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

[erg923]

I like having control over my workspace, especially in terms of ergonomics and comfort. I like having easy access to my fridge and snacks and food delivery. I like being home to be able to sign for packages or take them in as they're delivered. I do not miss the commute at all.

No one misses a commute. Ever. The "books on tape" and the "I like to think and decompress" people are either lying or in denial.

I have been working fully at home, although in a non-clinical service position for 5 years now. I simply cannot go back at this point! I take my kids to golf, football, and swim team. I do dishes and laundry. I can go to the driving range at 10 and/or help them practice their diving at the pool at 9,10,11. I go the market. I may wake up late. I may end my day early and go golfin at the club.

VA positions will not give you this degree of flexibility of course, but somethin is better than nothin!

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[PsyDWannabe]

Today I learned that trainees (interns) do not qualify for paid time off nor FMLA. So if you get pregnant during internship, you better have a bus load of external financial and social support or… I don’t even know what the alternative is now that Roe v. Wade has been overturned.

It’s wild to me because a doctorate in clinical psychology by nature takes severely underpaid yeeeaarrsss to complete and most people that do this are in their 20s or early 30s, which is prime time for starting a family. I hate to sound bitter but we literally shove millions of dollars worth of SC and benefits down the throat of vets who barely spent any time in service, but we can’t do this for trainees? Way to turn people off of civil service. Ugh.

 

[PsychPhDone]

Today I learned that trainees (interns) do not qualify for paid time off nor FMLA. So if you get pregnant during internship, you better have a bus load of external financial and social support or… I don’t even know what the alternative is now that Roe v. Wade has been overturned.

It’s wild to me because a doctorate in clinical psychology by nature takes severely underpaid yeeeaarrsss to complete and most people that do this are in their 20s or early 30s, which is prime time for starting a family. I hate to sound bitter but we literally shove millions of dollars worth of SC and benefits down the throat of vets who barely spent any time in service, but we can’t do this for trainees?

I think it's a bunch of 💩

 

[PsyDWannabe]

I think it's a bunch of 💩

Thank you!!!!!!! It’s unbelievable. Way to engender an aversion to sacrificing one’s life milestones for the greater good. And yes, interns are getting training in return but that is nowhere near a fair exchange.

 

[WisNeuro]

Thank you!!!!!!! It’s unbelievable. Way to engender an aversion to sacrificing one’s life milestones for the greater good. And yes, interns are getting training in return but that is nowhere near a fair exchange.

Remember this when we ask for help in lobbying for legislation. Due to reimbursement rules, there's a lot that we simply cannot bill for in terms of trainee's services. So, not only do we not get paid for a decent amount of the work you do, depending on patient population, we also can't bill for time spent training and supervising. In many places, the training budget is a giant red mark on the balance sheet.

 

[PsyDWannabe]

Remember this when we ask for help in lobbying for legislation. Due to reimbursement rules, there's a lot that we simply cannot bill for in terms of trainee's services. So, not only do we not get paid for a decent amount of the work you do, depending on patient population, we also can't bill for time spent training and supervising. In many places, the training budget is a giant red mark on the balance sheet.

I guess I always thought of training as an investment on the part of the institution. Especially in the VA system, seeing as the VA retains a lot of its trainees for the long term as independent practitioners.

 

[WisNeuro]

I guess I always thought of training as an investment on the part of the institution. Especially in the VA system, seeing as the VA retains a lot of its trainees for the long term as independent practitioners.

That may be an argument at the less desirable VAs, but doesn't hold much weight at most. We'd usually get several dozen applications anytime we posted a job. In general, the VA does not have much trouble recruiting psychologists (aside from CBOCs and very rural hospitals).

 

[erg923]

I guess I always thought of training as an investment on the part of the institution. Especially in the VA system, seeing as the VA retains a lot of its trainees for the long term as independent practitioners.

I'm lost. When i was an intern i had paid vacation, paid sick time, and paid federal holidays. When did this all the change?

 

[summerbabe]

I'm lost. When i was an intern i had paid vacation, paid sick time, and paid federal holidays. When did this all the change?

Those are still intact. It's that interns (and I believe postdocs too) don't qualify for FMLA since they aren't classified as employees, which sucks.

 

[ccpsych16]

I'm lost. When i was an intern i had paid vacation, paid sick time, and paid federal holidays. When did this all the change?

It hasn’t, except interns don’t qualify for FMLA and can’t contribute to retirement, which may have always been like that.

