Since the advent of the all-volunteer force, the U.S. Air Force has struggled with how best to attract and retain physicians and dentists. Both populations have declined in recent years. Multiyear Special Pay (MSP) is intended to keep physicians and dentists in the Air Force after their initial service obligations have expired. MSP has been successful in that eligible dentists, in particular, have often accepted it. Although most eligible physicians have heretofore refused MSP, physicians in some subpopulations, e.g., those who received residency training at military medical centers, have shown a growing inclination to accept it. Increasing MSP levels appears to increase the percentage of physicians who choose to accept MSP rather than leaving Air Force service. The authors recommend that the Air Force focus on increasing Medical Corps accessions and consider retention bonuses for dentists who have not yet completed the residencies that make them eligible for MSP.

The Air Force Medical Service (AFMS) currently runs three in-theater hospitals for severely injured or wounded personnel. Part of the practioners' preparation was treating DoD beneficiaries for a broad range of injuries and illnesses. Opportunities for this preparation are not as numerous "in house" as they once were, and AFMS does not always get proper credit for those gained elsewhere. Proper credit for that work is important for funding.

Policymakers and program managers are continually seeking ways to improve accountability in achieving an entity's mission. A key factor in improving accountability in achieving an entity's mission is to implement an effective internal control system. An effective internal control system helps an entity adapt to shifting environments, evolving demands, changing risks, and new priorities. As programs change and entities strive to improve operational processes and implement new technology, management continually evaluates its internal control system so that it is effective and updated when necessary. Section 3512 (c) and (d) of Title 31 of the United States Code (commonly known as the Federal Managers' Financial Integrity Act (FMFIA)) requires the Comptroller General to issue standards for internal control in the federal government.