Perspectives on Training and Working in the VHA: Implications for Primary Care Physician Recruitment and Retention.
Perspectives on Training and Working in the VHA: Implications for Primary Care Physician Recruitment and Retention.
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VHA 培训和工作的观点：对初级保健医生招聘和保留的影响。
DOI：
10.1097/acm.0000000000004619
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Wong,EdwinS
中科院分区：
文献类型：
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作者：
Moldestad,Megan;Sayre,George;Rinne,Seppo;Kaboli,PeterJ;Reddy,Ashok;Sanders,KarenM;Mao,Johnny;Henrikson,NoraB;Sterling,Ryan;Nelson,KarinM;Wong,EdwinS
美国初级保健医生短缺对寻求维持足够的初级保健劳动力的卫生系统提出了重大挑战。对退伍军人健康管理局（VHA）初级保健培训或工作的看法可能会产生对战略招聘的见解，使VHA和其他卫生系统对初级保健医生更具吸引力。作者试图了解的居民和工作人员的医生在VHA初级保健有限的任期内的经验，以确定因素，以指导卫生系统在改善招聘和retention.MethodThis定性探索性研究进行了2018年6月至2019年10月与24名内科住院医师和30名医生在VHA初级保健。通过对每个队列的地理区域、农村和性别进行抽样，确保异质性。作者进行了半结构化访谈，以确定在VHA和非VHA网站的培训和就业偏好的观点。结合内容分析被用来产生findings. ResultsTheauthors确定了4个关键的主题，围绕共同的价值观和VHA的使命驱动的文化：VHA的“社区”被认为是独特的，一个主要的贡献者工作满意度;设施级的领导支持是重要的看法，围绕骚扰的工作场所文化; VHA初级保健提供模式允许居民和工作人员医生为患者提供所需的护理，但并不总是能够发挥其潜力; VHA的就业情况也好于预期，结论使命和工作场所文化可能在未来医生对卫生系统的期望以及工作的医生的工作满意度方面发挥重要作用。在这些系统中。基于这些属性的医生招聘工作可能会在维持足够的医生队伍方面取得最大的成功。
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.MethodThis qualitative exploratory study was conducted from June 2018 to October 2019 with 24 internal medicine residents and 30 staff physicians in VHA primary care. Heterogeneity was ensured by sampling for geographical region, rurality, and gender within each cohort. The authors conducted semistructured interviews to ascertain perspectives on training and employment preferences at VHA and non-VHA sites. Combined content analysis was used to generate findings.ResultsThe authors identified 4 key themes, centered around shared values and the VHA’s mission-driven culture: the VHA “community” was perceived as unique and a major contributor to job satisfaction; facility-level leadership support was important to perceptions of workplace culture around harassment; the VHA primary care delivery model allowed residents and staff physicians to get patients needed care but did not always live up to its potential; and VHA employment was better than expected, but the process of getting hired was a challenge.ConclusionsMission and workplace culture may serve important roles in the desirability of health systems for prospective physicians and the job satisfaction of physicians who work in these systems. Physician recruitment efforts based on these attributes may yield the most success in maintaining a sufficient physician workforce.