title: Benchmarking US Department of Veterans Affairs dermatologic services: results from a national survey.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Dermatology, University of Colorado Denver, Aurora, Colorado, USA.
authors.forename: L Kendall
authors.initials: LK
authors.lastname: Krause
authors.forename: Leilani
authors.initials: L
authors.lastname: Townsend
authors.forename: Michael L
authors.initials: ML
authors.lastname: Orser
authors.forename: Jennifer
authors.initials: J
authors.lastname: Mulhausen
authors.forename: Jodi
authors.initials: J
authors.lastname: Duke
authors.forename: Weston T
authors.initials: WT
authors.lastname: Waxweiler
authors.forename: Robert P
authors.initials: RP
authors.lastname: Dellavalle
mesh_terms: D000553:Ambulatory Care / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D001291:Attitude of Health Personnel; D019985:Benchmarking / Q000706:statistics & numerical data*; D002321:Career Choice; D003880:Dermatology / Q000191:economics / Q000193:education / Q000706:statistics & numerical data*; D004503:Education, Medical, Graduate / Q000706:statistics & numerical data; D005260:Female; D005843:Geography / Q000706:statistics & numerical data; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006295:Health Resources / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data; D012456:Salaries and Fringe Benefits; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D016526:Workload