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Shared Values and VA’s Mission-Driven Culture Strengthen VA Primary Care Physician Recruitment and Retention
This study sought to understand the experiences of resident and staff physicians within VA primary care to identify factors to guide health systems in improving recruitment/retention. Four key themes emerged, centered around shared values and VA’s mission-driven culture: 1) VA “community” was perceived as unique and a major contributor to job satisfaction. In addition, there were perceptions of a strong work-life balance in VA, more so than in non-VA settings. 2) Facility-level leadership support was important to personal feelings of workplace culture around safety from harassment. One third of respondents mentioned being subjected to harassing or threatening remarks, most often from patients.
3) VA’s primary care delivery model allowed physicians to get patients needed care (e.g., addressing social determinants of health) but did not always rise to its full potential. Lack of support staff and perceptions that nurses were not permitted to work to the full scope of their licenses were reported. 4) VA employment was better than expected, but the hiring process was a challenge. The Veteran population was repeatedly mentioned as the reason physicians loved working for VA. VA could counteract challenges, including lower pay and slow hiring processes, by promoting the unique aspects of VA employment such as a mission-driven and community-based culture and the rewarding opportunity to serve a unique population.
Date: February 8, 2022
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Gender Differences in Relationship between Civility and Burnout among VA Primary Care Providers
This study analyzed gender differences in civility, burnout, and the relationship between civility and burnout among male and female primary care providers (PCPs). Findings showed that greater workplace civility was significantly associated with lower odds of burnout for women, reflecting that in workplaces with higher civility, women were less impacted by burnout. However, workplace civility was not significantly related to burnout among men. Almost half of the sample reported burnout (48%), but this difference was not significant between the genders. Across occupational groups, female nurse practitioners reported lower burnout compared to female physicians. Female supervisors also reported lower burnout rates. Black male and Asian female providers reported lower burnout compared to white male and female providers, respectively. Overall, burnout was lowest among employees with less than or equal to one year of tenure. Interventions tailored to gender- and primary care-specific needs should be employed to increase civility and reduce burnout among primary care providers.
Date: April 26, 2021
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Research Involvement Associated with Increased Satisfaction and Decreased Intent to Leave among VA Physicians
This study examined the influence of time spent on academic activities and perceived quality of care in relation to job attitudes among inpatient medicine physicians from 36 VA medical centers. Findings showed that physicians’ ratings of perceived quality of care and adequacy of physician staffing were the strongest predictors of overall job satisfaction and intent to leave. Adequacy of physician staffing was the strongest predictor of burnout. Among the job tasks that physicians spent their time on, research (involvement reported by 46% of respondents) was significantly associated with increased job satisfaction and decreased intent to leave. Research time showed a non-significant negative relation with burnout. Teaching involvement was reported by 72% of the respondents, and time spent in this activity showed a similar pattern with job attitudes as described above, but was not significant. Physicians’ perception of having sufficient registered nurse staffing also did not affect physicians’ attitudes about their job. Expanding opportunities for physician involvement with research may lead to more positive work experiences, which could potentially reduce turnover and improve system performance.
Date: April 5, 2018
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Intervention to Lessen Low-Value Electronic Health Record Notifications Reduces Workload for Primary Care Physicians
This study evaluated the impact of a national multi-component quality improvement program to reduce low-value electronic health record notifications. Findings showed that the program potentially saved 1.5 hours per week per primary care physician to enable higher-value work (based on prior estimates of 85 seconds to process each notification). The mean number of daily notifications per PCP decreased significantly from 128 to 116, however, the number of daily notifications remained high, suggesting the need for additional multifaceted interventions and protected clinical time to help manage them. Program impact appeared to be achieved by reducing certain types versus just the sheer number of mandatory notifications, underscoring the complexity of addressing notification burden.
Date: March 5, 2018
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