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

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Sanman said:
To be fair, most of us would be getting a tax cut.
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Maybe in the short-term, but look at what Trump I's tax cuts did....temporarily saved a few grand for families for a couple of years, but long term cost TRILLIONS in debt, with the vast vast majority of the benefit going to the top <1%. The same shell game is happening this time, but instead of expiring tax breaks for the 99%, there are delays in when TRILLIONS get added to the national debt. Cutting Medicare and Medicare is a large chunk of how some of the ultra wealthy tax breaks get covered, but even more gets added later by kicking the can down the road. I'm not an economist, but even a cursory review of the data coming out paints a horrid picture for the 99%. I'm a fiscally conservative independent and the "big beautiful bill" will add more debt than any prior piece of legislation in this country's history.
 
WisNeuro said:
Most likely, but those nearer to the top benefit even more. I'm looking at that SALT deduction raise at the moment. That one could be nice.
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This is true. However, my taxable household income is likely higher than yours already due to w-2 status and I doubt there are many of us here are under $100k in taxable income. Will the the billionaires make out better? Yes.
 
Sanman said:
This is true. However, my taxable household income is likely higher than yours already due to w-2 status and I doubt there are many of us here are under $100k in taxable income. Will the the billionaires make out better? Yes.
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We're a two W2 status household as well, I just happen to get pass through distribution income on top of that. But, we're also fairly high on the W2 alone as a PhD/MD household.
 
Therapist4Chnge said:
Maybe in the short-term, but look at what Trump I's tax cuts did....temporarily saved a few grand for families for a couple of years, but long term cost TRILLIONS in debt, with the vast vast majority of the benefit going to the top <1%. The same shell game is happening this time, but instead of expiring tax breaks for the 99%, there are delays in when TRILLIONS get added to the national debt. Cutting Medicare and Medicare is a large chunk of how some of the ultra wealthy tax breaks get covered, but even more gets added later by kicking the can down the road. I'm not an economist, but even a cursory review of the data coming out paints a horrid picture for the 99%. I'm a fiscally conservative independent and the "big beautiful bill" will add more debt than any prior piece of legislation in this country's history.
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Medicare or medicaid? Fully in agreement with your stance and I believe the larger issue for all of us when the government spends all its money and social security is not fixed. Because we will all see a cur to our future benefits.

That said, no able-bodied, fully licensed psychologist should be receiving Medicaid. Most of us should be on the upper end of the income scale and receiving at least a modest tax cut as a result of this. Now, the long-term effects on many of our patients and their ability to access care is of great relevance and a major concern.
 
WisNeuro said:
We're a two W2 status household as well, I just happen to get pass through distribution income on top of that. But, we're also fairly high on the W2 alone as a PhD/MD household.
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We are fairly high up too for similar reasons. Not sure which one of us would have the higher w-2 wages. You would have the higher capital gains.
 
Sanman said:
We are fairly high up too for similar reasons. Not sure which one of us would have the higher w-2 wages. You would have the higher capital gains.
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Ya’ll are just reinforcing why I need one of those millionaire matchmakers to find me an heiress who wants a CV Trophy Husband. 🤣
 
Therapist4Chnge said:
Ya’ll are just reinforcing why I need one of those millionaire matchmakers to find me an heiress who wants a CV Trophy Husband. 🤣
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Actually, I have a friend that pulled this off. The only good reason I have found for going to a private university for undergrad. I only met middle class folks at State U.
 
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futureapppsy2 said:
Heard from local leadership that there may be a total VHA hiring freeze coming very soon, with no exemptions, FWIW.
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I know this is likely but I hope not… I’ve applied to a couple unique/not often advertised positions and passed the initial stages.
 
yikes. I know a handful of 10yr+ VA people that left to open their own practice in just the past 2 months. I'm sad for the level of institutional knowledge, history, and committed care the VA is losing. Even if VA is able to hire to replace position, it is hard to imagine them being able to recruit the same caliber of talent they've gotten in the past.
 
