers of federal and

private physicians practiced (general surgery, internal medicine,

psychiatry, and family practice), our comparison of pay information from

studies of private sector physicians’ pay and the pay of federal physicians

who were paid under titles 37 and 38 showed that private sector

physicians were generally paid more. In other specialties (e.g., thoracic

surgery, radiology, and anesthesiology), private sector physicians were

paid considerably more, based on information from these studies.

Figure 1 shows for VA, DOD, Commissioned Corps, and private sector

physicians the median or average pay for selected medical specialties (see

table 6 for detailed dollar amounts).

8

We excluded HHS physicians in administratively determined pay plans from our analysis of HHS data

because most of these physicians were research fellows at the National Institutes of Health (NIH) and

their duties were different from other full-time HHS physicians.

9

Appendix II contains descriptions of these categories.

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Figure 1: Federal and Private Sector

Physicians’ Pay by Selected Medical

Specialties

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Physicians' pay

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Physician specialty

Median pay for HHS physicians receiving PCAs

MGMA

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Note: Average pay for title 5 physicians was not available by specialty. Average pay information

was the only information available for VA and Commissioned Corps physicians (Commissioned

Corps data were not available for general surgery). For military physicians, DOD estimated

average amounts paid to physicians in each specialty based on pay table data and program

information on amounts of special pay provided to physicians in these specialties. Medians are

used for private sector pay.

Source: GAO analysis of information provided by VA, the Commissioned Corps, DOD, and private

sector studies of physicians’ pay.

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Table 6: Federal and Private Sector Physicians’ Pay by Selected Medical Specialties

Physicians’ specialty MGMA AMGA Sullivan HHCS VA Corps Military

General surgery $216,560 $211,735 $206,360 $170,000 $138,710 N/A $100,960

Internal medicine 139,320 137,000 141,245 133,030 121,925 $100,850 82,400

Psychiatry 132,480 137,210 133,830 120,000 128,910 101,305 88,510

Family practice 129,150 129,415 136,370 120,000 117,410 97,930 84,575

Note 1: N/A indicates data were not available.

Note 2: Information on average pay was the only information available for VA and Commissioned

Corps physicians. For military physicians, DOD estimated average amounts paid to physicians in

each specialty based on pay table data and program information on amounts of special pay

provided to physicians in these specialties. Medians are used for private sector pay.

Source: GAO analysis of information provided by VA, the Commissioned Corps, DOD, and private

sector studies of physicians’ pay.

For other selected medical specialties—thoracic surgery, radiology, and

anesthesiology—private sector physicians’ pay greatly exceeded the

average pay of VA and military physicians. Comparisons of amounts paid to

private sector physicians and VA and military physicians for these selected

specialties are shown in figure 2 (see table 7 for detailed dollar amounts).

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Figure 2: Physicians’ Pay for VA,

Military, and Private Sector Physicians

in Thoracic Surgery, Radiology, and

Anesthesiology Specialties

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Military

Note: We did not present Commissioned Corps information because of the small number of

physicians in these specialties. For military physicians, DOD estimated average amounts paid to

radiologists and anesthesiologists based on pay table data and program information on amounts

of special pay provided to physicians in these specialties. VA amounts are averages, whereas

medians are used for private sector pay.

Source: GAO analysis of information provided by VA, DOD, and private sector studies of

physicians’ pay.

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Table 7: Physicians’ Pay for VA, Military, and Private Sector Physicians in Thoracic Surgery, Radiology, and

Anesthesiology Specialties

Physicians’ specialty MGMA AMGA Sullivan HHCS VA Militarya

Thoracic surgery $281,235 $385,125 $325,290 $231,450 $150,035 N/Ab

Radiology 247,505 231,705 216,335 160,680 149,160 $109,495

Anesthesiology 240,665 218,000 177,150 165,800 142,905 105,765

aFor military physicians, DOD estimated average amounts paid to radiologists and

anesthesiologists based on pay table data and program information on amounts of special pay

provided to physicians in these specialties. VA amounts are averages, whereas medians are

used for private sector pay.

bN/A indicates that data were not available because DOD groups its thoracic surgeons with

surgeons in other specialities.

Source: GAO analysis of information provided by VA, DOD, and private sector studies of

physicians’ pay.

In general, federal physicians’ pay is limited by (1) amounts provided

under basic pay schedules, (2) maximum authorized special payment

amounts, and (3) legislation stating that total pay cannot exceed specified

executive pay levels. Private sector physicians’ pay would not generally be

subject to these types of constraints.

Other Types of

Benefits, Pay, and

Allowances

Other compensation for which physicians may be eligible included

(1) nonwage compensation, such as health and retirement benefits;

(2) premium pay, such as overtime; (3) incentive pay for hazardous duty;

(3) other types of special pay, such as diving pay; (4) tax-free allowances,

such as subsistence and housing; and (5) miscellaneous benefits, such as

base exchange privileges.

For the agencies that we reviewed, the cost of nonwage compensation

(retirement and health and life insurance benefits) ranged from about

19 percent of basic pay for HHS physicians paid under title 5 to about

40 percent of basic pay for physicians in the military. In the private sector

studies that we reviewed, comparable information on nonwage

compensation was generally not available for the physicians studied.

Some federal physicians paid under titles 5 and 37 also received other

types of pay that were unrelated to their classification as a physician but

related more to hours of duty or special skills possessed. For example,

some HHS physicians paid under title 5 received overtime pay, which

averaged $3,100 (see table I.4), and some physicians in the military

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received aviation career incentive pay averaging about $4,000 annually

(see table I.5).

In addition to nonwage compensation and these other types of pay, most

physicians in the military and the Commissioned Corps received tax-free

allowances, the most common of which were for housing and subsistence.

Housing allowances averaged over $8,000 and subsistence allowances

averaged about $1,800. Because these allowances were not subject to

federal income tax, military and Commissioned Corps physicians also had

an additional tax advantage.10

Even though the amounts of these other types of benefits, premium and

incentive pays, and allowances were sizeable in some cases, we did not

include them in our primary analysis because the cost of some benefits

could not be readily quantified and because of the time constraints for

completing our analysis. Appendix I contains additional details on these

other types of compensation.

Agencies’ Actions

Affecting Physicians’

Pay

We identified two recent actions that affect or have the potential to affect

physicians’ pay. One involved a delegation of the use of certain title 38

personnel authorities to several agencies whose physicians are paid under

title 5. The other involved VA’s exploration of the feasibility of recognizing

physicians’ performance in establishing a new pay system.

In November 1993, following an OPM study that identified problems in

recruiting and retaining individuals in health care occupations, OPM

delegated, under 5 U.S.C. 5371, the authority contained in certain title 38

personnel provisions to HHS, DOD, VA,

11 and the Department of Justice. The

provisions that were delegated related directly to pay rates and systems,

premium pay, position classification, and hours of work.12 The purpose of

this delegation was to give these departments additional flexibilities to

maintain quality health-care staffs. As of May 1997, HHS was the only

agency to have used this expanded authority to provide special pay to its

10The amount of tax advantage received depends on family size and the amount of basic pay. For

example, with a family of three, a physician in the O-5 pay grade with 2 years of service with basic pay

of $39,809 would have a tax advantage of $2,101 and with 18 years in the service and basic pay of

$56,034 would have a tax advantage of $4,630, according to January 1996 military compensation pay

tables.

