Original Research

Urologist Workforce Variation Across the VHA

Fed Pract. 2015 March;32(3):18-22

References

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Limitations

This study should be interpreted in the context of several limitations. First, FY 2011 data were used; notably, the VHA urologist workforce remained relatively stable from 2008 through 2011. Second, characteristics of individual VHA urologists, clinical productivity, and skill level were not examined. However, a 2008 study found that nearly all VHA urologists are board certified, mitigating skill level concerns.¹⁴ Third, it is possible that demand is partially driven by existence of resources, and there may be patients who might benefit from urologic care but who are not yet diagnosed. The analysis is conservative in this regard, in that demand may be greater than what was detected using the selected study methods. Last, this study examined specialist workforce within a single system. However, ensuring specialist resources are well distributed is a concern for most health systems, particularly in light of recent policy efforts, including accountable care organizations.¹⁵

Conclusion

Much of the variation in the VHA urologist workforce exists at the facility rather than the regional level. Optimizing the distribution of these specialty care resources could be achieved through novel care delivery models within each regional network that are well-aligned with current VHA initiatives. Successfully utilizing this workforce distribution has the potential to improve urologic care for veterans across the country and could be applied to improve access to all types of specialists in underserved and understaffed areas.

Acknowledgments
Dr. Skolarus is supported by a VA HSR&D Career Development Award (CDA 12-171).

Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.

Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.