Non-VA Hospital Systems

[texanpsychdoc]

I was curious to see if there was really much of a difference in working as a psychologist with a non-VA hospital system. I've had some offers lately at private institutions, but I am unsure if I'd be jumping from the frying pan into the fire.

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[WisNeuro]

Some things are the same, some things are different. What kinds of things are you asking about, specifically?

 

[Sanman]

Productivity requirements are likely to be higher, offices will definitely be nicer.

 

[WisNeuro]

Productivity requirements are likely to be higher, offices will definitely be nicer.

In my personal experience, yes to both.

 

[jdawg2017]

I was curious to see if there was really much of a difference in working as a psychologist with a non-VA hospital system. I've had some offers lately at private institutions, but I am unsure if I'd be jumping from the frying pan into the fire.

One thing that has struck me (as a neuropsych trainee) is the lack of staff or technology support at VAs that make life infinitely more difficult for staff and trainees given the "tour of duty." For example, a flagship VA I trained at did not have psychometricians on staff, computerized cognitive tests of any kind, nor automated scoring software. This likely aligns with lower productivity expectations, because fewer patients can be seen if staff and trainees alike are taking 30+ minutes to do something that can take people 1-2 minutes with a computer program.

 

[cara susanna]

One thing that has struck me (as a neuropsych trainee) is that lack of staff or technology support at VAs that make life infinitely more difficult for staff and trainees given the "tour of duty." For example, a flagship VA I trained at did not have psychometricians on staff, computerized cognitive tests of any kind, nor automated scoring software. This likely aligns with lower productivity expectations, because fewer patients can be seen if staff and trainees alike are taking 30+ minutes to do something that can take people 1-2 minutes with a computer program.

I'm not neuropsych, but we don't even have a room to do testing in! We either have to use an empty office, our own office, or a conference room (with paper copies).

 

[WisNeuro]

The training software stuff washes out a little bit, as scoring time is billable time. But yes, having psychometrists helps as the scoring RVUs are the lowest of the eval.

 

[Therapist4Chnge]

We definitely had less selection of tests through the VA for neuropsych measures than at the AMCs I've worked at in the past. We had more "free" / out of copyright options in the VA, but we had all of the core tests. RVUs are def higher outside of the VA. Lack of a psychometrician was less of an issue in the VA because I was in training, but once licensed...I would have wanted one.

 

[texanpsychdoc]

Some things are the same, some things are different. What kinds of things are you asking about, specifically?

To be honest...I am not sure if I have a specific question. I am just wondering if life is better outside the VA in a different hospital system. I have at least one standing offer with a local and well-known AMC here that I have tossed around taking them up on their offer. I'm really not doing what I want, and I do feel like I am getting older and watching my passions fly by. I know there is some distorted thinking going on my end with not seeing my neuropsychology career go through, but surely I can try to make something work where I am doing more of what I want, have the free time and flexibility (e.g., work from home at times), and have excellent pay. That would be nice.

 

[WisNeuro]

To be honest...I am not sure if I have a specific question. I am just wondering if life is better outside the VA in a different hospital system. I have at least one standing offer with a local and well-known AMC here that I have tossed around taking them up on their offer. I'm really not doing what I want, and I do feel like I am getting older and watching my passions fly by. I know there is some distorted thinking going on my end with not seeing my neuropsychology career go through, but surely I can try to make something work where I am doing more of what I want, have the free time and flexibility (e.g., work from home at times), and have excellent pay. That would be nice.

Private practice

 

[texanpsychdoc]

Private practice

Well, it will take some time to build my practice while working full time with the VA. I would have to do it pretty much remotely until I can justify spending $$ for a physical office where I can do testing.

 

[Sanman]

Well, it will take some time to build my practice while working full time with the VA. I would have to do it pretty much remotely until I can justify spending $$ for a physical office where I can do testing.

So, the question becomes do you want to search for a job that might better meet your needs or a begin to build a business? When you take a job, what you do and how you do it are unlikely to be within your sole discretion. However, if you start a business, it requires your constant attention. Choices...

 

[texanpsychdoc]

So, the question becomes do you want to search for a job that might better meet your needs or a begin to build a business? When you take a job, what you do and how you do it are unlikely to be within your sole discretion. However, if you start a business, it requires your constant attention. Choices...

This is my second LLC I've started, so that part isn't exactly foreign to me, but there are lots of lessons I have learned from my first time having an LLC. I def. want to find ways to do better as to expand my revenue stream and to have it be more consistent before I remotely jump ship into private practice.

 

[smalltownpsych]

“If you build it they will come”. I think that having a physical office is one of the first steps. Investing, aka losing money is part of starting a business. Testing materials you can order as the patients show up, but the office should be ready to go. If you can rent a space or work out a deal with someone local that could be a cheaper way to get started.
One flaw in thinking that seems to be occurring after the pandemic is that leaving home for school or work isn’t that important or necessary so might as well stay at home. For some people this reasoning can be just fine, but for others, not so much.

 

[Sanman]

Definitely agree that at some point you have to commit. This is more true for assessment than psychotherapy as you need the the tests and materials (as well as a plan for what you will be assessing) prior to opening your yours. Add to that a low volume and high volume practice have different business plans.

 

[texanpsychdoc]

“If you build it they will come”. I think that having a physical office is one of the first steps. Investing, aka losing money is part of starting a business. Testing materials you can order as the patients show up, but the office should be ready to go. If you can rent a space or work out a deal with someone local that could be a cheaper way to get started.
One flaw in thinking that seems to be occurring after the pandemic is that leaving home for school or work isn’t that important or necessary so might as well stay at home. For some people this reasoning can be just fine, but for others, not so much.

Yeah - back where I was in Ohio, there wasn't a whole lot in terms of places to rent. Now where I live in the greater Houston area, I am sure there are. I am also more of an in-person type of person vs. tele-work, but I do like it at times.