[Hostage]

I suspect most of the 18,000 are physicians.

[DaveA37]

Typically, I believe these are “double dippers” who were at one time in the military and after they “retired” (from the military) immediately or soon there after, were hired by the VA.

[Sooth2222]

The VA states that it employs "over 14,000 physicians".

However, since not every VA doctor or dentist earns $180,000, I'll guess that a substantial number are bureaucrats who earn their $180,000 by hiding vets on waiting lists until they die.