OIG report: VA still struggles to recruit, retain clinicians

Veterans affairs sign
The VA still faces notable staffing shortages, according to a report from the OIG. (JeffOnWire/CC BY 2.0)

The VA health system still faces challenges in recruiting and retaining clinicians, according to a new report. 

The Department of Veterans Affairs Office of Inspector General released (PDF) its fifth annual look at staffing shortages in the agency, and for the first time the report also dives into pain points in recruitment for nonclinical staff.  

Medical officers and nurses were in the highest demand, but the agency also faces a dearth of human resources professionals and police, according to the analysis. But specific needs and reasons for the staffing shortages varied significantly between the 140 VA medical centers including the OIG's report.  

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"To no one's surprise, the report found a wide variety of staffing needs on the ground," said Rep. Neal Dunn, R-Fla., chairman of the House Committee on Veterans' Affairs subcommittee on health, at a hearing Thursday on the findings. 

While there was a lot of regional variance in the responses, OIG found three common staffing challenges across both nonclinical and clinical openings: 

  1. Not enough qualified applicants.
  2. Salaries that can't compete with private sector jobs.
  3. High turnover.

RELATED: Providers seek outside-the-box strategies to fill staffing shortages 

Peter Shelby, the VA's assistant secretary for the office of human resources and administration, said the agency's current three current pay systems don't offer the "agility" needed to compete against other healthcare organizations. 

The VA, he said, is building a system that allows for local flexibility while also having a "complete national strategy" in place. 

RELATED: Senate passes VA MISSION Act, raising concerns of privatization 

Staffers in some of the most demanding positions with the VA could earn three or four times the salary in a private sector job, he said. 

"When you couple that with the workload, it's very hard to retain them," he said. 

Shelby said that in addition to finding ways to compete on salary, the VA is working to create more central centers of excellence for hiring, and focusing on more opportunities for advancement and personal development. He said, though, that specific shortage numbers seem inflated just because of the size of the VA, and that it's recruitment and retention rate fluctuates between 9% and 10%, which is comparable to the private sector.

RELATED: VA's Clancy—Secretary nominee Wilkie has 'healthcare squarely on his brain' 

Ongoing vacancies in key roles at the VA could make it hard for the agency to address staffing shortages at lower levels, Max Steir, CEO of the Partnership for Public Service, said at the hearing. 

The department has been without a permanent secretary since David Shulkin, M.D., was fired in March. The undersecretary for health position has been vacant for 16 months, as have other appointed roles within the VA. 

Department of Defense official Robert Wilkie, who has served as interim secretary since Shulkin's ouster, was tapped to serve as full-time secretary in May, but was formally nominated just this week after a lengthy, unexplained paperwork delay, The Wall Street Journal reported.

The Senate Veterans Affairs Committee is scheduled to take up Wilkie's nomination on June 27.

"It's very difficult to run an organization when people are in short-term positions," Steir said. 

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