11OPM’s delegation to VA does not involve physicians’ special pay or other compensation for

physicians.

12OPM’s delegation regarding special pay pertains only to physicians at grades below the Senior

Executive Service and Executive Schedule levels.

Page 14 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
B-276378 

physicians. Information on how HHS used this title 38 pay authority showed

that, based on average pay, HHS physicians paid under title 38 earned

$17,825 more than HHS physicians receiving PCAs.

According to an HHS official, HHS agencies’ use of title 38 pay authorities

has enabled HHS to remain reasonably competitive with salary levels in the

private sector. Another HHS official said that budgetary constraints have

limited the number of physicians who can receive title 38 special pay and

have forced HHS to concentrate on positions for which recruitment and

retention have historically been difficult. For example, the FDA has focused

its efforts on providing title 38 special pay to supervisors and team leaders.

Another action that has the potential to affect physicians’ pay involved VA.

VA indicated that some thought was being given to changing the manner in

which its physicians are paid. In 1995 and 1996, a task force appointed by

VA’s Under Secretary for Health met to discuss the development of a new

pay system for physicians and dentists. The task force’s objectives were to

design a pay system that used a total salary concept that continued to

consider local pay markets along with a new incentive pay component to

reward exceptional performance and productivity.

VA officials told us that, as of July 1997, the Veterans Health Administration

was continuing to examine issues dealing with types of information

available regarding local market pay and how to measure and link clinical

performance and total salaries. Instead of physicians being automatically

entitled to special pay by virtue of their length of service, geographic

location, or medical specialty, the system under discussion would consider

the local market, an individual’s performance and experience, and other

relevant factors in determining physicians’ pay. VA officials also told us

that, because of the complexity of physicians’ pay, modifications to the

present system—which would require legislative action—are in the early

stages of study.

Agencies’ Comments HHS and VA provided written comments on a draft of our report. DOD’s

Deputy Director for Manpower and Support, Health Services and

Readiness Support, Office of the Assistant Secretary of Defense for Health

Affairs, and OPM’s Chief, Compensation Administration Division, Office of

Compensation Policy, provided oral comments on our draft report on

August 18 and 20, 1997, respectively. DOD, OPM, and VA said they generally

agreed with the report’s contents. The agencies’ comments, which were

essentially technical in nature or to clarify points, have been incorporated

Page 15 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
B-276378 

where appropriate. OMB was unable to provide official comments on our

draft report within the timeframe we requested. However, we discussed

and resolved comments of a technical nature with OMB staff familiar with

physicians’ pay issues and made changes to the report where appropriate.

We are sending copies of this report to the Chairmen and Ranking

Minority Members of interested congressional committees; the Secretaries

of HHS, Defense, and VA; and the Directors of OPM and OMB. Copies will be

made available to others on request.

Major contributors to this report were Larry Endy, Ed Tasca, Wayne

Barrett, and Jessica Botsford. Please contact me at (202) 512-9039 if you

have any questions concerning this report.

Sincerely yours,

Michael Brostek

Associate Director

Federal Management and

 Workforce Issues

Page 16 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Page 17 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Contents

Letter 1

Appendix I 

Additional Analyses of

Federal and Private

Sector Physicians’

Compensation

22

Federal Physicians’ Pay by Years of Service 22

Federal Physicians’ Pay by Position 24

Other Compensation 25

Appendix II 

Descriptions of

Special Payment

Provisions and Roles

of Federal Physicians

32

Types of Special Payments to Physicians 32

Roles of Federal Physicians 36

Appendix III 

Objectives, Scope,

and Methodology

41

Appendix IV 

Number of Full-Time

Federal Physicians

(September 1996)

46

Tables Table 1: Annual Physicians’ Pay for Federal Physicians in

Selected Agencies

5

Table 2: Annual Basic Pay for Federal Physicians in Selected

Agencies

6

Table 3: Annual Special Pay for Federal Physicians in Selected

Agencies

7

Table 4: Types and Amounts of Special Pay Received by Military

and Commissioned Corps Physicians

8

Table 5: Authorized Maximum Special Pay Amounts under Title

38

8

Table 6: Federal and Private Sector Physicians’ Pay by Selected

Medical Specialties

11

Page 18 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Contents

Table 7: Physicians’ Pay for VA, Military, and Private Sector

Physicians in Thoracic Surgery, Radiology, and Anesthesiology

Specialties

13

Table I.1: VA, HHS, and Commissioned Corps Average Physicians’

Pay by Years of Service

23

Table I.2: Average Federal Physicians’ Pay by Position 25

Table I.3: Types of Private Sector Employer-Provided Benefits 28

Table I.4: Other Types of Pay Received by HHS Physicians (1996) 29

Table I.5: Examples of Other Pay Received by Physicians in the

Military

30

Table I.6: Allowances Received by Military and Commissioned

Corps Physicians

31

Table II.1: PCAs by Agency (Fiscal Year 1996) 33

Table II.2: Length-of-Service and Special Pay Amounts for VA

Physicians Paid Under Title 38

34

Table II.3: Number of Physicians by Category and Number

Receiving PCAs (Fiscal Year 1996)

37

Table III.1: Information on Private Sector Studies 43

Figures Figure 1: Federal and Private Sector Physicians’ Pay by Selected

Medical Specialties

10

Figure 2: Physicians’ Pay for VA, Military, and Private Sector

Physicians in Thoracic Surgery, Radiology, and Anesthesiology

Specialties

12

Figure I.1: VA, HHS, and Commissioned Corps Average

Physicians’ Pay by Years of Service

23

Figure I.2 Average Federal Physicians’ Pay by Position 25

Page 19 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Contents

Abbreviations

AMGA American Medical Group Association

CDC Centers for Disease Control

C.F.R Code of Federal Regulations

COLA Cost-of-living allowance

CSRS Civil Service Retirement System

DOD Department of Defense

FDA Food and Drug Administration

FERS Federal Employees Retirement System

HHCS Hospital & Healthcare Compensation Service

HHS Department of Health and Human Services

HMO Health Maintenance Organizations

IHS Indian Health Service

MGMA Medical Group Management Association

NIH National Institutes of Health

OMB Office of Management and Budget

OPM Office of Personnel Management

PCA Physicians Comparability Allowance

U.S.C. United States Code

VA Department of Veterans Affairs

Page 20 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Page 21 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix I 

Additional Analyses of Federal and Private

Sector Physicians’ Compensation

In addition to the primary comparisons discussed in this report, we

developed additional analyses of physicians’ compensation. This appendix

presents average pay information, when it was available, based on

physicians’ years of service and pay grades or position types.13 We also

discuss other aspects of compensation in addition to basic and special

pay, including (1) employers’ contributions to the costs of physicians’

retirement and health and life insurance benefits—also referred to as

nonwage compensation; (2) other types of premium and incentive pay paid

under titles 5 and 37 to some physicians; and (3) tax-free allowances for

subsistence, housing, and other expenses paid under title 37 to most

physicians in the military and the Commissioned Corps.