 

[WisNeuro]

I'm lost. When i was an intern i had paid vacation, paid sick time, and paid federal holidays. When did this all the change?

They still receive AL and SL, to my knowledge, interns have never qualified for FMLA due to employee definition as well as time worked.

 

[JeyRo]

Huh, I was able to contribute to retirement when I was a postdoc... but I guess not internship?

 

[WisNeuro]

Huh, I was able to contribute to retirement when I was a postdoc... but I guess not internship?

If you were, I suspect that was an HR error.

"Postdoctoral residents are not covered by Federal Employee retirement and are not eligible for federal
life insurance benefits but are eligible for health insurance benefits."

 

[PsyDuck90]

As of this training cohort, VA interns are only eligible for medical health insurance (not dental or vision) and TPS, per my TD. Apparently OAG decided to reclassify interns, so they stripped a lot of the benefits eligibility that previous cohorts had access to. I've heard a rumor that interns can get dental through the union but nothing confirmed.

 

[R. Matey]

Talk to me about all your favorite parts about being fully telework (or halfsies in office/fully in office) if that's your situation. I'm having a hard time deciding whether to go fully virtual.

Getting a full night's worth of sleep and working out in the mornings instead of rushing to sit in traffic does a lot for my general well-being.

 

[PsychPhDone]

I had assumed the lack of intern benefits was related to their contract being 1 year but I may have assumed wrong. Regardless of reasoning, it is still 💩.

 

[deleted1038433]

Today I learned that trainees (interns) do not qualify for paid time off nor FMLA. So if you get pregnant during internship, you better have a bus load of external financial and social support or… I don’t even know what the alternative is now that Roe v. Wade has been overturned.

It’s wild to me because a doctorate in clinical psychology by nature takes severely underpaid yeeeaarrsss to complete and most people that do this are in their 20s or early 30s, which is prime time for starting a family. I hate to sound bitter but we literally shove millions of dollars worth of SC and benefits down the throat of vets who barely spent any time in service, but we can’t do this for trainees? Way to turn people off of civil service. Ugh.

If you complete a year of internship, that year will count toward your federal service and you will qualify for paid parental leave if you remain a federal employee. Feel free to PM me. I went through this process. Also, reach out to HR directly about HR-related questions. I received tons of inaccurate information about important questions from my training director as an intern and from supervisors once a staff psychologist.

 

[PsyDWannabe]

If you complete a year of internship, that year will count toward your federal service and you will qualify for paid parental leave if you remain a federal employee. Feel free to PM me. I went through this process. Also, reach out to HR directly about HR-related questions. I received tons of inaccurate information about important questions from my training director as an intern and from supervisors once a staff psychologist.

wow. all of this is enlightening and frustrating, especially the last part. My post was not about my personal situation, it’s about a peer, but I will certainly encourage her to join this site if she hasn’t already, and peruse these comments. Thank you so much for offering your insight!

 

[ccpsych16]

As an intern I contributed to FEGLI

 

[Shiori]

Talk to me about all your favorite parts about being fully telework (or halfsies in office/fully in office) if that's your situation. I'm having a hard time deciding whether to go fully virtual.

In addition to everything already stated, I have more flexibility with what I wear on the bottom half of my body. I can wear shorts on hot days without a second thought. Now that I think about it, I guess what I'm really getting at is that there is less harassment. I don't get inappropriate comments nearly as often when I'm not walking up and down the halls of the hospital.

 

[JeyRo]

Because I work at a CLC, I have not done the work-from-home thing (and IMHO, any geropsychologist or direct care worker who says you can do effective telework w/ a skilled nursing population is lying).

But, my commute is 15 minutes from home.

I really feel double blessed. I have an office, I get to get away from the house for a few hours a day, and I get to actually interact with real people at work as opposed to pixels on a screen. Yes, working CLCs right now has a lot of extra challenges (all the COVID stuff, lockdowns, etc. is really depressing at times) but on balance I think I have a pretty damn good deal.

 

[texanpsychdoc]

No one misses a commute. Ever. The "books on tape" and the "I like to think and decompress" people are either lying or in denial.

I have been working fully at home, although in a non-clinical service position for 5 years now. I simply cannot go back at this point! I take my kids to golf, football, and swim team. I do dishes and laundry. I can go to the driving range at 10 and/or help them practice their diving at the pool at 9,10,11. I go the market. I may wake up late. I may end my day early and go golfin at the club.

VA positions will not give you this degree of flexibility of course, but somethin is better than nothin!

You hiring?

 

[WisNeuro]

You hiring?

