Evidence map›Paper›PMID 40906012›Full record

ArticleJournal of general internal medicine2026

Comparing Work Experiences of Internal Medicine Physicians in Veterans Affairs and Non-Federal Hospitals: A National Survey.

Sarah K Gualano, M Todd Greene, Nathan Houchens, Richard J Schildhouse, David Ratz, Karen E Fowler, Sanjay Saint

Abstract readComparative Study
In one paragraph

Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sarah K GualanoMedicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA. sgualano@med.umich.edu.ORCID 0000-0001-5080-8743
M Todd GreeneDepartment of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Nathan HouchensMedicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Richard J SchildhouseMedicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.
David RatzCenter for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Karen E FowlerCenter for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Sanjay SaintMedicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.

Funding

AHRQ HHS R18 HS028963AHRQ HHS R18 HS028963-02
6 · The paper itself

Abstract

backgroundFewer physicians are pursuing careers in internal medicine due to workload, work-life integration, and documentation pressures. Integrated health systems like the Department of Veterans Affairs (VA) offer an alternative work model that may affect physicians' experiences differently compared to the private sector.

objectiveTo examine and compare the self-reported workplace experiences among VA and non-VA internists.

designA cross-sectional survey.

participantsA random sample of 1421 internal medicine physicians across the USA, with oversampling of hospitalists and VA physicians. Surveys were completed between June 2023 and May 2024. Of the total of 629 (44.3%) physicians responding, 618 indicated working in a VA or non-VA hospital. MAIN MEASURES: Our primary outcomes were several professional environment factors. Multivariable logistic regression was used to assess relationships between professional environment factors and practicing at the VA (vs. non-VA). All models were adjusted for sex, race, and years practicing as an internist. KEY POINTS: The odds of time engaging with health insurance companies (OR = 0.26; P < 0.001), medical record issues (OR = 0.44; P < 0.001), and malpractice concerns (OR = 0.56; P < 0.001) were significantly lower among VA internists compared with non-VA internists. VA internists were significantly less likely to report issues concerning work-life balance (OR = 0.63; P = 0.01).

conclusionsVA internists had reduced odds of some non-clinical administrative tasks and greater odds of better work-life balance. The VA's minimal engagement with insurance tasks and litigation concerns appears to present a compelling work environment.

Indexed as

Hospitals, VeteransInternal MedicineJob SatisfactionPhysiciansUnited States Department of Veterans AffairsWorkplaceAdultCross-Sectional StudiesFemaleHumansMaleMiddle AgedSurveys and QuestionnairesUnited StatesWorkloadburnoutwell-beingwork environmentwork experienceworkload

Identifiers

PMID40906012
PMCPMC12894548

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.