# Identifying Value-Driven Approaches to Strengthening the VA Physician Workforce

> **NIH VA I01** · VA PUGET SOUND HEALTHCARE SYSTEM · 2020 · —

## Abstract

Background: Primary care physician (PCP) shortages are a significant and growing problem confronting the
US healthcare system. An overall shortage of up to 53,000 PCPs is projected in the US by 2025, due in part to
increased demand for primary care services because of an aging population, growing disease burden and a
declining interest in primary care careers among medical residents. A shortage of PCPs in VA has recently
come under increased focus due to the emphasis on improving Veterans’ access to high quality and timely
healthcare. Providing timely access to primary care requires a sufficiently large PCP workforce. However, as of
May 2016, VA was reported to have been trying to fill up to 500 PCP positions, reflecting roughly 12% of the
current VA PCP workforce. Prior research has not examined several important individual, economic, job and
system-level factors associated with the recruitment and retention of PCPs by health systems. These
understudied factors include components of pay and compensation, academic affiliation, elements of the
patient-centered medical home model and workplace climate, which represent areas where VA data offer
unique contributions. In addition, no prior research has examined the relative importance of factors in
explaining PCP recruitment and retention. Identifying and prioritizing key factors associated with PCPs’
employment choices will help VA and other health systems with the strategic recruitment of PCPs and the
development of evidence-based strategies to retain high quality PCPs.
Objectives: The objectives of this study are to: 1) identify and prioritize individual, job, economic and system-
level factors associated with the choice of VA for employment and selection of rural practice (i.e. recruitment)
using existing VA data as well as new qualitative and survey data collected for this study and 2) identify and
prioritize individual, job, economic and system-level factors associated with long-run retention of PCPs within
VA and in rural VA clinics using administrative data and existing survey data.
Methods: This mixed methods study will examine VA administrative data, existing VA employee survey data,
public health resource data and new qualitative and survey data collected for this project. To measure factors
associated with VA recruitment and choice of rural practice setting (Aim 1), we will conduct structured
interviews with current internal medicine residents exposed to VA settings during their training and new PCPs
with a permanent VA position. We will then develop and administer a new survey instrument using key factors
identified in qualitative interviews and factors of particular interest in this study. Triangulation will then be used
to assess whether key factors and themes established in qualitative analyses generalize to the larger
population of internal medicine residents and new VA PCPs. We will perform descriptive analyses to compare
influential factors identified in interviews and surveys betwe...

## Key facts

- **NIH application ID:** 9691048
- **Project number:** 5I01HX002121-02
- **Recipient organization:** VA PUGET SOUND HEALTHCARE SYSTEM
- **Principal Investigator:** Edwin S. Wong
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-03-01 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9691048

## Citation

> US National Institutes of Health, RePORTER application 9691048, Identifying Value-Driven Approaches to Strengthening the VA Physician Workforce (5I01HX002121-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9691048. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*