Motivation and retention of dental officers in the Indian Health Service.

In 1955, responsibility for the health care of American Indians and Alaskan Natives was transferred from the Bureau of Indian Affairs to the U.S. Public Health Service and the Indian Health Service was established by Federal Legislation (P. L. 83-568).’ Since 1955, approximately 41 5 dental officers have been employed and subsequently separated from duty in the Indian Health Service. The success of the dental program in the Indian Health Service depends on the motives, desires, morale or its lack, degree of satisfaction with j o b or its lack, social attitudes, professional goals, and interactions and reactions with coworkers and the Indian people by the 180 commissioned dental officers and a few available contracting practitioners. After the conflict started in Vietnam, recruitment of dental officers for the Indian Health Service became relatively easy. This ease may be attributed, in part, to the opportunity for dental officers to fulfill their military obligation by serving two years in the Indian Health Service. The retention of dental officers and physicians in the Senrice for careers, however, has been a problem, particularly after the elimination of the draft of dentists and physicians in mid-1 973. The inducements t o retain officers as career-people by improvement in morale, satisfaction with job, and, to a lesser extent, through increased pay, have been commendable. Little information appears available for determining (I) whether the dentists, on being recruited, actually are interested in a career with the Indian Health Service, (2) whether the dentists coming into the Indian Health Service are the ones best suited for treating Indian people, (3) whether the probability is that dental officers will or may not choose t o make a career for themselves in the Indian Health Service, (4) what factors exist which will motivate dental officers to choose a career in the Indian Health Service or to leave it. Because it became apparent that many more questions can be raised than can be answered in the early future, a study was planned to test specific hypotheses for determining (1) if important differences in satisfaction with job exist between dentists now in the Indian Health Service and those who have left it, and (2) which elements of satisfaction with one’s job and which familial and demographic characteristics are related t o motivation of dental officers for satisfying careers. Guidelines also were developed t o help determine where efforts for recruitment should be concentrated, and then aid in predicting through the prospective study the types of dentists who are apt t o make a career of the Indian Health Service.