Federal Physicians’

Pay by Years of

Service

Consistent with previous comparisons in this report, VA and HHS physicians

receiving title 38 special pay were paid more than other federal physicians

based on their years of service. For HHS physicians paid under title 5 and

Commissioned Corps physicians paid under title 37, differences in pay

narrowed as years of service increased. Average pay for HHS title 5

physicians and Commissioned Corps physicians was nearly the same for

physicians with more than 20 years of service—$118,650 and $119,145,

respectively. For military physicians, information on amounts of special

pay was not readily available in the years-of-service groupings we

requested. Figure I.1 shows comparisons of average physicians’ pay based

on years of service (see table I.1 for dollar amounts).

13Because information was not available from the pay data provided, we did not develop pay

comparisons based on physicians’ roles as clinicians, researchers, teachers, or administrators.

Page 22 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix I 

Additional Analyses of Federal and Private

Sector Physicians’ Compensation

Figure I.1: VA, HHS, and

Commissioned Corps Average

Physicians’ Pay by Years of Service

0

30,000

60,000

90,000

120,000

150,000

Physicians' pay

1 to 4 5 to 9 10 to 19 20 or more

Years of service

VA title 38

HHS title 5 receiving 38 special pay

HHS title 5 eligible for PCAs

Commissioned Corps title 37

Source: GAO analysis of information provided by VA and HHS.

Table I.1: VA, HHS, and Commissioned

Corps Average Physicians’ Pay by

Years of Service Years of experience VA title 38

HHS with title

38 special pay HHS title 5

Commissioned

Corps

1 to 4 $117,035 $98,535 $91,535 $63,270

5 to 9 127,500 118,080 99,150 87,005

10 to 19 134,330 136,175 108,240 97,890

20 and more 137,910 148,470 118,650 119,145

Source: GAO analysis of information provided by VA and HHS.

Page 23 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix I 

Additional Analyses of Federal and Private

Sector Physicians’ Compensation

Federal Physicians’

Pay by Position

For executive-level pay,14 the average pay for VA physicians exceeded that

of HHS title 5 physicians by $17,580, or about 12 percent. The average pay

for these HHS physicians exceeded the average for Commissioned Corps

physicians in O-7 and O-8 pay grades (Admiral) by $10,455, or about

8 percent, and military physicians in O-7, O-8, and O-9, pay grades

(General) by $12,645, or about 10 percent.

For staff-level pay, the average for VA physicians (first level supervisors,

“chief grade,” and below) exceeded that of HHS title 5 physicians who were

paid under the General Schedule by about 24 percent, or $30,405. The

average pay for military and Commissioned Corps physicians was 39 and

24 percent less than the average for VA physicians. The average pay for HHS

physicians was about the same as the average for Commissioned Corps

physicians and about 20 percent more than the average for physicians in

the military.

Physicians’ pay for military and Commissioned Corps physicians varied

considerably by pay grade. Pay for Commissioned Corps physicians in the

O-3 pay grade averaged $39,030 and in the O-6 pay grade averaged

$118,845. According to DOD officials, a large percentage of military

physicians at the O-3 level are in graduate medical education programs in

either internships or residency training. These physicians were not eligible

for incentive or multiyear special pays that averaged about $27,000 and

were available to military physicians in higher pay grades. Figure I.2 shows

physicians’ pay by type of position (see table I.2 for detailed dollar

amounts).

14Includes VA physicians in the “executive grade” and higher, including Senior Executive Service and

executive level equivalents. According to 38 U.S.C.7404(b)(2), VA officials in the executive grade must

hold the position of chief of staff at a hospital, medical center, outpatient clinic (independent), or

comparable position. Title 5 executives are generally those in the Senior Executive Service or under

the Executive Schedule.

Page 24 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix I 

Additional Analyses of Federal and Private

Sector Physicians’ Compensation

Figure I.2 Average Federal Physicians’

Pay by Position

0

40,000

80,000

120,000

160,000

Physicians' pay

Executive Staff

Physicians' positions

VA title 38

HHS title 5 eligible for PCAs

Commissioned Corps title 37

Military title 37

Source: GAO analysis of pay data provided by federal agencies.

Table I.2: Average Federal Physicians’

Pay by Position

Pay grade VA title 38 HHS title 5

Commissioned

Corps Military title 37

Executive $146,240 $128,660 $118,205 $116,015a

Staff 128,215 97,810 97,265 78,160

aFor physicians at the O-7, O-8, and O-9 levels, GAO calculated this amount from DOD payroll

data on basic pay and DOD program information on special pay.

Source: GAO analysis of information provided by federal agencies.

Other Compensation Federal physicians may also be eligible for other types of compensation,

such as nonwage compensation, incentive or premium pay, or allowances.

In some cases, only small numbers of federal physicians receive these

Page 25 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix I 

Additional Analyses of Federal and Private

Sector Physicians’ Compensation

benefits. In the case of nonwage compensation for both federal and

private sector physicians, benefit costs were not always quantified. When

they were quantified, available estimates of benefit costs generally were

not calculated in a consistent fashion that permitted meaningful

comparisons among categories of physicians, either within the federal

sector or between the federal and private sectors. We therefore did not

include information on these other benefits in our principal comparisons.

Employer-Provided

Nonwage Compensation

Nonwage compensation includes employers’ retirement benefit

contributions and employers’ shares of physicians’ health and life

insurance costs.15 Nonwage compensation paid by federal agencies on

behalf of their employees ranged from 19 to 40 percent of basic pay.

Studies of private sector physicians that we reviewed did not contain

similar information on nonwage compensation. However, a 1994

Department of Labor study of employee benefits showed that, for

white-collar professional workers in the private sector, the cost of

employer-provided nonwage compensation (i.e., health and life insurance,

retirement, social security, and workers’ compensation benefits) was

about 23.4 percent of basic pay. Federal physicians paid under titles 5 and

38 are required to pay for a share of their nonwage compensation. Private

sector organizations may also require their physicians to contribute

toward the costs of these benefits. Information on the costs of nonwage

compensation that physicians received under titles 5, 37, and 38 and

according to private studies follows.

Title 5 Physicians: Based on information from the HHS payroll system, the

government’s costs for nonwage compensation averaged about $16,480 or

about 19 percent of basic pay for the HHS physicians paid under title 5. This

amount included the government’s share of retirement benefit costs under

the Civil Service Retirement System (CSRS) or the Federal Employees

Retirement System (FERS) as well as the government’s share of health and

life insurance costs. A more general measure of indirect cost is contained

in OMB Circular A-76.16 This circular states that in 1996 the standard cost

factor for federal civilian employees’ retirement benefits was 23.7 percent,

for life insurance and health benefits it was 7.05 percent, and for

miscellaneous fringe benefits it was 1.7 percent.

