Section 619 would increase dental officer additional special pay and provide the Secretary concerned the flexibility to target improved compensation at the junior dental officers who have a continuation rate at the first decision point that continues to fall.
Section 302b of title 37, United States Code, authorizes additional special pay for an officer who is an officer of the Dental Corps of the Army or the Navy or an officer of the Air Force designated as a dental officer, and is on active duty under a call or order to active duty for a period of not less than one year. Additional Special Pay (ASP) provides a retention incentive for dental officers and helps narrow the military-civilian pay gap. Current dental ASP rates have not changed since 1997. As a result, the pay gap between military and civilian pay has widened since authorization of current dental ASP rates.
In the Health Professions Retention-Accession Incentives Study (HPRAIS) I, the Center for Naval Analyses (CNA) showed that "the uniformed-civilian pay gap existed at every career juncture and that this pay gap was greater for specialists than for general dentists." CNA further stated that "the uniformed-civilian pay gap in 2000 dollars is substantial, averaging approximately $69,000 for general dentists and $113,000 for specialists." The American Dental Association's 2001 Survey of Dental Practice and 2002/2003 Survey of Advanced Dental Education reported an average annual net income of $270,000 for dental specialists and $159,550 for general practitioners. It reported that civilian net pay increased per year at a rate of 5 percent for general dentists and 8 percent for specialists. In HPRAIS II and III, CNA stated that "current uniformed dental ASP should be increased," targeting "the group for which compensation increases will have the most impact on improving uniformed dentist retention (those facing stay-leave decisions)."
Military dentistry's current experience validates CNA's findings. Critical shortages of dental officers in the four-to-ten year commissioned service group exists in all of the Services. This shortage, especially in the O-4 pay grade, severely jeopardizes the Department of Defense's (DoD's) ability to maintain an adequate number of general dentists, a reasonable deployment rotation for junior officers, and an adequate pool from which to train dental specialists. The current Navy O-4 pay grade manning at 66 percent is a result of low continuation rates of dental
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officers beyond the first term of service. In Fiscal Year (FY) 2005, only 40 percent of dental officers remained on active duty after the first decision point, down from 60 percent in 2001. Most of these officers leave military service due to high dental education debt and the large inequity in pay when compared to civilian dentists. According to the 2002/2003 Survey of Advanced Dental Education, the average education debt load for dentists graduating from dental schools in 2001 was $132,500, resulting in an average monthly debt payment of $1,200.
This section would target dental officers in these year groups with a dental ASP increase. Present annual dental ASP rates are $4,000 for those with less than three years of service (YOS), $6,000 from three to ten YOS, and $15,000 for ten plus YOS. This section would increase the $4,000 ASP rate to $10,000 and the $6,000 ASP rate to $12,000. These increases would provide increased incentives for junior officers to remain on active duty.
Furthermore, a recent Military Health System value estimation study by the TRICARE Management Activity showed that military dentistry (the direct care system) in FY 2001 delivered a 17 percent "profit margin." Clearly, direct system dental care is more cost-effective than private sector dental care. DoD's severe shortage of military dentists, however, results in productivity losses within our health care facilities that must be made up in the costly civilian sector. In FY 2004, the military departments obligated over $63 million for this private sector dental care; in FY 2005 that amount was $54.4 million.
Multiple factors degrade DoD's ability to staff health care facilities with appropriate levels of qualified dentists. The increased rate of retirements, losses outnumbering gains, and unfilled authorizations -- especially mid-career authorizations -- all point to an impending military dental health crisis at current pay levels for dentists. Annual trends have shown continual decreases in dental officer manning over the past years. Despite the 104 dental officer conversions in FY 2005, Navy dentistry was only manned at 91 percent at the end of FY 2005, down from 99 percent for FY 2000.
Cost Implications: This section seeks to provide to the Secretary concerned the discretionary authority to pay ASP up to the statutory maximum amount of $15,000 per year. The DoD estimates that this section would cost $4.1 million annually.
