Time card/duty hour Question for VA Physicians

[DolphinVA]

I'm trying to gain insight into a major source of discontent within our anesthesia group at a large VA hospital.

The situation:

Our work schedule appears pretty familiar, with a fair dispersion of call and compensatory rest days. However, behind the scenes when the timekeepers input our duty hours for the pay period, we are always considered having worked 0700-1530 (8 hours minus 30 min lunch). Because of this, NO one is allowed to leave the premises before 3p, irregardless of whether there is work to be done or not. Of course, we are expected to work extra if there are still cases (obviously I have no problem there), or overnight despite our hours still being clocked as 0700-1530. But there is an unwavering adherence to the 1500p leaving time for reasons I do not understand.

I've looked at the Title 38 documents. I've reviewed the duty hour provisions in the VA handbook. But I'm even more confused now -- besides not finding anything about the 3p business, it seems the manner we are accounting for our time isn't very compliant.

So for those of you with experience within the VA, how do you handle this behind the scenes? Obviously we are tied to patient care, but on light days (NYE for instance) several staff will be without clinical assignment for hours yet not released from duty -- essentially confining then to their office until they get the magic call at 3p to leave. This has led to some tense conversations with our chief and board runner, as it appears they are prioritizing ease of tracking duty hours over the lives of those in the group.

Appreciate everyone's input, and happy new year.

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[abolt18]

I'm trying to gain insight into a major source of discontent within our anesthesia group at a large VA hospital.

The situation:

Our work schedule appears pretty familiar, with a fair dispersion of call and compensatory rest days. However, behind the scenes when the timekeepers input our duty hours for the pay period, we are always considered having worked 0700-1530 (8 hours minus 30 min lunch). Because of this, NO one is allowed to leave the premises before 3p, irregardless of whether there is work to be done or not. Of course, we are expected to work extra if there are still cases (obviously I have no problem there), or overnight despite our hours still being clocked as 0700-1530. But there is an unwavering adherence to the 1500p leaving time for reasons I do not understand.

I've looked at the Title 38 documents. I've reviewed the duty hour provisions in the VA handbook. But I'm even more confused now -- besides not finding anything about the 3p business, it seems the manner we are accounting for our time isn't very compliant.

So for those of you with experience within the VA, how do you handle this behind the scenes? Obviously we are tied to patient care, but on light days (NYE for instance) several staff will be without clinical assignment for hours yet not released from duty -- essentially confining then to their office until they get the magic call at 3p to leave. This has led to some tense conversations with our chief and board runner, as it appears they are prioritizing ease of tracking duty hours over the lives of those in the group.

Appreciate everyone's input, and happy new year.

Is there not a system to allow YOU to enter your own hours?

 

[cchoukal]

I'm at a large academic VA and I have a lot of similar (but slightly different) frustrations with how our time and work are recorded. The way the VA thinks about work is based on what an outpatient primary care physician does, and doesn't at all reflect the realities of an acute-care specialty with 24-hr responsibilities. As a result, when it's time to ask for more staff, it can be difficult to demonstrate how much we're working. Similarly, since there is no definition of what a full time anesthesiologist's workload should be, it is difficult to bargain when you think you're working too much. Sorry, sir, but your RVUs are below the 25th percentile, so... Meanwhile, take today for example, I'm covering in-house airway call for 12 hrs. I will likely not generate a single RVU today, but I sure as heck feel like I'm working. Sadly, our departmental leadership has not found an effective way to advocate for either not doing this call or having it count toward our workload.

Many other academic VAs give their faculty a "compressed tour," which is basicall 4-10s, rather than 5-8s. On your off-tour day, you can be surfing or working at the University, or whatever. The other nice part about that tour is that now your week is only 4 days, so if you take a "week of vacation," it only uses 4 days of your "leave." I've been trying for years to compel our leadership to do this, but because it makes the scheduling harder, it hasn't happened.

For your unique problem... it seems like a local leadership issue, as we don't have the same issue (not that there are a lot of days when we're done at 3 anyway...). Given what I know about VA admin, I would be surprised if anyone knew if you were there til 3 or not, so long as your leaving didn't cause a case to be cancelled. IOW, unless your local VA is particularly well organized and well-staffed with effective administrators, it would seem the enforcement begins and ends with your department, and I think it's lame that your chief would abuse you in this way. I realize this probably doesn't help you. Sorry.

 

[deleted171991]

You guys seem to forget that the VA pays on an hourly basis. From their standpoint, if one claims to be at work and isn't, it's fraud (AWOL or whatever they call it). It's as simple as that.

I am sure one could leave early, with supervisor approval, as long as the timesheet reflects the correct worked hours. That would obviously result in a lower pay, but it would be legal.

Long term, I am sure there are flexible arrangements even for full-timers; the VA actually self-advertises itself as flexible, schedule-wise, that's why it's so popular with female physicians.

