Just a heads up, VA has a new patient satisfaction initiative. Patients now can email you 24 hours a day and you're expected to respond to X % of them within the first Y hours/days/weeks, please research more about the specifics. There's also VA politics and such to deal with, which may or may not be better than academic politics, depending on what sorts of things you want to deal with.
Source: I'm spending 70% of my 4th year at a VA.