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Benchmarking US Department of Veterans Affairs dermatologic services: Results from a national survey - 18/02/12

Doi : 10.1016/j.jaad.2011.01.020 
L. Kendall Krause, MD a, b, c, Leilani Townsend, DO d, Michael L. Orser, MAcc e, Jennifer Mulhausen, BA e, Jodi Duke, MPH, CPH a, Weston T. Waxweiler, BS f, Robert P. Dellavalle, MD, PhD, MSPH a, c, g,
a Department of Dermatology, University of Colorado Denver, Aurora, Colorado 
b Preventive Medicine Residency Program, University of Colorado Denver, Aurora, Colorado 
c Colorado School of Public Health, Aurora, Colorado 
d Dermatology Residency Program, St Joseph Mercy Hospital, Ann Arbor, Michigan 
e University of Colorado School of Medicine, Aurora, Colorado 
f Medical College of Georgia School of Medicine, Augusta, Georgia 
g Dermatology Service, Department of Veterans Affairs Medical Center, Denver, Colorado 

Reprint requests: Robert P. Dellavalle, MD, PhD, MSPH, Dermatology Service, Department of Veterans Affairs Medical Center, 1055 Clermont St, Box 165, Denver, CO 80220.

Abstract

Background

How well Department of Veterans Affairs (VA) dermatology services provide clinical care, medical education, and innovative research is a largely unexplored topic in the literature.

Objective

We sought to benchmark VA dermatology services by surveying VA dermatologists about their environment, resources, and the pros and cons of working in the VA.

Methods

Printed surveys were mailed to VA dermatologists and responses were compiled and analyzed.

Results

Of 105 dermatology services surveyed, 48% returned surveys completed by board-certified dermatologists (n = 50); 20 surveys completed by nondermatologists were excluded from the analysis. Most services trained dermatology residents (72%) and medical students (80%). One third of services reported significant research involvement. Qualitative analysis revealed the academic environment, patient population, and decreased business management responsibilities as the 3 most commonly cited advantages to VA employment. The most commonly listed disadvantages included low salaries, bureaucracy, and lack of resources.

Limitations

The survey data were self-reported and not independently verified. Not all services returned the survey.

Conclusions

Outpatient VA dermatology services accomplish significant primary care and preventive services (eg, sun safety counseling, skin cancer screening, and treatment). However, the small number of dedicated dermatology services, their irregular geographic distribution, and the lack of staffing and resources may adversely affect optimal patient care. Dermatologist responses regarding the positive and negative aspects of working in the VA system may lead to improved management strategies to better retain and recruit dermatologists to provide patient care, medical education, and medical research despite dramatically lower dermatologist salaries within the VA system compared with private practice.

Le texte complet de cet article est disponible en PDF.

Key words : dermatology, dermatology research, dermatology services, graduate medical education, qualitative analysis, Veterans Affairs


Plan


 Supported by a $4000 grant from the American Professors of Dermatology Inc. The sponsors had no role in the design or conduct of the study; in the collection, analysis, or interpretation of data; or in the preparation, review, or approval of the manuscript.
 Conflicts of interest: None declared.
 The opinions expressed in this article represent those of the authors and not of the government of the United States of America.


© 2011  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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