TIRR Memorial Hermann Job

[texanpsychdoc]

Hello,

I wanted to get everybody's thoughts and opinions about TIRR Memorial Hermann as a place to work. There are two positions (neuropsychologist and rehabilitation psychologist) that are open, but I wasn't sure how they are in terms of pay, benefits, reputation, atmosphere, etc. It would be great to get all perspectives (good, bad, ugly). Thanks!

---

Members don't see this ad.

 

[PsyNeuro37]

I have interviewed for their neuropsych training programs in the past. I can’t speak to most of what you’re asking from a staff perspective, but the staff I interacted with on interviews came off as very warm and the trainees echoed feeling very happy and supported. It’s a prestigious place in the rehab medicine world, US News has them ranked at #2 in the country for PM&R (for however much you care about those rankings). I had been told by my supervisors back when I interviewed that their neuropsych postdoc is excellent, but again can’t really speak to the staff side of it.

 

[PsyDr]

If you’re not a neuropsychologist, why would you work there?

 

[texanpsychdoc]

I am interviewing for their rehab psych position. Much of my background is neuro-rehab.

 

[erg923]

Why is their name so damn long! What is "TIIR?" And... is Pewee Herman involved here?

 

[texanpsychdoc]

I have interviewed for their neuropsych training programs in the past. I can’t speak to most of what you’re asking from a staff perspective, but the staff I interacted with on interviews came off as very warm and the trainees echoed feeling very happy and supported. It’s a prestigious place in the rehab medicine world, US News has them ranked at #2 in the country for PM&R (for however much you care about those rankings). I had been told by my supervisors back when I interviewed that their neuropsych postdoc is excellent, but again can’t really speak to the staff side of it.

That's nice to hear. I had applied to their internship program, and sadly was not even invited for an interview Then again, I had the same thing happen to other places I applied for internship and was not selected, only to be invited for a post-doc interview later on.

I have a friend who used to be a neuropsychologist there and has since moved on. They had advised me that they reduced the pay and vacation for much of their rehabilitation staff at the height of the pandemic. That was a bit concerning. They also advised me that many staff members (outside of the rehab division) did not regard the rehab folks all that well. It seemed like they felt illegitimate.

 

[erg923]

They had advised me that they reduced the pay and vacation for much of their rehabilitation staff at the height of the pandemic. That was a bit concerning. They also advised me that many staff members (outside of the rehab division) did not regard the rehab folks all that well. It seemed like they felt illegitimate.

Your (revenue?) problem is not MY problem.

As an aside, "medical necessity criteria" for outpatient services (and inpatient services) were relaxed significantly during the COVID pandemic across the country. So....

This may be just a row or....just total bullocks? Either way, I don't buy it!

Again, my mantra as an employed person in "corporate medicine" is to never to tolerate THEIR problem, as YOUR problem.

 

[Therapist4Chnge]

They recruited me a couple of times over the years, though before COVID...so I'm not sure how much changed. Solid staff and reputation. I do remember the pay being on the lower-end (as compared to other programs/AMCs), though I guess some did outside work too. Ultimately having to live in Texas was a dealbreaker, but I think they are viewed quite positively at a national level.

 

[texanpsychdoc]

They recruited me a couple of times over the years, though before COVID...so I'm not sure how much changed. Solid staff and reputation. I do remember the pay being on the lower-end (as compared to other programs/AMCs), though I guess some did outside work too. Ultimately having to live in Texas was a dealbreaker, but I think they are viewed quite positively at a national level.

We are moving back to Texas (my home state) because my spouse got a job down there. Now I am looking for work in the area. It's a shame they were paying lower compared to others. I will say I've been really eye-balling the Houston VA to "transfer" to as I would be a GS-12 come August 1st; pay rate for 2022 in Houston for a GS-12 is a little over $91K, so if TIRR can at least meet that or better, then they are going to be an option. What would really push me over is if either one offers a relocation bonus. I had been offered an inpatient job at Bay Pines VA last month with a $15K sign-on bonus, but had to decline.

 

[summerbabe]

I will say I've been really eye-balling the Houston VA to "transfer" to as I would be a GS-12 come August 1st;

Are you looking at a general BHIP job, speciality outpt, or inpt/residential? Texas VAs (big and small) are currently experiencing major issues with enrollment and demand for MH services far outpacing staff retention/expansion in ways that are likely contributing to staff dissatisfaction and burnout in significant ways.

Each location, clinic, and person will be different but definitely do some legwork as you explore options. Good luck!

 

[texanpsychdoc]

Are you looking at a general BHIP job, speciality outpt, or inpt/residential? Texas VAs (big and small) are currently experiencing major issues with enrollment and demand for MH services far outpacing staff retention/expansion in ways that are likely contributing to staff dissatisfaction and burnout in significant ways.

Each location, clinic, and person will be different but definitely do some legwork as you explore options. Good luck!

I did not know about their enrollment/demand issues. That explains why I've seen a ton of openings in Texas lately. I've been in talks with some BHIP managers at Houston VA. They have several openings in BHIP, including one that is really a good fit for me in their psych testing clinic; I would essentially be doing various psych testing, cog screeners, capacity evals, etc. that neuro wouldn't be doing. I'm really interested in inpatient work as well. I've applied to some remote stuff with San Antonio VA, but honestly, I am looking for something where I can do testing in addition to therapy. It seems like the Houston VA BHIP position might be a good fit.

