Veterans Administration practice

VA dermatology overview

VA dermatology involves practicing within the U.S. Department of Veterans Affairs health system, serving a unique population, military veterans. Physicians benefit from working in a mission-driven, government-funded environment with access to national resources, advanced technology, and structured work hours that support work-life balance.

Why dermatologists choose this

• Serve a mission-driven population: veterans who served the country.

• Predictable hours with strong work-life balance.

• Federal employment benefits, including pension, health coverage, and paid leave.

• Robust telemedicine infrastructure and national EHR integration.

• Opportunities for research and access to VA and NIH grant funding.

• Collegial work environment with minimal pressure to perform cosmetic procedures.

How this model works

Employment and structure

Dermatologists are employed by the federal government and work at VA medical centers or affiliated outpatient clinics. Employment is typically full-time with a clearly structured schedule and defined responsibilities in clinical care, research, or education.

Patient care model

The VA provides medically necessary dermatologic care to veterans only. Physicians see a diverse range of skin conditions including chronic dermatoses, skin cancer, and rare diseases. There is little to no cosmetic dermatology. Continuity of care is emphasized, and patient satisfaction is generally high.

Administrative support

VA dermatologists are fully supported by centralized systems for billing, credentialing, HR, and IT. The EHR system is standardized across all VA facilities, improving coordination and efficiency. Physicians are not burdened by insurance negotiations or productivity targets.

Compensation and benefits

Salaries are based on federal pay scales and are not tied to productivity. Physicians receive generous federal benefits including retirement pensions (FERS), health insurance, malpractice coverage, CME funding, and paid time off. Pay can increase with tenure, academic involvement, or leadership roles.

Technology and operations

The VA is a national leader in teledermatology, offering advanced infrastructure and support. All sites use the same EHR system, allowing for seamless communication and continuity across locations. Operational consistency supports collaboration and data sharing.

Career growth

VA dermatologists can pursue multiple avenues of advancement: leadership (such as section chief), research (with access to dedicated VA or NIH grants), or academic roles through university affiliations. Opportunities to build national reputation exist via telehealth innovation, systems-based care improvements, or veteran-focused dermatologic research. While there’s no ownership model, job security and federal pension benefits make this a long-term career path.

When this model makes sense

• For those motivated by public service and supporting military veterans.

• Ideal for focusing on medical dermatology rather than cosmetic procedures.

• A strong fit when predictable hours, administrative support, and pension benefits are priorities.

• Well-suited to physicians interested in research, telehealth, or systems-based care.

• Best for those seeking a collaborative, mission-driven practice environment

Success factors

• Understand that cosmetic services are rarely performed as the focus is on medically necessary care.

• Embrace collaboration with other departments through the integrated VA EHR.

• Be open to research and innovation, particularly in health delivery and access.

• Stay engaged in national VA initiatives around teledermatology and quality improvement.

• Consider academic affiliations to broaden your professional scope.

Potential challenges

• No cosmetic dermatology or cash-pay revenue opportunities.

• Salary may be lower than high-earning private practice roles (though offset by federal benefits).

• Bureaucratic processes and federal regulations can slow decision-making.

• Limited flexibility in how services are structured or marketed.

• Requires a strong service orientation and interest in adult patient populations.

Real-world example

Elma Baron, MD, Chief of Dermatology at the Cleveland VA Medical Center, transitioned from an academic role to full-time VA work to focus on telemedicine and innovative care delivery. She values the VA’s strong EHR systems, research opportunities, and the chance to serve a grateful, diverse veteran population. Her experience reflects the VA’s unique ability to support both personal mission and professional growth.

Early career advice

• Ask about available research opportunities and protected time for scholarly work.

• Inquire about how teledermatology is used and supported at the facility.

• Clarify clinical responsibilities versus academic or research roles.

• Ensure the local VA site has a collaborative dermatology team or academic affiliation.

• Choose this path if you’re passionate about serving veterans and value stable employment with structured work-life balance.

Related AAD resources

• Practice types: See our full menu of resources on practice types, from solo to institutional.

• Get started: Access our guide to getting started in practice, with resources on practice types and policies and procedures.

• Employment guide: See all our resources on contracts, questions for employers, and more.