The VA lacks key data to assess its recruitment and retention efforts for mission-critical physician occupations including primary care, mental health, gastroenterology, orthopedic surgery, and emergency medicine, the GAO has said.
It said the Veterans Health Administration is “unable to accurately count the total number of physicians who provide care in its VA medical centers”; while it has data on the numbers it employs and the numbers who work on a fee-basis, it lacks data on the number of contract physicians and physician trainees. Five of the six medical centers GAO studied use them, but “VHA has no information on the extent to which VAMCs nationwide use these arrangements.”
Further, “VHA has not evaluated the effectiveness of its physician recruitment and retention strategies. One such strategy–hiring physician trainees–is weakened by ineffectual hiring practices, such as delaying employment offers until graduation. VHA’s strategies could be strengthened by comprehensively evaluating the causes of recruitment and retention difficulties and identifying effective solutions,” GAO said.
It also said that staffing decisions are hampered by inconsistency in measuring productivity, such as the differing standards that two separate VA offices use for mental health care.
GAO recommended that the VA develop a process to count all physicians, provide guidance on productivity measurement, and evaluate its physician recruitment and retention strategies. VA concurred with four of the five recommendations, but not with one to accurately count all physicians, stating that its workforce assessment tools are sufficient.