JustNoticing said:
yikes. I know a handful of 10yr+ VA people that left to open their own practice in just the past 2 months. I'm sad for the level of institutional knowledge, history, and committed care the VA is losing. Even if VA is able to hire to replace position, it is hard to imagine them being able to recruit the same caliber of talent they've gotten in the past.
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This is what Vets have been voting for, for years. It's about time they finally get the consequences they voted for, and about time for those employees to finally not have to deal with the BS anymore.
 
JustNoticing said:
yikes. I know a handful of 10yr+ VA people that left to open their own practice in just the past 2 months. I'm sad for the level of institutional knowledge, history, and committed care the VA is losing. Even if VA is able to hire to replace position, it is hard to imagine them being able to recruit the same caliber of talent they've gotten in the past.
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Those are just the early folks. Most of the folks I know are setting up solo practices on the side while waiting for the fallout to see if they can get severance. Lots colleagues with new LLCs this year, myself included. They unfortunately denied my DRP request.
 
That's smart. I've thought about trying to get added to an insurance panel, but I don't really want to do private practice on the side.
 
cara susanna said:
That's smart. I've thought about trying to get added to an insurance panel, but I don't really want to do private practice on the side.
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Not worth it to get added to insurance for side work. However, if you want to see a few folks for cash, it is nice to have the LLC, phone number, website, intake forms, etc setup in advance if you need to go full time. You don't need a ton of clients to cover telehealth expenses. 1-3 would be fine.
 
Sanman said:
Not worth it to get added to insurance for side work. However, if you want to see a few folks for cash, it is nice to have the LLC, phone number, website, intake forms, etc setup in advance if you need to go full time. You don't need a ton of clients to cover telehealth expenses. 1-3 would be fine.
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Ah, in that case there is a pre-existing practice I could join.
 
Sanman said:
Those are just the early folks. Most of the folks I know are setting up solo practices on the side while waiting for the fallout to see if they can get severance. Lots colleagues with new LLCs this year, myself included. They unfortunately denied my DRP request.
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I know a few who have left due to this. I know another handful who are waiting out 1-3 years to meet certain pension requirements and then they are bouncing as soon as that is secured.
 
cara susanna said:
Ah, in that case there is a pre-existing practice I could join.
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PTSD IMEs/WC, make multiples of what you could make hourly doing clinical work. Decent demand in may jurisdictions. I get called in to travel to your area somewhat frequently to do both neuropsych and/or PTSD evals.
 
WisNeuro said:
PTSD IMEs/WC, make multiples of what you could make hourly doing clinical work. Decent demand in may jurisdictions. I get called in to travel to your area somewhat frequently to do both neuropsych and/or PTSD evals.
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I'm not completely opposed, but I also can't really figure how to get connected with that line of work.
 
Our director responded to the news of the VA contracting with OPM for RIFs by saying that “Collins said that veteran healthcare wouldn’t be affected!” Like… why would anyone believe Collins? 🤦‍♀️
 
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futureapppsy2 said:
Our director responded to the news of the VA contracting with OPM for RIFs by saying that “Collins said that veteran healthcare wouldn’t be affected! Like… why would anyone believe Collins? 🤦‍♀️
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Who cares about "Veteran Healthcare"? This is about quality of life for staff. VBA is already working mandated OT and they plan on firing more of them. You can fire some providers and mandate everyone else to work Saturday. So "veteran healthcare" is not affected. Yeah, but I still have to work Saturday then.
 