 

[summerbabe]

I did not know about their enrollment/demand issues.

One metric that VA uses is the 'next 3rd available apt' and it wouldn't surprise me one bit if some/a lot of BHIP providers in the Houston and San Antonio systems are well into the fall already in terms of booked apts (I don't have exact current deets but this is an educated guess). I'm also aware of some non-Texas systems where therapy providers are also fully booked into the fall and veterans are virtually begged to accept community care.

There also seems to be a slight rise in places that are encouraging their BHIP psychologists to consider scheduling a few 30 min therapy apts a day instead of the full hour to maximize # of pts you see, which means more notes, impromptu CSREs, etc.

They have several openings in BHIP, including one that is really a good fit for me in their psych testing clinic; I would essentially be doing various psych testing, cog screeners, capacity evals, etc. that neuro wouldn't be doing.

A protected testing role could be really good but also potentially awful depending on the details.

You'll probably be mapped 90-95% clinical which would mean 25ish bookable patient hours. If it's 10 hours of testing and 15 single hr therapy hours, that leaves you with like 2 hours a day for all of your documentation, which would suck if they also adhere strictly to a 24 hour clock for therapy notes.

Versus if you get an hour of protected writing time for each testing hour and perhaps a slight decrease in therapy caseload (5 hrs testing/wk, 5 hrs report writing/wk, 12 therapy patients/week + regular admin/meeting/lunch times).

I really enjoy my current VA gig in a specialty service line and not looking to leave anytime soon but BHIP is a mixed bag with a ton of providers leaving BHIP positions nationwide for very valid reasons so definitely ask questions and negotiate when possible. Good luck!

 

[texanpsychdoc]

One metric that VA uses is the 'next 3rd available apt' and it wouldn't surprise me one bit if some/a lot of BHIP providers in the Houston and San Antonio systems are well into the fall already in terms of booked apts (I don't have exact current deets but this is an educated guess). I'm also aware of some non-Texas systems where therapy providers are also fully booked into the fall and veterans are virtually begged to accept community care.

There also seems to be a slight rise in places that are encouraging their BHIP psychologists to consider scheduling a few 30 min therapy apts a day instead of the full hour to maximize # of pts you see, which means more notes, impromptu CSREs, etc.

A protected testing role could be really good but also potentially awful depending on the details.

You'll probably be mapped 90-95% clinical which would mean 25ish bookable patient hours. If it's 10 hours of testing and 15 single hr therapy hours, that leaves you with like 2 hours a day for all of your documentation, which would suck if they also adhere strictly to a 24 hour clock for therapy notes.

Versus if you get an hour of protected writing time for each testing hour and perhaps a slight decrease in therapy caseload (5 hrs testing/wk, 5 hrs report writing/wk, 12 therapy patients/week + regular admin/meeting/lunch times).

I really enjoy my current VA gig in a specialty service line and not looking to leave anytime soon but BHIP is a mixed bag with a ton of providers leaving BHIP positions nationwide for very valid reasons so definitely ask questions and negotiate when possible. Good luck!

Yeah, that's about comparable to my current BHIP job at the VA I am at now. Hopefully I can find something that allows me to do more testing/assessment.

 

[PsyDWannabe]

They recruited me a couple of times over the years, though before COVID...so I'm not sure how much changed. Solid staff and reputation. I do remember the pay being on the lower-end (as compared to other programs/AMCs), though I guess some did outside work too. Ultimately having to live in Texas was a dealbreaker, but I think they are viewed quite positively at a national level.

Sidenote: I know of several nationally well-regarded institutions who treat their mental health/Psychology/neuropsychology staff like pure crap, based on reports from actual staff members who are dying to get away but can't for some reason or the other. Some AMCs on this list? You wouldn't even believe, because they are so highly reputable on a general level. Makes me sick every time I hear stories like that.

 

[texanpsychdoc]

So...I ended up getting an interview invitation for the job. I probably have more questions now. I did not complete a post-doc in either rehab or neuro. I did a master's in cognitive neuroscience, then went into a doctoral program with a neuro track, completed multiple practica in neuro and rehab, published in neuro and rehab, did a quant. dissertation in neuro, and completed a 3-month neuro rotation at my VA internship. Texas has guidelines, not rules, that highlight what they believe are to be the best practices for gaining the knowledge necessary to practice as a neuropsychologist. With that in mind, I am still perplexed as to why they are interviewing me for the neuro position there. The rehab position I can see happening more so than the neuro position. Not withstanding this, TIRR has an internship and post-doc program, so how come they aren't filling these roles with internal trainees?

 

[Therapist4Chnge]

In regard to filling roles with internal trainees...some places really resist doing it, while others have a clear history of holding onto fellows. Where I did my fellowship training (R1 AMC), rarely did they keep fellows, but there were multiple faculty who came back after 3-10+ yrs if/when a position opened up. I liked this approach bc it kept a broader base of training and experiences, though they also understood the demands of the Uni and dept. For better or worse, funding and dept politics often dictate who is considered for positions, especially if someone is an internal candidate. There can also be hiring rules that impact hiring (i.e. must post publicly for X days, must interview a diverse range of candidates, etc).