VA Mental Health Provider Venting / Problem-solving / Peer Support Thread

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Yeah, we have full time telework employees and gave away their offices a long time ago so 🤷‍♀️
Kenan Thompson Eating GIF by Saturday Night Live


I will just be watching the show.
 
I wonder what that would look like for all the clinics struggling with space. Even with teleworking and remote positions, space is a significant issue. I imagine addressing actual problems isn't the goal though. We're working off vibes here.

It won't happen overnight. Teleworking is much easier to get rid of than fully remote positions. I imagine that it will take time to figure out how to house everyone. However, it will be a mess all around. That said, VA is in a better position that something like EPA, IRS, or DOE. Especially for actual healthcare providers. My VA has remote medical directors and if you force them all back in and they quit (because they don't live there), I imagine we are shutting down parts of the hospital. That will go over well.
 
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I am so burnt out by my VA cell phone requiring me to change my pin and not letting me use old pins that I have now set the dumbest possible pin for it (I probably shouldn't say what it is specifically, so use your imagination)

I gave up on numbers and went to letters now. However, I was so sick of it that my password was 1-2-3-4 at one point.
 
There are some pretty substantial rumors that the new administration is not going to allow any telework for federal employees, so I'm not sure what that would mean for those cushy VACO jobs
Interesting, I assume they can’t change jobs that have been coded as fully virtual.

But I imagine many of these mid level management jobs have telework at the discretion of the agency and they are required to live within a certain distance from their central office location, even if they essentially work full time remotely.
 
There are some pretty substantial rumors that the new administration is not going to allow any telework for federal employees, so I'm not sure what that would mean for those cushy VACO jobs
I've always wondered that about VA. I can understand the need to have providers present in the clinic, but I've never worked at a VA that did not have space issues. Easiest way to improve access when you don't have space for more doctors? Hire doctors for remote positions. Cheaper than contracting with community providers, and you'll get better continuity of care.

But then there seems to be this pervasive idea, even within VA among leadership, that VA clinicians are slackers, can't be trusted to monitor themselves, and will all take advantage of the situation if allowed to telework.
 
Interesting, I assume they can’t change jobs that have been coded as fully virtual.

But I imagine many of these mid level management jobs have telework at the discretion of the agency and they are required to live within a certain distance from their central office location, even if they essentially work full time remotely.

Some are telework. However, I have looked at a few of these position postings and know a few VACO folks where the rule is simply show up to any location in your VISN. Some had even managed to secure offices pre-pandemic.
 
I've always wondered that about VA. I can understand the need to have providers present in the clinic, but I've never worked at a VA that did not have space issues. Easiest way to improve access when you don't have space for more doctors? Hire doctors for remote positions. Cheaper than contracting with community providers, and you'll get better continuity of care.

But then there seems to be this pervasive idea, even within VA among leadership, that VA clinicians are slackers, can't be trusted to monitor themselves, and will all take advantage of the situation if allowed to telework.

The other half of the problem is that the people hiring you/managing personnel have no idea about the reality. When I was originally hired at the VA, my SF-50 was listed as the main medical center, my HBPC team was housed out of a CBOC and I was told to report there. Turns out there was no space and the whole team had been teleworking for over a year due to office space issues. So much for the right hand knowing what the left is doing.

I often wonder if forced to RTO, how long it would take for someone to figure out if I never actually showed up and just continued to work at home.
 
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I know some people who work for VACO who live on like the other side of the country, or at least several states away
 
Interesting, I assume they can’t change jobs that have been coded as fully virtual.

But I imagine many of these mid level management jobs have telework at the discretion of the agency and they are required to live within a certain distance from their central office location, even if they essentially work full time remotely.

I have a fully remote VA clinical job, was hired as fully remote, was not required to relocate (and I live several states away from the hospital I work for). I am definitely worried about the stability of it with the new admin, though my entire team is virtual/remote so knocking out this position would be losing an entire BHIP which feels like an unwise choice... I am hoping to make it through the next few years
 
I have a fully remote VA clinical job, was hired as fully remote, was not required to relocate (and I live several states away from the hospital I work for). I am definitely worried about the stability of it with the new admin, though my entire team is virtual/remote so knocking out this position would be losing an entire BHIP which feels like an unwise choice... I am hoping to make it through the next few years

You aren't alone. There are a lot of folks in the same position, myself included. Though there is a lot of rhetoric, I don't think that the reality will be as chaotic as the talk will make it seem. At the very least, I think that there will be some notice and time to plan. There has been a big push towards telehealth that last few years and the interruption in patient care would make for terrible press.
 
You aren't alone. There are a lot of folks in the same position, myself included. Though there is a lot of rhetoric, I don't think that the reality will be as chaotic as the talk will make it seem. At the very least, I think that there will be some notice and time to plan. There has been a big push towards telehealth that last few years and the interruption in patient care would make for terrible press.
I’m not worried about fully remote clinical jobs until further notice.

To start, the entire national Clinical Resource Hub infrastructure would need to be dismantled and providers re-assigned (eg when C&P depts were disbanded but those people had to find homes in other clinics if they didn’t voluntarily leave), which would massively impact patient care and hospital processes. And then there’s the fully remote hiring that has happened locally to recruit and/or expand staff.

I read a The Hill op-ed that just was published and they spoke of proponents in Congress being upset that federal buildings are not being utilized, which shouldn’t include hospitals since there’s almost certainly a lack of space versus too much space.
 
You aren't alone. There are a lot of folks in the same position, myself included. Though there is a lot of rhetoric, I don't think that the reality will be as chaotic as the talk will make it seem. At the very least, I think that there will be some notice and time to plan. There has been a big push towards telehealth that last few years and the interruption in patient care would make for terrible press.