Random question but did your pre-employment physicals require/involve bloodwork (CBC, CMP, TSH, etc)? My first one, in 2023, did but the subsequent ones (for the same position class) just required the standard titers and TB tests. I’m beginning to wonder if my first occupational health physician just had a lot of time on his hands (I appreciated the free bloodwork, though!).
 
futureapppsy2 said:
Random question but did your pre-employment physicals require/involve bloodwork (CBC, CMP, TSH, etc)? My first one, in 2023, did but the subsequent ones (for the same position class) just required the standard titers and TB tests. I’m beginning to wonder if my first occupational health physician just had a lot of time on his hands (I appreciated the free bloodwork, though!).
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It's been a while since I've had one, but I think mine did.
 
futureapppsy2 said:
Random question but did your pre-employment physicals require/involve bloodwork (CBC, CMP, TSH, etc)? My first one, in 2023, did but the subsequent ones (for the same position class) just required the standard titers and TB tests. I’m beginning to wonder if my first occupational health physician just had a lot of time on his hands (I appreciated the free bloodwork, though!).
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Not for me. Basic. Unless the extra never got sent to me.
 
futureapppsy2 said:
Random question but did your pre-employment physicals require/involve bloodwork (CBC, CMP, TSH, etc)? My first one, in 2023, did but the subsequent ones (for the same position class) just required the standard titers and TB tests. I’m beginning to wonder if my first occupational health physician just had a lot of time on his hands (I appreciated the free bloodwork, though!).
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Just had one recently and it was just the vaccines related stuff and drug test. No real work up or even asking me to touch my toes or prove I could stand from a chair like they did once.
 
Sanman said:
Ending Performance Rating Inflation: OPM's Strategy For Fair Evaluations | FedSmith.com


Die Slow The Princess Bride GIF by filmeditor


  1. Balanced Distribution of Ratings: Agencies should prevent an excessive number of employees from being rated at the highest performance levels, ensuring meaningful distinctions in evaluations.
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Never really affected me either way. At my last VA position, we were told that neuropsychologists would never meet criteria for a bonus because of the volume of patients that we saw, and how leadership factored that in to productivity. We tried, to no avail, to show them how that figure made no sense for our evals, as we usually had far higher RVUs than other psychologists, but they just shrugged and said that's just the way it was.
 
WisNeuro said:
Never really affected me either way. At my last VA position, we were told that neuropsychologists would never meet criteria for a bonus because of the volume of patients that we saw, and how leadership factored that in to productivity. We tried, to no avail, to show them how that figure made no sense for our evals, as we usually had far higher RVUs than other psychologists, but they just shrugged and said that's just the way it was.
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I could care less about the bonus. I have received something small most years (averaging about $1000). However, I am anticipating a Jack Welsh style stack ranking and firing the bottom 10%.
 
Sanman said:
Ending Performance Rating Inflation: OPM's Strategy For Fair Evaluations | FedSmith.com


Die Slow The Princess Bride GIF by filmeditor


  1. Balanced Distribution of Ratings: Agencies should prevent an excessive number of employees from being rated at the highest performance levels, ensuring meaningful distinctions in evaluations.
Click to expand...
My Dean at my academic job is trying to do something similar, and it actually resulted in some people’s, possibly including mine, merit ratings being lowered after the fact, because he wants “more competition, comparison, and aggression” among faculty. Sounds great—no possible negative effects for anyone.
 
futureapppsy2 said:
My Dean at my academic job is trying to do something similar, and it actually resulted in some people’s, possibly including mine, merit ratings being lowered after the fact, because he wants “more competition, comparison, and aggression” among faculty. Sounds great—no possible negative effects for anyone.
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They sound incredibly unprepared & uninformed for what consequences can result in response. Good Luck!
 
futureapppsy2 said:
My Dean at my academic job is trying to do something similar, and it actually resulted in some people’s, possibly including mine, merit ratings being lowered after the fact, because he wants “more competition, comparison, and aggression” among faculty. Sounds great—no possible negative effects for anyone.
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Would the dean prefer his tires slashed or his car egged?
 
futureapppsy2 said:
My Dean at my academic job is trying to do something similar, and it actually resulted in some people’s, possibly including mine, merit ratings being lowered after the fact, because he wants “more competition, comparison, and aggression” among faculty. Sounds great—no possible negative effects for anyone.
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Bitterman!
 
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