Title 38 History and Introduction
Title 38 Physician and Dentist Pay (PDP)
Purpose of Authority
Physician and Dentist Pay (PDP) is a supplementary pay system established to facilitate the recruitment and retention of civilian physicians and dentists.
Statutory History
The Title 38 system was established in 1946 to facilitate the rapid staffing of veterans' hospitals at the end of World War II. At the VA, Title 38 represents a separate personnel system for 12 different occupations utilized in the Veterans Health Administration hospitals. Physicians and dentists at the VA are covered by the provisions of Title 38, Chapter 74 and internal VA implementation policies.
The Office of Personnel Management (OPM) received authority to extend selected provisions of Title 38 to Federal health care positions via the Federal Employees Pay Comparability Act of 1990; the authority is encoded in Section 5371 of Title 5. OPM's authority is limited to specific personnel functional areas, i.e., position classification, pay systems, premium pay and work scheduling. It does not include Title 38 appointment or leave provisions.
Following an extensive interagency study of recruitment and retention problems in health care occupations in 1991-92, OPM delegated selected provisions of Title 38 to several Federal agencies. The delegation agreement between OPM and the Department of Health and Human Services (HHS) was signed on 12/14/93. It required coordination and communication with other Federal departments on the use of delegated provisions and stipulated that HHS was to avoid unwarranted competition with other Federal departments.
Among the authorities delegated was Title 38 Physician Special Pay (PSP) and hours of employment for physicians and dentists. Implementation of this authority required the consensus of the Interagency Committee on Health Care Occupations. That Committee is comprised of the Departments of Defense, HHS, Justice, and Veterans Affairs, and the Armed Forces Retirement Home and is chaired by OPM. The initial HHS PSP plan was approved by the Committee in 1995; a revised plan was approved in 1998. In July 2007, the HHS Physician and Dentist Pay plan was approved. The HHS plan is published as HHS Instruction 590-1, Title 38 Physician and Dentist Pay.
Discretionary Application
The delegation agreement made PDP available within HHS for highly qualified physicians and dentists who are engaged in direct patient care services or services incident to patient care. While payment of PDP is optional with each HHS component, once PDP is paid to a position or specific category of positions, other physicians or dentists performing the same or similar duties also must be considered for PDP.
NIH Implementation and Evaluation
At NIH, implementation of PSP initially was limited to physicians who performed direct patient care services. Coverage was extended to physicians who oversee large interventional clinical trials in 1996 and was expanded to include dentists in 1998.
NIH policies and procedures governing the use of PDP at NIH are reviewed periodically by the Director of NIH and other NIH management officials. Evaluations also are conducted to assess the effect of PDP on recruitment and retention of physicians and dentists, and to identify the extent of NIH’s use of PDP and any problems associated with the authority.