You don't want to work for the corporate insurance "The Man." Look into the PP sector, we'll set you up with the same flexibility

 

[thebalmofhurtminds]

Because I work at a CLC, I have not done the work-from-home thing (and IMHO, any geropsychologist or direct care worker who says you can do effective telework w/ a skilled nursing population is lying).

But, my commute is 15 minutes from home.

I really feel double blessed. I have an office, I get to get away from the house for a few hours a day, and I get to actually interact with real people at work as opposed to pixels on a screen. Yes, working CLCs right now has a lot of extra challenges (all the COVID stuff, lockdowns, etc. is really depressing at times) but on balance I think I have a pretty damn good deal.

Telework is still working with "real people." I appreciate your position and can see how that would be best for you, but that kind of rhetoric really hurts the campaign for telehealth/telework. My patients are still real, even if they are on a screen.

 

[JeyRo]

Telework is still working with "real people." I appreciate your position and can see how that would be best for you, but that kind of rhetoric really hurts the campaign for telehealth/telework. My patients are still real, even if they are on a screen.

Um, yes, obviously I wasn't literally saying that people on the other side of screens don't actually exist...?

That being said - telework is all fine and dandy, but it's not a panacea by any stretch when it comes to my population.

Those with dementia, communication disorders, functional issues, and any number of the oldest-old cohort (e.g., issues with technophobia, poor technology literacy, etc.) are, IMHO, harmed by trying to forcibly conscript them into the "campaign for telehealth/telework."

Just my opinion.

 

[Sanman]

Um, yes, obviously I wasn't literally saying that people on the other side of screens don't actually exist...?

That being said - telework is all fine and dandy, but it's not a panacea by any stretch when it comes to my population.

Those with dementia, communication disorders, functional issues, and any number of the oldest-old cohort (e.g., issues with technophobia, poor technology literacy, etc.) are, IMHO, harmed by trying to forcibly conscript them into the "campaign for telehealth/telework."

Just my opinion.

There are positives and negatives, with the ⁰increased focus on RVUs in the VA, I am not sure how programs like HBPC will fair in the longer term. Telehealth will not take the place of real face to face contact. However, I am not sure that even the VA wants to spend the money on rural patient populations. Technology may be their last chance at quality care.

 

[summerbabe]

There are positives and negatives, with the ⁰increased focus on RVUs in the VA, I am not sure how programs like HBPC will fair in the longer term. Telehealth will not take the place of real face to face contact. However, I am not sure that even the VA wants to spend the money on rural patient populations. Technology may be their last chance at quality care.

100% agreed. My VISN is majorly expanding tele-med, including tele-urology and tele-cardiology (that I'm aware of) and include combinations of having patients occasionally drive to their nearest clinic for certain types of care while also sending some of these tele-providers to specific strategic locations every once in a while to see a grouping of patients over a few day period.

 

[summerbabe]

Those with dementia, communication disorders, functional issues, and any number of the oldest-old cohort (e.g., issues with technophobia, poor technology literacy, etc.) are, IMHO, harmed by trying to forcibly conscript them into the "campaign for telehealth/telework."

I agree, there are definitely populations where in-person care is either best or necessary.

But as COVID has changed many people's perspectives on work, I can see demand in things like CLC positions dropping in the future as current position holders leave and some positions remain unfilled, which will also result in loss of care.

I imagine neuropsych will get called in more frequently and perhaps telehealth or tele-consultation options might be explore but some of the work done by current CLC geropsychologists will be piecemealed together by MD/RN/SW only teams.

 

[JeyRo]

There are positives and negatives, with the ⁰increased focus on RVUs in the VA, I am not sure how programs like HBPC will fair in the longer term. Telehealth will not take the place of real face to face contact. However, I am not sure that even the VA wants to spend the money on rural patient populations. Technology may be their last chance at quality care.

I suspect HBPC can / is faring better with telehealth than CLC populations ever will.

They tend to be at least somewhat younger than CLC folks, & there's usually at least one or more people in the home who are functionally / cognitively intact enough to facilitate a meaningful telehealth contact (yes, theoretically nurses can do that here but practically speaking it's just not going to happen).

 

[deleted1038433]

Tell me about your traumatic and/or abusive VHA training experiences as an intern, postdoc, or staff member. I'm curious about other people's experiences.

 

[WisNeuro]

Nothing traumatic or abusive. I actually loved internship and postdoc at the VA. I still contend the VA is, in general, the best training ground in psychology. Being a staff member, though, that can be tough. Arbitrary productivity measurements, team leads that are generally clueless, entitled patient population that gets way too much leeway, payscale that ceilings out quickly, etc.

