MEDICAL-SCHOOL AFFILIATIONS WITH DEPARTMENT-OF-VETERANS-AFFAIRS MEDICAL-CENTERS - ATTITUDES OF MEDICAL-CENTER LEADERSHIP

Affiliations between Department of Veterans Affairs [VA] medical centers and colleges of medicine are important to both parties. Recently, the values and costs of these relations have come under increasing scrutiny. In this study, the authors attempted to determine the attitudes of local VA medical center leadership members toward these affiliations. A mail survey of directors, associate directors, and chiefs of staff of VA medical centers was undertaken. Respondents were asked to score their agreement or disagreement with each of eight statements defining various features and values of VA-medical school affiliations. Scores were reported on a Likert scale of 1 (strongly agree) to 7 (strongly disagree). Strongly positive general attitudes toward VA-university affiliations were found from the results. Mean scores averaged 2.02. However, responses to statements identifying specific concerns with these affiliations (eg, diversion of resources away from VA toward university goals and the lower status of VA-based faculty) were less positive. More positive general attitudes and less negativity about specific concerns were expressed by chiefs of staff than by medical center directors or associate medical center directors and by leaders of highly affiliated medical centers than by leaders of other types of centers. Therefore, local VA medical center leaders have very positive general attitudes toward university affiliations. However, specific problem areas do exist. These issues and attitudes are important for leaders of both the VA health-care system and academic medical centers to consider when developing and implementing local and national policies.