Perspectives on Training and Working in the VHA: Implications for Primary Care Physician Recruitment and Retention

Abstract

PurposeThe primary care physician shortage in the United States presents significant challenges for health systems seeking to maintain a sufficient primary care workforce. Perspectives on training or working in primary care in the Veterans Health Administration (VHA) may yield insights into strategic recruitment to make the VHA and other health systems more attractive to primary care physicians. The authors sought to understand the experiences of resident and staff physicians with limited tenure within VHA primary care to identify factors to guide health systems in improving recruitment and retention.

Inclination to pursue Veterans Health Administration for primary care practice: survey of medical residents

“…We used VA's Corporate Data Warehouse to identify all staff with a provider taxonomy of physician resident who were assigned to a primary care provider panel between December 2020 and July 2021. Further details are described in a prior study ( 12 ).…”

“…We developed a conceptual model to guide our selection of survey measures and to ensure conceptual completeness ( Figure 1 ). We based our model on existing published conceptual models on practice choice, physician satisfaction, and burnout, as well as prior qualitative research highlighting aspects of VA employment that may influence career choice, including the VA mission, culture, care delivery model, and administrative aspects of Federal employment ( 12 – 18 ). The team developed the conceptual model to both build on previous models and highlight aspects of the VA setting.…”

Valuing the Partnership Between the Veterans Health Administration and Academic Medicine

“…These 5 tenets square solidly with the missions of the VA, and their themes are visited in 3 articles 16–18 appearing in this issue of our journal.…”

“…And … through (4) collaboration with communities and partners…, and (5) commitment to rigorous and forward-looking standards of equity, professionalism, and ethics…. 15 These 5 tenets square solidly with the missions of the VA, and their themes are visited in 3 articles [16][17][18] appearing in this issue of our journal.…”

“…In a second article, Moldestad et al 17 describe the milieu in which VA primary care providers view their roles, and reflect on insights, from participants in their qualitative study, into the recruitment and retention of VA primary care clinicians. The authors found that the culture and the singular focus on the mission to care for veterans enable clinicians to go the "extra mile, " to address social determinants of health, and to be collaborative in their care models.…”