15For more information on employer-provided benefits, see Tax Policy: Effects of Changing the Tax

Treatment of Fringe Benefits (GAO/GGD-92-43, Apr. 7, 1992).

16Circular A-76 establishes federal policy for the performance of recurring commercial activities and

provides guidance for determining whether recurring commercial activities should be operated under

contract with commercial sources, in-house, or through interservice support agreements.

Page 26 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix I 

Additional Analyses of Federal and Private

Sector Physicians’ Compensation

Title 38 Physicians: According to a VA official, the total cost of nonwage

compensation for its employees was about 25 percent of basic and special

pay. In 1996, average basic and special pay for VA physicians was about

$128,540. Based on VA estimates, nonwage compensation would be about

$32,135 if these benefits averaged 25 percent of physicians’ pay.

The dollar value of nonwage compensation for VA physicians was higher

than the dollar value of these benefits for HHS physicians paid under title 5.

Physicians paid under title 38 can include physicians’ special pay as part of

basic pay in determining retirement annuities under CSRS and FERS. In

contrast, PCAs earned by title 5 physicians and special payments to

physicians in the military and the Commissioned Corps are not considered

part of basic pay for retirement benefit calculation purposes.

Title 37 Physicians: For fiscal year 1996, the DOD actuary estimated the

cost of military retirement benefits to be 32.9 percent of basic pay. Costs

of other nonwage compensation for military personnel were 1.45 percent

for medicare hospital insurance benefits and 6.2 percent for old age,

survivors, and disability insurance benefits on basic pay up to $62,700.

Physicians in the military and the Commissioned Corps and their

dependents may receive free health care benefits in military facilities, but

DOD has not developed, in terms of basic pay, information on the cost of

providing these benefits.

Physicians in the military and the Commissioned Corps also may receive

other benefits and privileges that are neither easily quantified nor readily

susceptible to comparison. Examples of several of these benefits include

eligibility to purchase goods and services at military base commissaries

and exchanges at prices generally lower than those charged by

commercial facilities and access to military service clubs and other

DOD-sponsored recreational facilities.

Further, these physicians have the option of declaring a state of residence,

regardless of where they are actually stationed or the length of time they

spend in that state. This can be of significant value for those selecting

residency in states with no personal income taxes. While these benefits

and privileges can be of considerable value to physicians in the military

and the Commissioned Corps, we did not attempt to estimate their

comparative values or costs.

Private Sector Physicians: Information from studies of private sector

physicians showed that the organizations that were surveyed also

Page 27 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix I 

Additional Analyses of Federal and Private

Sector Physicians’ Compensation

provided physicians with nonwage compensation. Table I.3 shows

information on the types of benefits provided and the percentage of survey

respondents providing the benefit. These studies did not provide

information on total employer costs of these benefits or on the cost of

these benefits as a percentage of basic pay.

Table I.3: Types of Private Sector

Employer-Provided Benefits

Hospital and

Healthcare

Compensation Service

(January 1997 data)

Sullivan, Cotter, and

Associates,

Incorporated (January

1996 data)

Private sector organizations

Type of benefit

Percentage providing

benefit

Percentage providing

benefit

Retirement a 95

Defined benefit plan 63 b

Defined contribution plan 81 b

Group medical insurance 99 100

Group life insurance 97 99

aTotal percentage providing retirement benefits not reported.

bPercentage receiving each type of retirement benefit not reported.

Source: Studies of private sector physicians’ pay.

In addition to the benefits shown in table I.3, other benefits for which

some organizations provided payment included vision care, professional

organizations’ dues, continuing education expenses, personal time off, and

flexible benefit plans.17 Federal agencies may also pay educational and

training expenses for their physicians.

The HHCS study indicated that about 60 percent of the 179 participant

organizations that responded offered a “fixed” set of employee fringe

benefits, 32 percent offered a “flexible” or “cafeteria” set of benefits, and

8 percent offered both fixed and flexible benefits. Flexible benefit or

cafeteria plans are generally not available to federal employees.

Premium, Incentive, and

Other Types of Pay

Some physicians paid under titles 5 and 37 also received premium,

incentive, or other types of pay based on factors such as hours of duty,

17Flexible or cafeteria benefit plans allow employees to choose from a list of fringe benefits that best

fit their families’ needs. Benefits commonly offered by flexible benefit plans include medical and

dental insurance, life insurance, accidental death and disability insurance, and long-term disability

insurance.

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Appendix I 

Additional Analyses of Federal and Private

Sector Physicians’ Compensation

possession of special skills, performance, or working under extreme

conditions. These other types of pay were not based on an individual’s

occupation as a physician but were earnings based on the

above-mentioned circumstances. For those physicians receiving these

types of pay, compensation was increased by amounts that ranged from a

few dollars to over $24,000. Based on agency-provided information, tables

I.4 and I.5 list for physicians paid under titles 5 and 37 (1) other types of

pay; (2) numbers of physicians receiving the pay; (3) average amounts

received; and (4) where available, ranges of compensation received.

Title 5 Physicians: Table I.4 contains information on other types of pay

earned by at least 50 HHS physicians.

Table I.4: Other Types of Pay Received

by HHS Physicians (1996) 

Types of additional paya

Number receiving

compensation

Average amount

received

Range of

compensation

received

Award 652 $1,610 $100 to $13,565

Overtime 330 3,100 5 to 21,865

Holiday 145 585 5 to 3,780

Night 82 1,125 5 to 6,180

Uniform 63 240 15 to 415

Retentionb 62 11,100 750 to 24,525

Sunday 58 850 40 to 4,935

aPhysicians may receive more than one type of additional pay. Also, HHS physicians receiving

special payments under title 38 cannot earn premium pay that is paid under chapter 55 of title 5

(e.g., overtime pay, holiday premium pay, night pay differentials, and Sunday premium pay).

bHHS’s personnel manual states that physicians who receive PCAs may also receive retention

allowances. The manual further states that every effort must be made to ensure that they are

authorized only in extreme cases.

Source: GAO analysis of HHS payroll information.

Physicians paid under title 5 may also be eligible for other payments, such

as recruitment bonuses, relocation allowances, and certain cost-of-living

allowances (COLA) that are not identified in table I.4.

Title 37 Physicians: Other types of pay that physicians in the military

received are listed in table I.5.

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Additional Analyses of Federal and Private

Sector Physicians’ Compensation

Table I.5: Examples of Other Pay

Received by Physicians in the Military

Number receiving pay

Average annual

amount received

Types of pay Army Air Force Army Air Force

Aviator career incentive 189 502 $3,980 $4,270

Hostile fire 98 95 1,800 1,800

Foreign language 2 103 805 1,075

Source: GAO analysis of Army and Air Force pay data.

Some physicians may be eligible to simultaneously receive more than one

type of incentive or special pay. Unlike some title 5 physicians, physicians

in the military and the Commissioned Corps do not receive compensation

for working overtime, at night, on Sundays, or on holidays.