 

[cchoukal]

Not sure, FFP, what information is informing your perspective. I suppose at some level, maybe the VA sees it this way, but this certainly isn't true on the ground. We get a set salary for a vaguely-defined amount of work. The main avenue of flexibility, as far as I can tell, is the Compressed Tour, and if you can get your department to support it, it's not only a decent deal, but also a more accurate reflection of what most of us are actually working.

 

[ProwlerturnGas]

The first rule of working at the VA is to not take a job with the VA

 

[IMGASMD]

The first rule of working at the VA is to not take a job with the VA

I thought they still have good pensions?

 

[cchoukal]

It can be a good gig. Benefits and retirement are quite good, although newer hires get a slightly worse deal, liked every where else.

 

[gasdoc77]

I'm trying to gain insight into a major source of discontent within our anesthesia group at a large VA hospital.

The situation:

Our work schedule appears pretty familiar, with a fair dispersion of call and compensatory rest days. However, behind the scenes when the timekeepers input our duty hours for the pay period, we are always considered having worked 0700-1530 (8 hours minus 30 min lunch). Because of this, NO one is allowed to leave the premises before 3p, irregardless of whether there is work to be done or not. Of course, we are expected to work extra if there are still cases (obviously I have no problem there), or overnight despite our hours still being clocked as 0700-1530. But there is an unwavering adherence to the 1500p leaving time for reasons I do not understand.

I've looked at the Title 38 documents. I've reviewed the duty hour provisions in the VA handbook. But I'm even more confused now -- besides not finding anything about the 3p business, it seems the manner we are accounting for our time isn't very compliant.

So for those of you with experience within the VA, how do you handle this behind the scenes? Obviously we are tied to patient care, but on light days (NYE for instance) several staff will be without clinical assignment for hours yet not released from duty -- essentially confining then to their office until they get the magic call at 3p to leave. This has led to some tense conversations with our chief and board runner, as it appears they are prioritizing ease of tracking duty hours over the lives of those in the group.

Appreciate everyone's input, and happy new year.

I have thought about the VA more than one time but that sounds absurd. So if they are going to be strict about 3 pm, then it seems they could NEVER require you to stay over or it is now theft of YOUR time. Furthermore, your 30 minute lunch means you should be able to leave the premesis and run errands (they will have to provide lunch break coverage even if you are supervising)... otherwise it is not truly your time and is again theft. You see the slippery slope. Everyone should simply be professional and respectful of each other. The watchdog culture is condescending.

 

[secretasianman]

From my limited experience and from hearsay, everything depends on what kind of chief you have, and how far he/she will go to fight for you. I also agree that the accounting seems nebulous..

 

[spike7585]

I'm trying to gain insight into a major source of discontent within our anesthesia group at a large VA hospital.

The situation:

Our work schedule appears pretty familiar, with a fair dispersion of call and compensatory rest days. However, behind the scenes when the timekeepers input our duty hours for the pay period, we are always considered having worked 0700-1530 (8 hours minus 30 min lunch). Because of this, NO one is allowed to leave the premises before 3p, irregardless of whether there is work to be done or not. Of course, we are expected to work extra if there are still cases (obviously I have no problem there), or overnight despite our hours still being clocked as 0700-1530. But there is an unwavering adherence to the 1500p leaving time for reasons I do not understand.

I've looked at the Title 38 documents. I've reviewed the duty hour provisions in the VA handbook. But I'm even more confused now -- besides not finding anything about the 3p business, it seems the manner we are accounting for our time isn't very compliant.

So for those of you with experience within the VA, how do you handle this behind the scenes? Obviously we are tied to patient care, but on light days (NYE for instance) several staff will be without clinical assignment for hours yet not released from duty -- essentially confining then to their office until they get the magic call at 3p to leave. This has led to some tense conversations with our chief and board runner, as it appears they are prioritizing ease of tracking duty hours over the lives of those in the group.

Appreciate everyone's input, and happy new year.

Out of curiosity, have you heard anything regarding your surgical colleagues? I can't imagine they finish their OR lineup at 13:00 and sit there till 15:00 to be "dismissed"

 

[pgg]

The VA is a sweet deal for ex-military physicians who left active duty before they were eligible for retirement (i.e. 90% of them). Instead of flushing those years away they can be credited toward VA time after a very reasonable buy-in.

 

[DolphinVA]

Out of curiosity, have you heard anything regarding your surgical colleagues? I can't imagine they finish their OR lineup at 13:00 and sit there till 15:00 to be "dismissed"

They certainly don't. All other physician care line/depts I interact with (surgery, medicine, cardiology, GI) let the staff have reasonable latitude and put whatever they have to within the timekeeping system to suffice. I'm 99% certain this situation started with our last chief, but the true motivation behind it then and now I haven't the slightest.

Interestingly the VA handbook is very clear that all activities in support of the VA mission, and not income-producing from elsewhere, can count towards duty hours without specification of having to be on VA property. So sometime in the past my department decided pretending to work while onsite is preferable to pretending to work from home, the coffee house down the block, or the affiliate colleges.

Also interesting that the handbook is so easily available, the content regarding our situation relatively brief, yet no one in the command structure I ask is familiar with it. That's why I reached out to you all.