I've been working at a contract CBOC for the last 6 months and, for various reasons, considering a switch to direct VA employment.
It's not all that bad, and there are some pluses to working with the vets.
For me, the 30% pay cut may be difficult, though EDRP and PSLF are both tax-free and unavailable to contractors).
What I will say, is that in the contract clinic, I've had the ability and opportunity to run my practice somewhat similar to how I've worked at a good CMHC in the past. I've used nursing staff to return non-urgent phone calls (ie: when a patient calls and leaves a message that they have a "medication problem, and I want to talk to the doctor" it sure helps to be able to have the nurse call them back & play phone tag all day to find out what the problem actually is, and whether I actually need to talk to them to address it).
With that admin staff, however, my no show rate is also generally less than 10% (pts received reminder calls the day prior to all behavioral appts and spots were filled almost immediately), and they're not marked no-show until 15 minutes into the hour, at which point I am supposed to call them and find out why they no showed (which can often turn into a 15 minute phone call that the veteran tries to use in lieu of a face-to-face visit).
