• Mark Douglas Tyson and Lori B Lerner.
• Dartmouth Medical School, Hanover, New Hampshire 03755, USA. Mark.Tyson.@Dartmouth.edu
• J. Urol. 2008 Oct 1; 180 (4): 1460-2.

PurposeThe Veterans Health Administration has multiple employment arrangements for its physician staff. Urological care to veterans is provided by urologists who work in the Veterans Affairs system under 1 arrangement, including full-time Veterans Affairs, contract Veterans Affairs, part-time Veterans Affairs and fee for service. We assessed the similarities and differences of these employment arrangements, while considering factors such as race, gender, professional activities and salary.Materials And MethodsA database was created of all urologists who provide care at Veterans Affairs Medical Centers across the United States regardless of the employment arrangement. A 14-item survey was sent to these 305 urologists. Participants were required to have finished residency training and be employed by the Veterans Affairs on a full-time, part-time, contract or fee for service basis.ResultsA total of 118 surveys were completed for a 39% response rate. Compared to full-time urologists contract urologists were younger (p = 0.02), earned higher annual wages (p = 0.01), worked longer hours per week (p = 0.001), and spent more hours on direct patient care (p = 0.001) and teaching residents (p = 0.03), although they spent the same number of hours on research and administrative duties.ConclusionsThe practice environment of the contract urologist in the Veterans Affairs system is comparable in many ways to that of the full-time employee. However, the tendency of many contract urologists to be employed in a separate practice setting has led to higher incomes and longer work hours.

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