Companies that contract with the VA and military hospitals

[psychstudent5]

I've seen a lot of job listings for clinical psychologists from corporations that have contracts with a VA or military medical center. The pay seems to be hourly, but above average pay. Also, the benefits and workday hours seem to be pretty good. Has anyone worked as a psychologist in this capacity (or knows someone who has)? What do y'all know about these positions?

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[WisNeuro]

I know the VA has an issue with actually paying some of these people. Which is why it's nearly impossible for us to actually contract out for certain services. And, the people they get to do contract C&Ps are some of the most inept clinicians I have ever read reports from.

 

[Fan_of_Meehl]

I know the VA has an issue with actually paying some of these people. Which is why it's nearly impossible for us to actually contract out for certain services. And, the people they get to do contract C&Ps are some of the most inept clinicians I have ever read reports from.

If you have an ounce of professional integrity or have any decent training whatsoever relating to properly assessing and diagnosing mental disorders, I would strongly recommend against taking a psychologist position with one of these companies doing compensation and pension exams. The number of 'exams' they have to do per day (I've heard up to 6-8) only allows them minimal time (20-30mins, if they take that) to do a brief mental health screening and/or mental status exam, not a thorough psychological interview/assessment that would allow for the proper diagnostic workup for multiple co-morbid major mental disorders (PTSD, major depressive disorder, substance use disorder, personality disorders). The VA's own official training materials and manuals for how to PROPERLY conduct a mental health compensation and pension examination recommend something like 3-4 hours for the full process, which includes (for a responsible clinician) chart review, clinical interview, and often psychological testing...and even that time frame will seem inadequate in many cases with extensive histories, complex presentations, and any degree of difficulty in the interview process. There's no way to try to accomplish 6-8 of these PER DAY without committing de facto malpractice. That being said, I know nothing about these actual specific positions that you describe...I would recommend contacting them for more information but be advised about the mental health compensation and pension mills.

 

[erg923]

I've seen a lot of job listings for clinical psychologists from corporations that have contracts with a VA or military medical center. The pay seems to be hourly, but above average pay. Also, the benefits and workday hours seem to be pretty good. Has anyone worked as a psychologist in this capacity (or knows someone who has)? What do y'all know about these positions?

If you are referring to Lockeed-Martin and its associated subgroup of companies (QTC, etc) that are assisting with the VAs C&P backlog, I would stay away. The exams Ive seen from their contractors are laughable. And honestly, I'm not sure what the appeal is. The model incentivizes volume vs quality...which is the exact opposite mentality one needs to have to practice forensic psychology, which is essentially what disability exams are, right? You also don't have the liability protection, professional and personal, that you have if you actually worked for the VHA/VBA.

There are some other companies that seem to provide psychologists for time-limited contracts to various DoD facilities. These all seem pretty time limited from what I've seen, and lots of job hopping for an ECP may not be the best way to build your career. If you want to contract hop, that's fine, not for me though.

 

[PsyDr]

I know a few that contracted to provide healthcare on military bases. My general take was that there was a huge push to see as many patients as possible, often in unreasonable levels (e.g., seeing a new patient every 31 minutes for psychotherapy).

 

[Therapist4Chnge]

I've consistently heard bad things about those contracting companies. The pay isn't worth it and the (albeit small) risk of having a sub-standard report comeback to bite you later....no way.

Those companies are being paid $$$ for the volume.

 

[Sanman]

There are a number of companies that do C&P evals. They vary in payment (per eval or per hour) and setting (some will let you do it in your PP office or in theirs). Are the evals thorough? No, because they are one offs with no access to the VA/military database for records reviews. Your standard contract money mill situation or a way to supplement your private practice, let your ethics and your comfort/discomfort with liability guide you on that. Is it more about time vs quality? Yes, but that is standard practice in fee for service healthcare. The DOD/military contracts are different. Some are better than others and the liability is likely smaller, but again you are doing government work without the benefits of being a federal employee in the best case scenario. I run into similar issues all the time in nursing homes (requiring 18 90832 sessions per day for employees). IMO, caveat emptor. Chances are you won't be sued given all the half-baked work I see out there, but is that all you really want? ERG is right about hopping from place to place part as well.