Title 38 Physicians: According to a VA official, VA full-time physicians are

considered to be on duty for 24 hours a day. As such, they are not eligible

for premium pay, such as overtime and for work on Sunday or at night. VA

physicians also do not receive locality-based comparability payments

under 5 U.S.C. 5304; however, they may receive geographic location pay if

they work in areas where extraordinary recruitment or retention

difficulties exist. They may also be eligible for recruitment bonuses and

retention allowances under 38 U.S.C. 7410.

Allowances for Military

and Commissioned Corps

Physicians

Physicians in the military and the Commissioned Corps may be entitled to

a variety of different allowances related to such elements as subsistence,

housing, family separation, and COLAs. Table I.6 shows, for these

physicians, average annual allowances received and the number of

physicians receiving them. Allowances are tax free and generally vary

depending on marital status, family size, and pay grade.

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Additional Analyses of Federal and Private

Sector Physicians’ Compensation

Table I.6: Allowances Received by Military and Commissioned Corps Physicians

Number receiving allowance Average allowance amounts

Types of allowance Army Air Force Corps Army Air Force Corps

Basic housing 4,085 3,611 1,443 $8,265 $8,355 $9,540

Basic subsistencea 4,726 4,068 1,458 1,800 1,805 1,795

Overseas station-COLA 846 429 137 5,125 6,050 5,940

Overseas station-housing 215 229 N/A 8,950 5,740 N/A

Overseas station-other housing 1,037 904 N/A 680 450 N/A

Family separation 96 51 N/A 1,330 1,910 N/A

Variable housingb 3,801 3,580 1,256 2,755 1,890 3,895

Note: N/A indicates data were not applicable.

aDifferences in basic subsistence amounts were due to differences in time periods for which the

data was collected.

bVariable housing allowances supplement basic quarters allowances for service members who

reside in high-cost areas in the United States.

Source: GAO analysis of Army, Air Force, and Commissioned Corps pay data.

Because allowances are not subject to federal income tax, physicians in

the military and the Commissioned Corps also receive a tax advantage that

can be expressed as the additional income that they would have to receive

in order to be left with the same net take-home pay, if allowances were

taxable. Because many allowances vary by pay grade and number of

dependents, the tax advantage varies. For example, according to

January 1996 military compensation pay tables, the tax advantage for an

officer in the O-4 pay grade ranged from $1,889 to $3,813, depending on

family size and years of service. For an officer in the O-6 pay grade, it

ranged from $2,168 to $4,777.

Page 31 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix II 

Descriptions of Special Payment Provisions

and Roles of Federal Physicians

In addition to basic pay, federal physicians may be entitled to various

special payments, depending on the laws under which they are paid. Each

of the laws—title 5 for most civilian physicians in federal agencies other

than VA, title 38 for VA physicians and selected title 5 physicians, and title

37 for physicians in the military and the Commissioned Corps—spells out

(1) requirements that are to be met for physicians to receive special

payments and (2) dollar ranges for these payments. Special payments may

be provided in varying amounts based on different factors, such as a

physician’s years of service, medical specialty or category of service,

geographic location, or length-of-service agreement. In general, physicians

who received special payments under titles 37 and 38 received more types

and higher amounts of these payments than physicians paid under title 5.

The following sections discuss these special payment provisions and the

roles of federal physicians paid under these laws.

Types of Special

Payments to

Physicians

Title 5-PCAs Federal physicians paid under title 5 may be eligible for PCAs if agencies

document significant recruitment and retention problems and if physicians

enter into a service agreement with their employing agencies. These

agreements require physicians to complete periods of service of 1 or 2

years.

The maximum allowance is $14,000 per year for physicians with less than

24 months of federal service and $20,000 for physicians with more than 24

months of service. While these are the maximum amounts authorized by

law, some agencies have established schedules that limit PCAs based on the

characterization of the positions in which physicians serve. For example,

for physicians with more than 24 months of service, the maximum

allowance is $10,000 for occupational health physicians and for physicians

performing disability evaluations, according to HHS’ personnel manual.

PCAs are not considered basic pay for purposes of calculating premium pay

(e,g., overtime, night, and holiday pay), payments for accumulated and

accrued annual leave and severance pay, compensation for work injuries,

or retirement and life insurance benefits.

Page 32 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix II 

Descriptions of Special Payment Provisions

and Roles of Federal Physicians

Table II.1 shows the agencies employing the most physicians under title 5

and the percentage of physicians receiving PCAs in fiscal year 1996.

Table II.1: PCAs by Agency (Fiscal

Year 1996) 

Federal departments and

agencies

Number of

physicians

eligible for PCAs

Physicians

with PCAs

Percentage

with PCAs

HHS 1,363 1,019 75

DOD 633 487 77

Justice 198 183 92

State 60 54 90

Other agencies (14) 148 98 66

Total 2,402 1,841 77

Source: GAO analysis of OMB information.

The number of physicians eligible for PCAs in the 14 other agencies ranged

from 1 to 35; 8 of these agencies employed fewer than 10 physicians. Five

of the 14 agencies did not provide PCAs to any of their physicians. Officials

with the National Aeronautics and Space Administration, with 27 eligible

physicians, and the Tennessee Valley Authority, with 4 eligible physicians,

told us that PCAs were not necessary to retain or recruit physicians in their

agencies.

Title 38 Special Payment

Provisions

Title 38 authorizes several different special payments for physicians. While

most of the physicians receiving special payments under title 38 are

employed by VA, OPM has authorized agencies (HHS, DOD, and the

Department of Justice) that pay physicians under title 5 to pay selected

physicians’ special payments under title 38. Physicians receiving these

payments are not eligible to receive PCAs. Under title 38, physicians may be

eligible for one or more of the following types of special payments.

• Full-time status: Physicians who have full-time status are entitled to a

special payment of $9,000 annually.

• Length of service: Physicians are entitled to length of service awards that

range from $4,000 for 2 to 4 years of service to $25,000 for 12 or more

years of service. VA has established a schedule for length of service pay,

which is shown in table II.2.

Page 33 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
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Descriptions of Special Payment Provisions

and Roles of Federal Physicians

Table II.2: Length-of-Service and

Special Pay Amounts for VA

Physicians Paid Under Title 38

Length of service

At least But less than

Special pay

amount

2 years 3 years $4,000

3 years 4 years 6,000

4 years 6 years 9,000

6 years 8 years 12,000

8 years 12 years 15,000

12 years 20 years 18,000

20 years 25 years 20,000

25 years 25,000

Source: VA.

• Scarce medical specialty: Physicians serving in medical specialties for

which there are extraordinary recruitment and retention difficulties may

receive payments of up to $40,000. Physicians serving in executive

positions in VA’s headquarters office are prohibited from receiving scarce

specialty pay.

• Responsibility pay: Physicians serving in executive positions either in field

offices or in VA’s headquarters office may be eligible for amounts ranging

from $4,500 for a service chief to $45,000 for the Under Secretary of

Health, based on the specific position in which they serve.

• Board certification: Physicians are entitled to a special payment of $2,000

if they are board certified. If they are certified in a subspecialty or

secondary board, they are entitled to an additional $500.

