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Veterans Health Administration Staff Shortages

VHA faces a unique set of recruitment and retention challenges.

“We try to maximize salaries, our relocation incentive, our Education Debt Reduction [EDR] program – which increased from $120,000 to up to a $200,000 loan reimbursement. The results of the EDR have been outstanding, one of our best recruitment and retention tools. In FY 18, we had a little more than 1,200 participating and our forecast for FY 19 is about 1,500. The program applies to clinical physicians, but any categories that are in the top 10 critical occupations are eligible. That includes mental health, nurses, etc., so long as they are involved in patient care. We do nationally targeted advertising campaigns, are expanding our efforts in telemedicine, and are working to transition medical professionals coming out of the military to work in the VA.”

VA medical facility VAMM18B web

Seen here is the Department of Veterans Affairs Ann Arbor Healthcare System medical facility. Nationwide there is a shortage of doctors and nurses. Each year the VHA’s clinical and non-clinical hiring needs are greatest among nurses, licensed practical nurses, pharmacists, and diagnostic radiology technicians. Photo by Susan Montgomery

In recent years, the VA has come under fire for long wait times for veterans to see doctors or schedule procedures, but Perry said a lot of progress has been made in the past five years, thanks to changes in how care is gauged.

“Staffing shortages are not an indicator of performance or impact on wait times,” he said. “Outcomes for access, quality, and satisfaction scores we see are the areas we focus on. For 2018, through June, our average wait time for primary care was 4.5 days, 8 days for specialty care, and just 3.7 days for mental health care. Same-day service in urgent care is not included, just normal scheduled appointments.

“The data we were looking at five years ago had lots of variations, and we were not held to consistent standards or monitoring, so the numbers varied widely by area. In 2014, there was a concerted effort to make access a key driver and priority; the results we see today are because of that.”

In recent years, the VA has come under fire for long wait times for veterans to see doctors or schedule procedures, but Perry said a lot of progress has been made in the past five years, thanks to changes in how care is gauged.

Perry has a very positive outlook on the VHA’s future in terms of both the speed and quality of care it will be able to provide a still-growing and diverse veteran population and the number of physicians and other clinical care professionals the organization will be able to field, although the raw numbers, taken out of context, still may cause concern and criticism. And if it does begin to see truly negative results, “we will look for ways to deal with those.

“If we continue on the trajectory we’re on now with our growth, I think the vacancy numbers will correspond to that growth. If I add another 10,000 physicians next year and have a 10 percent vacancy rate now, I can expect to see that vacancy rate grow as well. My focus is on looking at the outcomes on which we measure true success,” he concluded.

“How we focus on the care we deliver is the most important issue. We have a shift in demographics, with an aging population, and a shift in care coverage. Making sure we focus on the right measures is the best way to deliver on how we provide the care and services expected of us.”


This article was originally published in the 2018 Fall edition of Veterans Affairs & Military Medicine Outlook By Faircount, LLC

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J.R. Wilson has been a full-time freelance writer, focusing primarily on aerospace, defense and high...