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MRC 04-371 – HSR&D Study

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MRC 04-371
Researching Recruiting and Retention of Highly Skilled Physicians in VA
Richard G. Best PhD MS BS
South Texas Health Care System, San Antonio, TX
San Antonio, TX
Funding Period: July 2004 - December 2004

BACKGROUND/RATIONALE:
Considerable research in the field of industrial and organizational (I/O) psychology sheds theoretical light on the recruitment process, including literature on the psychological dynamics underlying job choice, theories on applicant attraction to the organization. Similar advances have been made in the field of retention, particularly in the areas of organizational commitment, violations of psychological contracts, and intentions to leave the organization. The VA is facing a human capital crisis expected to continue over the next several years due to a large portion of the workforce nearing retirement eligibility. This is highlighted by the projection that approximately half of the VA workforce is currently eligible for optional or early retirement while another 36% will be eligible for regular retirement by the year 2007. In view of the salience of workforce projections, it is important to examine the influence of VA’s intramural research program on recruitment and retention of VA physicians.

OBJECTIVE(S):
The primary purpose of this proposal was to better understand the role of the VA’s intramural research program in attracting and retaining highly skilled physicians. This study: 1. Reviewed the research literature specific to recruitment and retention processes; 2. Build upon previous work that has investigated satisfaction with support for research efforts in VA; 3. Identify and/or develop psychometrically sound measures of factors hypothesized to influence recruiting and retention efforts that may ultimately be used to assess the validity of the theoretical model.

METHODS:
We used a multiple methods approach combining both qualitative and quantitative techniques. The first phase consisted of a literature synthesis, followed by semi-structured interviews (among VA physicians) which were analyzed using grounded theory techniques. The combination of the literature review and the results of the interviews were used to develop a theoretical model. In phase II, we identified/developed measures of the factors identified in Phase I and distributed a web-based survey. Data from the survey were factor analyzed (using exploratory approaches) and examined for psychometric reliability.

FINDINGS/RESULTS:
Results of the qualitative review of the literature identified factors such as financial considerations, factors directly related to research programs and support, organizational factors, community issues, individual personality characteristics, and environmental factors such as labor market conditions and geographic area specific issues. Exploratory factor analysis of the survey data yielded a six-factor solution offered as the theoretical model for better understanding the influence of VA’s intramural research program on physician recruitment and retention. These factors are: 1) Satisfaction with research support; 2) Intellectual stimulation opportunities; 3) Perceived clinical support; 4) Satisfaction with compensation; 5) Colleagues; and 6) Community characteristics. Psychometrically, the measures for the six factors revealed good internal consistency with alpha coefficients ranging from .74 to .97.

IMPACT:
The results of this study are intended to provide the evidence on which to base policy regarding VA’s intramural research program, providing a foundation on which to consider interventions, such as realistic job previews, and re-design of clinician researcher roles to better match the values and personal preferences of highly skilled physicians.

PUBLICATIONS:
None at this time.


DRA: Health Systems
DRE: none
Keywords: Management, Staffing
MeSH Terms: none

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