• Geographic location: Physicians serving in specific geographic locations

where extraordinary recruitment or retention difficulties exist are eligible

for geographic location pay of up to $17,000 annually.

• Exceptional qualifications: VA’s Under Secretary of Health may approve, on

a case-by-case basis, special payments at an annual rate of not more than

$15,000 for physicians with exceptional qualifications within a specialty.

Page 34 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix II 

Descriptions of Special Payment Provisions

and Roles of Federal Physicians

Title 5 Physicians

Receiving Title 38 Pay

HHS, DOD, and the Department of Justice, which pay physicians under title

5, were authorized, under a delegation of title 38 pay authority from OPM,

to use the same categories of special payments to physicians described in

the previous section in paying their physicians. OPM delegated title 38 pay

authority to these agencies and VA18 in November 1993 to provide them

with added flexibilities needed to maintain a quality health care staff. HHS

agencies began using its delegated authority to make special payments to

physicians under title 38 in August and September 1995. DOD has

formalized a plan for the title 38 special pay authority, but as of April 1997,

it had not used the authority to pay its physicians. Justice has not

formalized a plan for using this authority. On June 27, 1997, OPM extended

title 38 pay authority to HHS, DOD, and Justice through June 30, 2002.

HHS guidelines for implementing OPM’s delegation of authority provide for

almost identical special payment amounts using criteria similar to those

used by VA. HHS limits special payments for length of service to $18,000

compared with $25,000 for VA. Also, by law (5 U.S.C. 5371(c)(1)), members

of the Senior Executive Service are not eligible for special payments under

title 38.

Title 37 Special Payment

Provisions

Under title 37, physicians in the military and Commissioned Corps

physicians are eligible for types of special payments for physicians similar

to those available to title 38 physicians. Special payments and the amounts

authorized are discussed below.

• Variable special pay: Physicians in the military and Commissioned Corps

physicians are entitled to variable special pay. Variable special pay is paid

monthly and ranges from $1,200 annually for interns to $12,000 annually

for officers with 6 but less than 8 years of service. After 8 years, this pay

declines based on the theory that future retirement benefits and other

types of special payments will serve as greater incentives for physicians to

stay on active duty.

• Board-certified special pay: Physicians who are board-certified in their

respective specialties are entitled to amounts ranging from $2,500 to

$6,000 annually, based on their years of service. Physicians with less than

10 years of service receive $2,500 annually; physicians with 18 or more

years of service receive $6,000 annually. Board certified pay is paid

monthly.

18OPM’s delegation agreement with VA expands the use of some of VA’s existing title 38 authorities. It

does not involve special payments to physicians or other compensation for physicians.

Page 35 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix II 

Descriptions of Special Payment Provisions

and Roles of Federal Physicians

• Additional special pay: Physicians who sign an agreement to serve at least

1 additional year from the effective date of their service agreements are

entitled to $15,000 annually, which is paid at the beginning of the 1-year

period. Physicians who are undergoing internships or initial residency

programs do not qualify for additional special payments.

• Multiyear special pay: Physicians who are fully qualified in designated

medical specialties are eligible to enter into written agreements to provide

2, 3, or 4 more years of service. The duration of the agreement determines

the amount payable. Annual amounts ranging from $2,000 to $14,000 are

payable upon acceptance of the agreement and on the anniversary of the

agreement. To receive multiyear special pay, physicians must have

completed any service commitment incurred for medical education and

training or completed 8 years of service. In either case, these physicians

must be below the pay grade of O-7 (General or Admiral). Every year, the

Assistant Secretary of Defense for Health Affairs convenes a Triservice

Flag Officer Review Board to determine the annual amount provided for

each specialty, to be based primarily on the staffing level in each specialty

community.

In fiscal year 1996, physicians who signed 4-year agreements could receive

$14,000 for each year of the agreement in medical specialties, such as

family practice, orthopedic surgery, emergency medicine, internal

medicine, and urology. Other medical specialties received less. Also,

multiyear special pay was not available for all specialists; for example, in

fiscal year 1996, anesthesiologists and physicians in the pediatric and

internal medicine subspecialties were not eligible to sign agreements for

multiyear special pay under title 37.

• Incentive special pay: Physicians who sign an agreement to remain on

active duty for at least 1 year and who are fully qualified in medical

specialties designated as critical and practice in that specialty a substantial

portion of the time or who meet other criteria related to their assignment

may be authorized to receive up to $36,000 in incentive special pay.

Physicians must be in pay grade O-6 and below to receive this pay, which

is a lump-sum payment at the beginning of the 12-month period. The Flag

Officer Review Board annually determines the authorized amount of

incentive special pay for each specialty.

Roles of Federal

Physicians

Federal physicians serve in a variety of categories and medical specialties,

depending on the mission of the employing federal agency and the needs

Page 36 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix II 

Descriptions of Special Payment Provisions

and Roles of Federal Physicians

of the population served. The following sections describe, by pay

authority, the roles that these physicians fill in their employing agencies.

Title 5 Physicians Federal regulations related to PCAs (5 C.F.R 595) require heads of agencies

to establish, as a minimum, the following separate categories of physicians

for purposes of determining if there are significant recruitment and

retention problems.

• Category 1: Positions primarily involved in the practice of medicine or

direct service to patients in hospitals, clinics, public health programs,

diagnostic centers, and similar settings.

• Category 2: Positions primarily involved in the conduct of medical

research and experimental work or the identification of causes or sources

of diseases or disease outbreaks.

• Category 3: Positions primarily involved in the evaluation of physical

fitness or the provision of initial treatment of on-the-job illness or injury.

• Category 4: Positions not described above, including positions involving

disability evaluation and rating, training, or the administration of patient

care or medical research and experimental programs.

PCAs may be paid only to physicians serving in positions in categories

determined by the agency to have significant recruitment and retention

problems. Table II.3 shows, for the agencies with the most physicians

being paid under title 5, the number of physicians in each category and the

number receiving PCAs.

Table II.3: Number of Physicians by Category and Number Receiving PCAs (Fiscal Year 1996) 

(Direct care providers) (Researchers) (Fitness examiners)

(Administrators or

disability examiners)

Category 1 Category II Category III

Category IV

Federal Agency Number PCAs Number PCAs Number PCAs Number PCAs

HHS 404 343 813 532 0 0 146 144

DOD 485 354 32 29 116 104 0 0

Justice 198 183 0 0 0 0 0 0

State 51 45 0 0 0 0 9 9

Other 31 26 33 15 18 7 66 50

Totals 1,169 951 878 576 134 111 221 203

Source: GAO analysis of OMB data.

Page 37 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix II 

Descriptions of Special Payment Provisions

and Roles of Federal Physicians

In addition to HHS physicians who were paid under title 5, some physicians

in HHS were eligible for special payments under title 38. In fiscal year 1996,

HHS provided physicians’ special payments under title 38 to 294 physicians.

Most of these physicians were employed in the Food and Drug

Administration (FDA), Indian Health Service (IHS), and NIH.

Even though physicians in the federal government are paid under a

number of different pay plans, there is some commonality in the types of

positions they fill in the agencies for which they work.