Ugh sorry to hear you're in a similar spot! I had a similar thought about the bad press of it all, and then talked myself back into emotion mind and got nervous again. I agree though, we rely a lot on our remote providers (including all the CRH) and the loss of all of them would crush the in person providers. There aren't enough to make up for it!
 
I’m not worried about fully remote clinical jobs until further notice.

To start, the entire national Clinical Resource Hub infrastructure would need to be dismantled and providers re-assigned (eg when C&P depts were disbanded but those people had to find homes in other clinics if they didn’t voluntarily leave), which would massively impact patient care and hospital processes. And then there’s the fully remote hiring that has happened locally to recruit and/or expand staff.

I read a The Hill op-ed that just was published and they spoke of proponents in Congress being upset that federal buildings are not being utilized, which shouldn’t include hospitals since there’s almost certainly a lack of space versus too much space.

I needed to hear this, thank you đź’•
 
The cabinet picks just keep getting worse and worse. I wish he'd just announce the VA secretary and get it over with at this point.
 
The cabinet picks just keep getting worse and worse. I wish he'd just announce the VA secretary and get it over with at this point.

Nah, we need more clowns in this car. Let's also create another several departments. Because, nothing says "we don't like big government" by making up new government positions for your friends.
 
The cabinet picks just keep getting worse and worse. I wish he'd just announce the VA secretary and get it over with at this point.
While I have zero inside scoop details, Dennis McDonough (who had zero healthcare or military experience whatsoever prior to his appointment) has been spearheading the access above all push (which sounds exactly like something a career bureaucrat would do) so it probably can’t get any worse.
 
While I have zero inside scoop details, Dennis McDonough (who had zero healthcare or military experience whatsoever prior to his appointment) has been spearheading the access above all push (which sounds exactly like something a career bureaucrat would do) so it probably can’t get any worse.

Ohh, yeah, that does track. But I am pretty sure it could still get worse, lol.
 

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I would seriously get behind Kareem Abdul-Jabbar as VA secretary. Larry Bird can head up all the SUDS programs, too.
 
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Is it just me or does Matt Gaetz look like he was born to play the lead in American Psycho?
 
So...this just dropped in the news:

House Approves Wide-Ranging Veterans Bill After Bipartisan Compromise Reached


From the article:
"But another of the contentious sections made it into the approved bill. That section would ban the department from overriding a VA doctor's referral for their patient to get outside care. The ban would last two years, after which the VA would need to report to Congress on its effects."

Holy whiplash, Batman. We JUST got DONE with being scolded/counseled that licensed independent providers are now NOT allowed to refer directly to specialty care in the community. I think only some sort of super-secret-squirrel person/committee has the authority to make community care referrals at this point.

It will be an interesting year, going forward.
 
Oh snap, so they can't decline our community care referrals anymore?

Also, how is the VA going to pay for this? We're already underwater financially.
Hell...I gotta say that I'm secretly thrilled with the prospect of actually being given some (even slim) measure of decisionmaking authority over...you know...my own supposedly independent practice of my profession at the VA. It seems like half my day (when I'm not running into walls/barriers) involves various permutations of the childhood game, 'Mother-May-I?'
 
Oh snap, so they can't decline our community care referrals anymore?

Also, how is the VA going to pay for this? We're already underwater financially.
Who cares how they pay for it lol. Their problem not mine. I'm just glad we might be able to have one release valve they can't stop for the never ending referrals.
 
Who cares how they pay for it lol. Their problem not mine. I'm just glad we might be able to have one release valve they can't stop for the never ending referrals.
100% this.

And, I'm not a VA 'policy wonk' or 'important' person who 'knows things' in the VA hierarchy or anything (I'm just a 100% full-time provider who sees patients all day long for services--someone who WORKS for a living) but...

Isn't there some law that says if we can't provide vets with a psychotherapy appointment within 30 days then we're SUPPOSED to refer them to the community??? I think I read that somewhere. What do we do when vets or their families confront us with that fact?

Yeah, I realize that in most areas (ours included) the wait for MH appointments in the community can be as long or longer than within our system...but...if the veteran confidently, appropriately, but stridently asserts his/her RIGHT to a community referral if we can't see him within 30 days...

Oh, right. I get it. I'm supposed to be the shucking/jiving 'White House Press Secretary' with the veteran and his/her family and, you know, just 'handle' the situation politically and put the public image of the VA as an organization above the veteran's needs. Got it.
 
They can lay psychologists off but that would be a political nightmare.
My guess is that the sociopolitical "Beast" (Leviathan?) that is the VA will just lay off / downsize most of the "general mental healh" and psychotherapy-providing psychologists under the guise of cheaper/faster/better options of using social workers and bachelors-level counselors, medical marijuana, service llamas, Tai Chi, 'whole health,' and MDMA since these are the popular choices for 'treating' PTSD that the public will demand.

My local VA hospital would have to shut down MH therapy services since, here, 90% of the psychotherapy is provided by PhD's/PsyD's.

And, oh yeah...monthly 30 min "therapy appointments" and 30-50 patients in 'recovery' oriented groups and phone apps to treat mental illness as far as the eye can see...since no one actually, you know READS our own VA/DoD Expert Consensus guidelines and all...they just mindlessly chant/parrot the incantation, "evidence-based therapy, evidence-based therapy, BAAAWK!!!, evidence-based therapy... "

Good times a'comin.
 
I'm curious which services the veterans would fight hardest to keep. I know they deeply connected to all of the political structures in my state and would lose their collective minds if we started removing things. We can't even get rid of our ancient PTSD groups that are basically social events. Just transitioning them to peer support specialists instead of us felt like an act of congress.

I feel like they would fight for therapy and chiropractic services. Honestly, anything related to pain management will be defended vigorously.
 
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