Indian Health Service:

Efforts to Recruit Health Care Professionals

HEHS-94-180FS: Published: Jul 7, 1994. Publicly Released: Jul 7, 1994.

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Pursuant to a congressional request, GAO reviewed the Indian Health Service's (IHS) employment practices, focusing on: (1) whether differences exist in the salary schedules within the various IHS service areas; (2) the effectiveness of current manpower recruitment programs in the Aberdeen, South Dakota, service area; and (3) IHS and the Department of Veterans Affairs' (VA) processes for determining health professionals' pay, benefits, and bonuses.

GAO found that: (1) although all IHS health care professionals receive the same amount of base pay, certain physicians receive additional bonuses or allowances to compensate for their duty in undesirable locations; (2) IHS has had difficulty in delivering adequate health care in many states because of problems in recruiting and retaining qualified physicians and health care professionals; (3) physician recruitment and retainment in the Aberdeen service area is hampered by the relatively low pay offered, lack of adequate housing for health care professionals, remoteness of reservations, cultural differences between the physicians and their patients, and general lack of amenities; (4) the Aberdeen service area has a higher vacancy rate for physicians than all but one other IHS area; (5) the vacancy rate at the Pine Ridge, South Dakota, hospital has remained particularly high; (6) VA has experienced similar problems in recruiting and retaining physicians in isolated areas; and (7) to increase physician recruitment and retention, IHS is considering adopting the VA physician pay structure, increasing physicians' base salary, increasing loan repayment and scholarship programs, reducing IHS physicians' workload, and involving health professionals in cultural activities.

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