The following section illustrates the roles of federal physicians.

Titles 5, 37, and 38 physicians in HHS: HHS physicians may be paid as

civilians under title 5 and as Commissioned Corps personnel under title 37.

In addition, some title 5 physicians received special payments under title

38 as a result of the previously mentioned delegation of authority.

Examples of physicians’ roles in the HHS agencies that employ the most

physicians are listed as follows:

• FDA: Approximately 95 percent of FDA’s physicians are involved in

researching and evaluating the clinical research data related to technology

assessment, investigational studies, or marketing of medical/patient care

services or products. According to OMB’s annual report on PCAs, FDA

competes with pharmaceutical companies for physicians qualified to

support the regulation of food, prescription and over-the-counter drugs,

and medical devices.

• NIH: NIH physicians are involved in intramural medical research, extramural

and collaborative research, or the administration of these programs. NIH

competes with the academic community and with private sector

pharmaceutical firms for physicians with outstanding research skills.

• IHS: IHS provides a comprehensive health services delivery system,

including hospital and ambulatory medical care and prevention and

rehabilitation services, for American Indians and Alaska Natives. Much of

the population served by IHS is scattered over long distances and in remote

areas. IHS physicians are paid as civil servants under title 5 or as

Commissioned Corps officers under title 37. IHS has 914 physicians and

administers 37 hospitals and numerous health centers.

• Centers for Disease Control (CDC): Physicians at CDC provide leadership

and direction in areas such as the prevention of infectious and chronic

diseases, environmental health, occupational safety, international health,

epidemiologic and laboratory research, data analysis and information

management, and health promotion.

Page 38 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix II 

Descriptions of Special Payment Provisions

and Roles of Federal Physicians

Title 38 physicians at VA: According to VA payroll system data, VA had over

7,300 full-time physicians that had been employed for at least 1 year, as of

December 1996. VA physicians serve in the largest federal medical-care

delivery system in the United States, providing care to over 2.9 million

patients in 1996. These physicians have training in numerous specialties

and provide inpatient and outpatient hospital subacute, rehabilitative and

psychiatric care, and residential and nursing-home care. In addition to

providing patient care, numerous VA physicians are involved in

administering its facilities; conducting basic, clinical, epidemiological, and

behavioral research; and training medical residents and students.

Title 37 Commissioned Corps physicians: Commissioned Corps payroll

data indicated that, as of December 1996, the Corps had over 1,450

full-time physicians who had been on duty for at least 1 year.

Approximately 1,210 or 80 percent of these physicians were with the

following HHS agencies: NIH (473), IHS (337), CDC (331), and FDA (69). Other

Corps physicians either were with the remaining HHS agencies or were

detailed to such other federal agencies as the Bureau of Prisons and the

Coast Guard. In a 1996 report on the Commissioned Corps,19 we noted that

Commissioned Corps officers and federal civilian employees often had

similar duties and some—physicians, nurses, and pharmacists—had

identical duties.

Title 37 military physicians: As of September, 30, 1996, the Army, Navy,

and Air Force had about 13,000 military physicians. About 12 percent of

these physicians had graduated from the Uniformed Services University of

the Health Sciences, a 4-year, tuition free medical school established by

DOD in response to the Department’s need to attract and retain physicians.

About 80 percent of the 13,000 physicians received financial assistance for

their medical education in civilian medical schools under DOD’s Health

Professions Scholarship Program. The remaining physicians were brought

into the military through direct accession.

A wide range of medical specialties are needed to support operational

forces during times of war and other military operations and to maintain

and sustain the well-being of the fighting forces in preparation for war.

Military physicians also provide health care services to nonactive duty

beneficiaries and to the dependents of active and nonactive duty

personnel. Furthermore, military physicians also contribute to research

19Federal Personnel: Issues on the Need for the Public Health Service’s Commissioned Corps

(GAO/GGD-96-55, May 7, 1996).

Page 39 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix II 

Descriptions of Special Payment Provisions

and Roles of Federal Physicians

efforts conducted in areas such as Acquired Immune Deficiency

Syndrome, breast cancer, and blood research. As of September 1996, of

the 13,000 DOD physicians, over 1,000 were serving internships, and about

2,900 were in specialty training programs.

Differences exist between military physicians paid under title 37 and DOD

civilian physicians paid under title 5. According to DOD officials, the DOD

civil service system is structured to hire physicians primarily at the

GS-13/14/15 levels where experience requirements and pay are

significantly higher than they are for military physicians at the O-3 and O-4

levels (approximately 70 percent of the military physicians). The civil

service does not have a significant attrition rate when compared with the

attrition rate of junior military physicians. The result of the different

employment situations is that most civilian physicians are employed at

grade levels comparable with military pay grades O-5 and O-6.

Page 40 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix III 

Objectives, Scope, and Methodology

Because the authority to enter agreements to pay PCAs is due to expire on

September 30, 1997, Representative Constance A. Morella requested a

report on federal and private sector physicians’ pay and benefits.

Following discussions with her office, we agreed that our principal

objectives would be to (1) compare amounts paid to federal physicians

under title 5 to amounts paid under other sections of the U.S. Code with

each other and with amounts paid to private sector physicians,

(2) determine what other types of pay and benefits federally employed

physicians receive, and (3) identify ongoing agency efforts that have the

potential for affecting federal physicians’ pay.

To compare physicians’ pay, we obtained and analyzed information on

physicians’ basic pay and on any special payments that were available only

to physicians. For purposes of this report, basic pay means a rate of pay

established under titles 5, 22, 37, or 38, including a special salary rate

under 5 U.S.C. 5305 (or similar authority) and a locality-adjusted rate of pay

under 5 U.S.C. 5304. On the basis of our preliminary work, we agreed to

obtain physicians’ pay and benefit information for full-time federal

physicians paid under title 5, most of whom were with HHS or DOD;

physicians with the Public Health Service’s Commissioned Corps or on

military duty and paid under title 37; physicians with VA and paid under

title 38; and title 5 physicians with HHS who received special payments

under title 38. We also reviewed federal statutes and regulations on special

pay that is available only to physicians, for information on the various

types of special pay that physicians could receive.

HHS, VA, and the Commissioned Corps provided us with actual annualized

pay data for full-time federal physicians with over 1 year of service for the

12-month period ending December 1996. Payroll information for military

physicians was obtained from Defense Finance and Accounting Service

pay centers for the Army and Air Force. Army and Air Force information

was for the 12-month periods ending January and March 1997,

respectively. The same comparable data used for the Army and Air Force

could not be obtained from the Navy pay and personnel system. According

to DOD officials, because all three military departments use the same pay

rates, Army and Air Force data provide a fairly accurate representation of

pay for military physicians. Unless reported separately, amounts and

averages for DOD military physicians were based on combined information

from the Army’s and Air Force’s payroll systems. According to data from

the Defense Manpower Data Center, as of September 1996, of the 13,051

physicians in the military, 8,955 were in the Army and Air Force. From the

information provided by the Army and Air Force, we could not determine

Page 41 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix III 

Objectives, Scope, and Methodology

median pay amounts or identify amounts paid at the 25th and 75th

percentile for military physicians. We did not independently verify the

accuracy of any pay data we obtained.