 

[throwaway_psychdr]

Tell me about your traumatic and/or abusive VHA training experiences as an intern, postdoc, or staff member. I'm curious about other people's experiences.

I think what I find abusive about the VA is not necessarily one incident but a general culture of not setting appropriate boundaries and not respecting clinicians’ judgements. I find it incredibly stressful to not be able to do (or in a lot of cases, not do) something I think is clinically appropriate. And to not get support from supervisors or other management around reasonable boundaries. I think it’s incredibly toxic- it leads to a huge amount of compassion fatigue and creates/encourages unrealistic expectations on the part of the patients. Really bad combo. This may be more pronounced at the VAs I’ve worked at but it does seem to be a general trend.

 

[cara susanna]

I think what I find abusive about the VA is not necessarily one incident but a general culture of not setting appropriate boundaries and not respecting clinicians’ judgements. I find it incredibly stressful to not be able to do (or in a lot of cases, not do) something I think is clinically appropriate. And to not get support from supervisors or other management around reasonable boundaries. I think it’s incredibly toxic- it leads to a huge amount of compassion fatigue and creates/encourages unrealistic expectations on the part of the patients. Really bad combo. This may be more pronounced at the VAs I’ve worked at but it does seem to be a general trend.

From my experience, trainees are pretty protected from that.

I had a supervisor who was abusive and apparently it was years before this person was removed from supervising. Ironically, the removal happened when I was being supervised by them and then my rotation collapsed. Still was glad to not have them as my supervisor, though!

 

[texanpsychdoc]

Nothing traumatic or abusive. I actually loved internship and postdoc at the VA. I still contend the VA is, in general, the best training ground in psychology. Being a staff member, though, that can be tough. Arbitrary productivity measurements, team leads that are generally clueless, entitled patient population that gets way too much leeway, payscale that ceilings out quickly, etc.

For the most part, I think my experiences thus far parallel how you described it. Alternatively, I will say that I had matched to a neuro track VA internship and ended up switching out of that track 3 months into it because the supervisor was a total Karen and I just couldn't see myself toughing it out 3 more months. I felt really bad because I had worked so hard to specialize in neuro, only to drop out of the track, which didn't do me any favors when I applied to the few neuro post docs around my area. I will say that working as a BHIP psychologist for the past year, it has been rewarding on many levels, but I am exhausted and burnt out, and I am an early early career psychologist. It scares me that I am already burnt out. And I agree, I think the VA is probably the best place to get trained, and the salary as an early career is awesome compared to non-VA employers, but you will hit that ceiling soon.

 

[texanpsychdoc]

I think what I find abusive about the VA is not necessarily one incident but a general culture of not setting appropriate boundaries and not respecting clinicians’ judgements. I find it incredibly stressful to not be able to do (or in a lot of cases, not do) something I think is clinically appropriate. And to not get support from supervisors or other management around reasonable boundaries. I think it’s incredibly toxic- it leads to a huge amount of compassion fatigue and creates/encourages unrealistic expectations on the part of the patients. Really bad combo. This may be more pronounced at the VAs I’ve worked at but it does seem to be a general trend.

So so much this. We have at least one supervisor who will say all day long that they will never make you see a veteran you are not comfortable or competent to see, but then....get voluntold to see them. Or, when you do express apprehension to see that veteran, it seems like they gaslight you into seeing them by framing it in a way of "this is a good learning experience for you" only to not actually provide any fruitful/meaningful consultation, guidance, etc. I am often taking on veterans who I flat out have zero competencies in evaluating or treating, only to find myself literally thumbing through the digital DSM as I am in session with them to figure things out as I go. Then, if I express my discontent with this whole crap shoot, I am basically told "well, we can transfer them, but this is experiential avoidance; what will happen in the future?"

 

[texanpsychdoc]

You don't want to work for the corporate insurance "The Man." Look into the PP sector, we'll set you up with the same flexibility

I am just uncertain if I can have the desired pay, work-life balance, benefits, retirement, etc., working in private practice. I really do not want to be working 50+ hours a week. I have some colleagues I work with in my part-time gig conducting forensic evals who are working 80 hours a week. I just don't see myself doing that, and I think that's what has deterred me from going further with other forensic types of work.

 

[WisNeuro]

I am just uncertain if I can have the desired pay, work-life balance, benefits, retirement, etc., working in private practice. I really do not want to be working 50+ hours a week. I have some colleagues I work with in my part-time gig conducting forensic evals who are working 80 hours a week. I just don't see myself doing that, and I think that's what has deterred me from going further with other forensic types of work.

