Physicians Remain at Top of Staffing Shortage in VA

VHA has just published its FY 2022 Workplace Occupation report. This is the ninth iteration of this staffing report and the fifth that evaluated facility level data. The report notes that Nurses and Physicians remain at the top of the list of occupations with significant staffing shortages. 

In this year’s report, there were 10 clinical occupations, 9 non-clinical occupations, 3 MD specialty areas (Psychiatry, Primary Care, and GI), and 7 nurse specialties that were identified by 20% or more of VHA’s 139 Health Care Systems, or by 50% or more of the VISN’s as having staffing shortages. This annual report compiled by WMC (Workforce Management Committee) is designed to provide data for a structured approach to workforce planning; to identify existing shortages; and impact hiring initiatives across VA.  

Some of the hiring initiative, for example, include VHA being given non-competitive hiring authority for Title 38 occupations, and OPM can grant direct hire authority for Title 5 occupations to agencies that can demonstrate occupational shortages. In addition, top shortage occupation designation is a critical piece of developing workforce planning strategies such as workforce development programs, intern programs, scholarship and loan repayment programs, recruitment and retention incentives, legislative proposals, and other workforce strategy development.

The Office of the Inspector General found that there were 2622 roles with severe occupational shortage across the VA which represents a 22% increase over fiscal year 2021. The loss rate for physicians outpaces the growth rate leading to a new deficit of physicians across the department. The OIG also noted that the shortages continue despite VA receiving direct hire authority for nine positions in fiscal year 2022. The OIG report noted that 87% of facilities have severe shortages of physicians and 91% of facilities have severe shortages of nursing staff.

In the FY22 report by WMC, Medical Officers (Job series 0602) ranked second among clinical shortages, with over half of the 139 health care systems reporting vacancies. There are 23,448 physicians on board in VHA, with a 12.9% vacancy rate as of December 2022.  Of note, the report highlights the three-year average turnover rate of 7.9% with a 1.7% average growth rate.  It was interesting to note that in fiscal year 2021, there were 2540 new physician hires, and 2196 physician losses (due to retirement / separation, etc.). That is a net gain of only 344 physicians enterprise wide or a gain of only 1.4%.   

91% of respondents said recruitment challenges were the main cause of physician staffing shortages, and  82% of respondents noted a limited supply of physician candidates. The tools used to improve supply and recruitment were noted to be recruitment/relocation incentives and non-competitive hiring practices.

If you are interested in your own facility’s contribution to this report, you can view the appendix to the report (Appendix C), which lists each facility by VISN and how they viewed their local staffing shortages. The document does not address the myriad of challenges that NAVAPD hears about from our members regarding the hiring process, and HR modernization.  The average three year turnover of almost 8%, speaks to the inherent challenges of an HR system that does not operate smoothly.  NAVAPD is advocating on your behalf for improvement of HR processes that would streamline hiring of physician and dentists. NAVAPD would like to understand what issues you see in your facilities regarding recruitment and/or retention.  

NAVAPD has been told that the target “days to hire” for Title 38 employees is 100 days, which is supposed to be from the MSS entry to onboarding.  Our members report that the 100-day timeline is frequently not met and can exceed that by 70-100 days and that often it takes 90-100 days for HR to assign the MSS action. NAVAPD would like to know if your facility is on track with that timeline. We would also like to know what tools you think VA could employ to improve recruitment and retention of physician and dentist professional staff.

NAVAPD was founded by physicians who recognized the need for representation to Congress and Leadership.  As this document shows, that founding principle remains relevant four decades later.  Efforts to improve recruitment and retention of Physicians and Dentists clearly remains a top priority for VHA and for NAVAPD.  

NAVAPD relies on input from our members to provide counsel to Congress on how to make VHA the employer of choice.  Membership is way to amplify the voice of Physicians and Dentists whose mission is to provide state of the art care to Veteran patients.  Please encourage your colleagues to join NAVAPD.  You can always contact us by using the contact feature on our website www.navapd.org