DOD’s Directorate of Compensation prepares extensive pay-related

information in the form of pay tables for all military personnel. These

tables show for each pay grade, longevity step, and family size,

information such as basic pay, quarters and subsistence allowances, and

Social Security and federal income tax withholdings. Also, DOD health

affairs staff have developed information showing estimated amounts of

special pay that military physicians in various pay grades are likely to earn

on an annual basis. This information, together with staffing data, can be

used to estimate amounts paid to DOD’s military physicians.

We sought actual rather than estimated payroll data from all agencies for

our primary analyses because these data would more accurately reflect the

pay of physicians. We also sought actual data to avoid the potential

difficulty of comparing data among agencies that used different estimating

methodologies or of comparing estimated and actual data provided by

these agencies. However, actual pay data in the formats and timeframes

we specified were not always readily available.

For information on DOD physicians paid under title 5, DOD program officials

for the Army and Navy provided us with estimated annualized pay data

based on information for an April 1997 pay period, which was multiplied

by 26—the number of pay periods in 1 year. The Air Force obtained annual

physicians’ pay data from its personnel data system. We used the data

provided to avoid the additional time that would have been involved in

collecting actual pay data for these physicians from multiple pay centers.

For pay and benefits data for private sector physicians, we identified

physician compensation studies listed in Modern Healthcare.

20 From the

studies listed and a discussion with the author of the above-mentioned

article, we judgmentally selected and purchased four studies that

contained information on physicians employed primarily in group

practices, HMOs, and hospitals. We selected these studies because they

contained information on (1) physicians practicing in settings that were

similar to those in which federal physicians practiced, rather than

information on physicians operating as sole practitioners and (2) amounts

paid to physicians as salary and direct compensation, rather than as net

income. Because these studies did not contain information on the median

20Modern Healthcare, July 15, 1996.

Page 42 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix III 

Objectives, Scope, and Methodology

pay of all physicians surveyed, we were unable to make across-the-board

comparisons between federal physicians’ pay and private sector

physicians’ pay. However, these studies contained information on median

pay for physicians in selected medical specialties. Where possible, we

compared the pay of VA, Commissioned Corps, and military physicians

with the pay of private sector physicians in the following medical

specialties—general surgery, internal medicine, psychiatry, and family

practice. These were medical specialties where large numbers of federal

and private sector physicians practiced.

The organizations that prepared these pay surveys have been conducting

physician pay studies from 4 to 21 years. We did not independently verify

the data shown in these studies. Information on the scope of these studies

is shown in table III.1.

Table III.1: Information on Private Sector Studies

Study publisher

Time period

covered

Number of

physicians

covered

Number of

medical

specialties

covered

Types of organizations

responding

Hospital & Healthcare Compensation

Servicea

1996 12,676 42

324 hospitals, group

practice facilities, and

HMOs

American Medical Group Association 1995 23,280 69 272 group practices

Medical Group Management Association 1995b 28,928 57 1,380 group practices

Sullivan, Cotter and Associates,

Incorporated 1995 14,000 94

192 hospitals, group

practices, and HMOs

aThe HHCS study contained information on government and nongovernment physicians. We used

the information on nongovernment physicians.

bIn some cases, information was for a more recently completed 12-month period.

Source: Private sector studies indicated.

The preparers of two of these studies cautioned users of their reports that

the data provided by responding medical practices might not be

representative of all physicians or all medical groups because the data

were not based on a random sample of medical groups. Two of these

preparers also recommended the use of medians in evaluating physicians’

pay, because the median is not subject to the distortion that may occur in

the mean (average) when extremely high or low values are included in the

data set. We therefore used medians when presenting private sector data.

However, we used averages in our analyses of federal data because

Page 43 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix III 

Objectives, Scope, and Methodology

median pay was not available for all federal physicians’ groups we

compared. Also, in most cases, the averages differed only slightly from the

medians.

To determine other types of pay and benefits received by federal

physicians, we reviewed (1) federal statutes and regulations on pay and

benefits that physicians could receive in addition to their basic and special

pay and (2) actual pay information provided by the agencies reviewed. We

also asked these agencies for information on the cost of other

compensation that the government paid for, either in whole or in part, but

which was not included in physicians’ pay. For example, employer costs

include amounts paid for Social Security and other federal retirement

benefits and for the government’s share of costs for employees’ health and

life insurance benefits. After receiving the data from these agencies, and

depending on how the agencies formatted the data, we made additional

calculations or reformatted the data to make it as consistent as possible.

Regarding the objective to identify ongoing agency efforts that could

potentially affect physicians’ pay, we asked agency officials if they were

involved in activities that had the potential for affecting physicians’ pay.

In addition to the limitations indicated above:

• We did not make a determination on whether PCAs should be increased or

whether there should be a minimum comparability allowance because we

did not collect and compare information on such factors as (1) physicians’

duties and responsibilities, (2) amounts of supervision physicians either

received or provided, and (3) actual retention and recruitment concerns

experienced.

• The military service pay centers for the Army and Air Force provided us

with total amounts of basic pay, special pay for physicians, incentive pay,

and allowances. From this information, we could calculate averages but

could not determine median or percentile pay.

• Because of the small numbers of physicians involved and the specialized

reasons for which they were hired, we did not compare pay and benefit

data for physicians employed by the Uniformed Services University of the

Health Sciences under 10 U.S.C. 2113 (f)(1) or in the Senior Biomedical

Research Services under 42 U.S.C. 237.

We requested comments on a draft of this report from the Secretaries of

HHS, Defense, and VA; and the Directors of OPM and OMB. Written comments

from HHS and VA and oral comments from DOD and OPM were incorporated

Page 44 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix III 

Objectives, Scope, and Methodology

in the report, where appropriate. Similarly, we incorporated comments

from OMB staff familiar with physicians’ pay issues.

We did our work in Washington, D.C., from December 1996 to August 1997

in accordance with generally accepted government auditing standards.

Page 45 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
Appendix IV 

Number of Full-Time Federal Physicians

(September 1996)

Federal physicians Number

Militarya 13,051

Veterans Affairsb 8,048

Commissioned Corpsc 1,594

Other government physiciansd 2,770

Total 25,463

Note: Numbers of physicians in this table do not correspond to those used as the bases for

analysis in other sections of this report. Our analyses generally were based on physicians that

had 12 months of service during the year.

aPhysicians in the military (Army, Navy, and Air Force) and paid under title 37.

bAlmost all VA physicians are paid under title 38. A few are paid under title 5.

cInformation is for December 1996. Corps physicians are paid under title 37.

dMost of these physicians are paid under title 5 and are with HHS or DOD.

Source: OPM’s Central Personnel Data File, Defense Manpower Data Center, and the

Commissioned Corps.

(410101) Page 46 GAO/GGD-97-170 Analyses of Federal Physicians’ Pay and Benefits
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