If they're working 80+ hours in a pp forensic position, it's because they want to make bank, not to make the same they could at the VA. I'm probably averaging 30 hours a week and more than double my old hospital salary. All while shielding more of my earnings from taxes than before. If they're not absolutely killing it, they need to look at their fee schedule.

 

[Sanman]

Tell me about your traumatic and/or abusive VHA training experiences as an intern, postdoc, or staff member. I'm curious about other people's experiences.

I had some bad training experiences at the VA (and some good ones). Looking back as an employee, the bad ones all seem to stem from people who had no interest in training me and poor supervisory structures in the training program. Supervisors that forgot/missed supervision and were generally absent, ones that wanted things written word for word their way without any explanation, etc. A lot of this has to do with the incentives (or lack there of) for training folks in this system. These people were only in using me as cheap labor to improve their numbers. However, this is the only incentive that the VA gives you for training people.

 

[WisNeuro]

I had some bad training experiences at the VA (and some good ones). Looking back as an employee, the bad ones all seem to stem from people who had no interest in training me and poor supervisory structures in the training program. Supervisors that forgot/missed supervision and were generally absent, ones that wanted things written word for word their way without any explanation, etc. A lot of this has to do with the incentives of (or lack there of) for training folks in this system. These people were only in using me as cheap labor to improve their numbers. However, this is the only incentive that the VA gives you for training people.

The VA setting one of the few where this works for faculty/staff. I do remember getting juiced RVU numbers, especially when I had good trainees. Kind of a rude awakening in other settings when you find out how much of a financial and time blackhole trainees are for the most part.

 

[Sanman]

The VA setting one of the few where this works for faculty/staff. I do remember getting juiced RVU numbers, especially when I had good trainees. Kind of a rude awakening in other settings when you find out how much of a financial and time blackhole trainees are for the most part.

Honestly, doing it correctly is still a blackhole. I am just burning my time teaching didactics and supervising assessments. It is quicker to knock them out myself and I am usually not the primary supervisor long-term, so by the time they get good I am usually not the beneficiary. Still, I enjoy the interactions.

 

[WisNeuro]

Honestly, doing it correctly is still a blackhole. I am just burning my time teaching didactics and supervising assessments. It is quicker to knock them out myself and I am usually not the primary supervisor long-term, so by the time they get good I am usually not the beneficiary. Still, I enjoy the interactions.

By and large, yeah, trainees still cost more time than the offset you get. But, every now and then you'd just get that stellar trainee that needed only minimal revisions on reports. Those were glorious. I also thoroughly enjoyed supervising, so that was a bonus in the VA system. Also, only needed 3-4 evals/week to hit productivity goals, so I did a lot of reading in my office to pass the time.

 

[cara susanna]

Anyone else frequently get requests for psych diagnostic testing from people who aren't receiving mental health treatment in the VA (like, they're being seen in the community)? I find it so frustrating that we're being asked to do testing for treatment planning purposes when the person in question isn't even receiving treatment with anyone in our clinic. It's annoying because to me it feels like we're being forced to pick up the slack from non-VA providers. Like, why is it the VA's problem that your facility doesn't have your own testing services?

I also hate when providers tell us what to do testing with. Like, we frequently get requests (including VA therapists) for someone to get an MMPI. I don't even use the MMPI when I do psych testing. Sometimes I wonder what people think the MMPI actually is.

Okay, rant over. Thank you.

 

[WisNeuro]

Anyone else frequently get requests for psych diagnostic testing from people who aren't receiving mental health treatment in the VA (like, they're being seen in the community)? I find it so frustrating that we're being asked to do testing for treatment planning purposes when the person in question isn't even receiving treatment with anyone in our clinic. It's annoying because to me it feels like we're being forced to pick up the slack from non-VA providers. Like, why is it the VA's problem that your facility doesn't have your own testing services?

I also hate when providers tell us what to do testing with. Like, we frequently get requests (including VA therapists) for someone to get an MMPI. I don't even use the MMPI when I do psych testing. Sometimes I wonder what people think the MMPI actually is.

Okay, rant over. Thank you.

Back when we had to do a small number of ADHD stuff in the VA, we'd get referrals from non psychologists that would say "suspect ADHD, do CPT/TOVA." We'd just accept the referral and note back something to the effect of "referral scheduled, test selection up to provider conducting the eval, we do not use the CPT/TOVA." You want that useless test, give it your damn self. Also, I'm not your ****ing lab, I decide the tests to perform, not you.