 

[psychstudent5]

Thanks for the replies everyone. The positions I see are not for c&p evals. They seem to be more therapy based. Are the therapy based ones just as bad as the c&p evals?

I am not interested in job hopping, doing shoddy work, providing poor service to patients, or being a liability. So, I am very much reconsidering being interested in these positions. It's hard sometime to separate the wheat from the chaff in searching for jobs.

 

[Therapist4Chnge]

I have no idea about non-assessment contract/3rd party work with the VA, though hopefully others do.

 

[erg923]

Thanks for the replies everyone. The positions I see are not for c&p evals. They seem to be more therapy based. Are the therapy based ones just as bad as the c&p evals?

I am not interested in job hopping, doing shoddy work, providing poor service to patients, or being a liability. So, I am very much reconsidering being interested in these positions. It's hard sometime to separate the wheat from the chaff in searching for jobs.

The VA only contracts out their C&P, not their clinical work (other than the choice program). So, the clinical jobs are likely for active duty or reserve locations/hospitals. Again, I don't know about these other than the fact that they are typically one-year contracts that sometimes renew (for multiple years) and sometimes not. I could not live like that, especially early career.

 

[erg923]

I run into similar issues all the time in nursing homes (requiring 18 90832 sessions per day for employees). IMO, caveat emptor.

Is this serious?

I would bet dollars to donuts this produces 16 minute "check-in/chat" sessions so that documentation can actually be completed after each session...am I right?

I cannot imagine having to write 18 therapy notes after the end of 9 hours of clinical work.

For some reference, 90832 is the predominant code I use for intervention in primary care mental health and the most of have ever seen (coded) in one 8 hour day is 10.

 

[AcronymAllergy]

18/day? Yeah, that's ridiculous. And folks wonder why MH treatment then gets a bad rep for essentially being "just talking" to someone with limited efficacy.

 

[Sanman]

So take it with a slight grain of salt as I have never interviewed at this company (and it is a large one), but a friend/colleague that did and was offered a position said it was:

90791- 6-7/day
90834- 10-11/day
90837 - 8/day
90832 - 16/day

Since then another colleague that we hired intereviewed there and said they upped it to 18/day.

Given that I still need to at least 10-12 90832 session per day at both the companies I have worked and the standard has been going up with declining revenue. I have some different requirements due to my admin duties currently, but I end up having to deal with the fall out of other people's shoddy work which is causing its own stress.

 

[Sanman]

To answer the OP, I have not heard anything bad about the DOD gigs with active duty members. However, I and always concerned when I see ongoing advertising for a job and the one year contract is a no go for me. However, if you do interview find out some details and report back. Ask about productivity requirements prior to taking the job.

 

[erg923]

So take it with a slight grain of salt as I have never interviewed at this company (and it is a large one), but a friend/colleague that did and was offered a position said it was:

90791- 6-7/day
90834- 10-11/day
90837 - 8/day
90832 - 16/day

Since then another colleague that we hired intereviewed there and said they upped it to 18/day.

Given that I still need to at least 10-12 90832 session per day at both the companies I have worked and the standard has been going up with declining revenue. I have some different requirements due to my admin duties currently, but I end up having to deal with the fall out of other people's shoddy work which is causing its own stress.

So, its a workhouse/meatgrinder. I think thats clear. Its 8-16 patients per day. I dont think that sustainable, not to mention enjoyable, for post people over the course of years. Job rather than career? Come to the VA, we are much more friendly.

 

[Therapist4Chnge]

So take it with a slight grain of salt as I have never interviewed at this company (and it is a large one), but a friend/colleague that did and was offered a position said it was....

I'm guessing Kaiser P? $100k+/yr salaries with good benefits, but high workloads...at least that is what I've been told by multiple clinicians.

 

[Sanman]

Not Kaiser. This is geriatric behavioral health company (nursing homes). I get spammed by recruiter calls all the time. Salary is 80-85k with average benefits from the offers I have heard and I am not taking that pay cut.