Retention of Military Physicians

The Differential Effects of Practice Opportunities Across the Three Services

by Benjamin F. Mundell

Download eBook for Free

FormatFile SizeNotes
PDF file 1 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.

This dissertation looks at the link between practice opportunities and physician retention. Data on physicians who entered the Army, Air Force, or Navy and became fully qualified — finishing post-medical school training — between June 1996 and June 2009 are used to explore this question. Two other factors that are commonly believed to be correlated with retention — whether a physician pursues a military or civilian residency and deployment history — are also examined. Physicians are a vital part of a well functioning military health system and therefore the accession and retention of military physicians who have the skills necessary for caring for wounded soldiers is especially important. Most agree that increasing wages for military physicians would increase retention. What is not well understood is the link between increased practice opportunities and retentions. This dissertation suggests that such a link does exist. Additionally, it appears that the effects attributed to residency type — civilian or military — are less significant than the results reported in other studies on physician retention. Physicians, as a group, face less deployment than other military career fields and yet deployments early in a physician's career are negatively correlated with retention. Deployments later in a physician's career are positively correlated with retention and likely the result of a preference for deployments and military service.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Background

  • Chapter Three

    Data

  • Chapter Four

    Methods

  • Chapter Five

    Empircal Results of the Physician Retention Model

  • Chapter Six

    Policy Changes and the Effects on Physician Duration

  • Chapter Seven

    Conclusion

  • Appendix A

    Regular Military Compensation

  • Appendix B

    Determing when a physician is fully qualified

  • Appendix C

    Additional Physician Specialty Transition Tables

  • Appendix D

    Additional Survival Curves For each specialty

  • Appendix E

    Additional Duration Analysis Results

This document was submitted as a dissertation in September 2010 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Sue Hosek (Chair), Paul Heaton, and Mark Friedberg.

This report is part of the RAND Corporation dissertation series. Pardee RAND dissertations are produced by graduate fellows of the Pardee RAND Graduate School, the world's leading producer of Ph.D.'s in policy analysis. The dissertations are supervised, reviewed, and approved by a Pardee RAND faculty committee overseeing each dissertation.

Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.