 

[Sanman]

Anyone else frequently get requests for psych diagnostic testing from people who aren't receiving mental health treatment in the VA (like, they're being seen in the community)? I find it so frustrating that we're being asked to do testing for treatment planning purposes when the person in question isn't even receiving treatment with anyone in our clinic. It's annoying because to me it feels like we're being forced to pick up the slack from non-VA providers. Like, why is it the VA's problem that your facility doesn't have your own testing services?

I also hate when providers tell us what to do testing with. Like, we frequently get requests (including VA therapists) for someone to get an MMPI. I don't even use the MMPI when I do psych testing. Sometimes I wonder what people think the MMPI actually is.

Okay, rant over. Thank you.

I don't get that very often but HBPC often has to coordinate with private PCPs/Neurologists that want to play psych doctor for dementia folks and then hit up the VA for the free things they can't provide. It is always a mess.

 

[WisNeuro]

I don't get that but HBPC often has to coordinate with private PCPs/Neurologists that want to play psych doctor for dementia folks and then hit up the VA for the free things they can't provide. It is always a mess.

I could also see it for neuropsych assessments depending on the region. If the community waitlist is 6+ months, they can likely be seen much sooner in the VA.

 

[summerbabe]

It scares me that I am already burnt out.

I'm also early career and have only been in VA since internship and postdoc and wonder whether experiences with burnout parallel what one would find in a different setting if one is primarily a therapist. Or if there are some VA specific processes that really contribute to this.

Part of it is the sheer amount of patients that are seen, which should take a toll in any setting. And there can be admin/bureaucratic burdens, productivity pressures, poor experiences with leadership, and more at any institution. Or worry about income in a private practice and dealing with insurance companies.

 

[Sanman]

I could also see it for neuropsych assessments depending on the region. If the community waitlist is 6+ months, they can likely be seen much sooner in the VA.

Sadly, I see more dx's based on MMSE/ MOCA scores and Donepezil scripts thrown out like candy than a rush for neuropsych from outside providers.

 

[WisNeuro]

Sadly, I see more dx's based on MMSE/ MOCA scores and Donepezil scripts thrown out like candy than a rush for neuropsych from outside providers.

Yeah, I see plenty of those as well. Also plenty of people diagnosing older adults (75+) based on MoCA cutscores that are not accurate when you look at community based norms.

 

[texanpsychdoc]

Anyone else frequently get requests for psych diagnostic testing from people who aren't receiving mental health treatment in the VA (like, they're being seen in the community)? I find it so frustrating that we're being asked to do testing for treatment planning purposes when the person in question isn't even receiving treatment with anyone in our clinic. It's annoying because to me it feels like we're being forced to pick up the slack from non-VA providers. Like, why is it the VA's problem that your facility doesn't have your own testing services?

I also hate when providers tell us what to do testing with. Like, we frequently get requests (including VA therapists) for someone to get an MMPI. I don't even use the MMPI when I do psych testing. Sometimes I wonder what people think the MMPI actually is.

Okay, rant over. Thank you.

I tend to take on all the non-neuro testing cases (a lot of diagnostic clarification, ADHD, and SLD). I am fortunate to have two neuropsychologists to consult with on more challenging cases, and they typically ask me for tests I want to order (just recently purchased the full Barkley series for ADHD evals). I get a bunch of referrals from providers outside the main VA, such as our CBOCs (typically from SW or psychiatry), and get a bunch of referrals from our NPs, and some from our psychologists. I don't think I have yet been faced with an outside referral for me to do the assessment. That seems weird.

 

[Fan_of_Meehl]

Anyone else frequently get requests for psych diagnostic testing from people who aren't receiving mental health treatment in the VA (like, they're being seen in the community)? I find it so frustrating that we're being asked to do testing for treatment planning purposes when the person in question isn't even receiving treatment with anyone in our clinic. It's annoying because to me it feels like we're being forced to pick up the slack from non-VA providers. Like, why is it the VA's problem that your facility doesn't have your own testing services?

I also hate when providers tell us what to do testing with. Like, we frequently get requests (including VA therapists) for someone to get an MMPI. I don't even use the MMPI when I do psych testing. Sometimes I wonder what people think the MMPI actually is.

Okay, rant over. Thank you.

We don't get these. Sounds odd. What is the identified problem on the consult? 'Acute MMPI Deficiency, Single Episode, Severe?'