The U.S. Department of Veterans Affairs (VA) is in the midst of fundamental changes after a period of struggle and public criticism—and some of those changes could make it an appealing place for physicians to work.
Appeal for help
David Shulkin, MD, undersecretary of health at the VA, delivered that message of hope for his once-beleaguered organization during a presentation at the 2016 AMA Annual Meeting in Chicago. He issued a passionate appeal for physicians to contribute to the VA’s colossal rebuilding effort.
“We desperately need physicians and have to make it an attractive place to work,” Dr. Shulkin, a primary care physician, said. “I think we’re working on that.”
The VA has openings for 1,800 physicians and 44,000 employees of all kinds as it accommodates a growing patient population, Dr. Shulkin said.
An agency in crisis
The VA hit a low point in 2014 when it drew criticism over excessive patient wait times and allegations of deceptive record-keeping at its Phoenix medical center. President Obama called for an investigation after it was discovered that 40 veterans had died in Phoenix while awaiting treatment.
The scandal soon spread as shoddy practices were discovered at centers around the nation. In May 2014 President Obama accepted VA Director Eric Shinseki’s resignation.
The crisis has spurred the VA to respond with five key efforts, Dr. Shulkin said:
- Reducing wait times for patients
- Engaging employees once again in their sense of mission
- Adopting best practices consistently across all VA facilities
- Partnering with the private sector to expand access to care
- Restoring the confidence of veterans and the public in the VA
Dr. Shulkin said the VA has already reduced wait times, and this year has set a goal of same-day access to care for veterans. As conditions improve, the VA is becoming a more satisfying place for physicians to work, he said.
Fewer contributors to burnout
For example, VA physicians don’t have to deal with insurance companies and medical liability issues, he said.
“You don’t have to deal with a lot of the things that create burnout in the private sector,” he told physicians.
He said physicians who go to work for the VA will discover many reasons to be proud of its historic mission. For instance, in partnership with 1,800 other institutions, the VA is the largest trainer of physicians in the nation. It is a leader in reducing hepatitis C, addressing the opioids crisis and preventing suicide, he said.
Dr. Shulkin also touted the long and distinguished history of VA research that has paved the way for solutions in prosthetics, cancer, liver transplant, CAT scans and dialysis.
“The discoveries that have come out the VA are important to all of us in American medicine,” he said.
New AMA policy
Also at the 2016 AMA Annual Meeting, physicians adopted new policy that directs the AMA to work with the VA to enhance its loan forgiveness efforts to help with physician recruitment and retention and to improve patient access in VA facilities. That includes a call for the Public Service Loan Forgiveness Program to allow physicians to receive immediate loan forgiveness when they practice in a VA facility.
The AMA also will be working with the VA to minimize the administrative burdens that can prevent physicians who are not employed by the VA from volunteering their time to care for veterans.
