Addressing shortages of doctors, nurses and other medical personnel require VA’s high-priority attention, GAO has said, along with numerous other management-related issues where recommendations from past reports remain pending.

The VA has suffered for years from shortages and turnover in many medical fields, which in turn have been tied into the scandals over wait times and quality of care and moves to have more care of veterans provided outside the VA system.


GAO noted that in late 2017, the VA started a review of recruitment, retention and relocation incentives for physicians as it had recommended but that the department still lacks an assessment of all of its in-house and contract physicians, information that GAO said the VA needs for workforce planning purposes. It said the VA similarly is still studying the value of incentive payments for nurses and where improvements could be made.

The report also said that the VA has made only “limited overall progress” in ensuring that meaningful distinctions are being made in employee performance evaluations. It said that among other changes, the department needs to standardize employee performance plan elements and “better support ongoing and effective performance conversations between supervisors and employees” about performance.