The VA is not bad...
I have my continuity clinic at the VA and l.o.v.e. it. Love it. The EMR makes care much easier, patient population is gratifying, plenty of pathology. My VA attendings appear to have a pretty decent lifestyle, plenty of time to divide among research, clinical, then attend on the inpatient side once in a while...and I never see clinic attendings there past 5p.m.
FAR less CYA medicine seen in the private sector, no litigiousness. Performance indicators are followed religiously and electronic reminders pop up if I haven't checked by diabetic's feet, given a new hypertensive HCTZ, given immunizations, etc...makes outpatient medicine much easier.
I hate dealing with our fragmented health care system in the private sector...so much time finding out information from other hospitals, doctors, etc. I don't even know what is on those "Press Ganey" surveys, but am constantly reminded of them and am starting to feel like a waitress or flight attendant. Seriously, I overheard a nurse manager telling the floor nurses to round "every hour" to ensure that the patient was satisfied, to offer a beverage or snack, etc. Meanwhile, I won't be notified if a patient's vital signs are abnormal b/c the nurse was too busy charting her hourly rounds for her 7 patients. It's ridiculous. These aren't hotels -- they are hospitals!