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

[psycho1391]

some of their objectives including shortening meetings (making standard meeting times 25 and 50 mins), streamlining TMS training requirements, and implementing 'servant leadership' philosophies' but, again, time will tell if any of these wonderful ideas are implemented. I would love it if they were.

I like those ideas too.

I may be pessimistic, but I think the only thing out of there coming to fruition is the streamlining TMS training requirements. The other two ideas are really up to the individual managers/supervisors, and unless their performance evaluations contain measures of those things I don't think much is going to change.

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[cara susanna]

Hopefully any burnout reduction initiatives would address systems issues and not just "hold yoga classes over lunch."

 

[PsychPhDone]

Lol this is the first I heard of it

What are everyone's thoughts about the burnout initiative?

 

[Fan_of_Meehl]

Hopefully any burnout reduction initiatives would address systems issues and not just "hold yoga classes over lunch."

We will be glad to sign you up for our virtual McMindfulness seminar from 12:00 - 12:30 M - F at www.youdeserveabreaktoday.com

 

[Sanman]

We will be glad to sign you up for our virtual McMindfulness seminar from 12:00 - 12:30 M - F at www.youdeserveabreaktoday.com

Do you think running the McMindfulness seminar is a remote position? Maybe a gs-14? Asking for a friend (who is actually me)...

 

[Fan_of_Meehl]

Do you think running the McMindfulness seminar is a remote position? Maybe a gs-14? Asking for a friend (who is actually me)...

Afraid that position (actually, an SES position based out of D.C.) is taken. Doesn't list the specific name of the person holding the position but he goes by the call sign "RobbleRobbleRobble."

 

[summerbabe]

I hope something good comes out of this but it does ring hollow coming on the tail end of a whole bunch of recent burnout-inducing directives that’s being initiated from the highest levels of VA.

 

[JustNoticing]

Hopefully any burnout reduction initiatives would address systems issues and not just "hold yoga classes over lunch."

I actually sent an email directly to Steven Lieberman ( VA undersecretary of health) responding to one of his emails about about the REBOOT task force telling him if I get one more email telling me to do yoga or mindfulness, I'd go postal. FWIW, he actually took it well and said he gets it. But I've been disappointed that "more time off" was named as a priority during the focus groups they had, yet is not on the priority list. I've emailed them telling the REBOOT folks that it is gaslighting nonsense to be sending us emails about work/life balance when non-title38 employees start with 13 days off a year. etc.

 

[ccpsych16]

some things I’d actually want:

-more flexible leave policy (45 days or else you jump through a million hoops? come on.)
-leave accrual on par with doctors and nurses (i.e. more hours per pp right off the bat).
-similarly end of year “bonuses” on par with them.
-increase in pay
-bulk hire more staff in every single area
-de-emphasize productivity benchmarks—we shouldn’t be worried about no shows etc affecting performance reviews due to low RVUs

These are mostly issues that I (obviously) haven’t personally dealt with but I’ve seen over the past 3 years as a trainee. Every supervisor I’ve had talks about wanting these things. Not yoga at 7pm on Wednesdays via Zoom.

 

[WisNeuro]

I actually sent an email directly to Steven Lieberman ( VA undersecretary of health) responding to one of his emails about about the REBOOT task force telling him if I get one more email telling me to do yoga or mindfulness, I'd go postal. FWIW, he actually took it well and said he gets it. But I've been disappointed that "more time off" was named as a priority during the focus groups they had, yet is not on the priority list. I've emailed them telling the REBOOT folks that it is gaslighting nonsense to be sending us emails about work/life balance when non-title38 employees start with 13 days off a year. etc.

To be fair, VA employees, even psychologists, have one of the most favorable PTO policies of any healthcare org I have seen. I haven't seen any other starting package that includes anywhere near the amount of PTO that the VA provides. It could be more flexible, but that's also an issue with every healthcare org. Many places have a at least a 45 day window to request leave. Some it's 60+ days for PTO.

 

[Fan_of_Meehl]

I actually sent an email directly to Steven Lieberman ( VA undersecretary of health) responding to one of his emails about about the REBOOT task force telling him if I get one more email telling me to do yoga or mindfulness, I'd go postal. FWIW, he actually took it well and said he gets it. But I've been disappointed that "more time off" was named as a priority during the focus groups they had, yet is not on the priority list. I've emailed them telling the REBOOT folks that it is gaslighting nonsense to be sending us emails about work/life balance when non-title38 employees start with 13 days off a year. etc.

For me there are two things--really, aspects of the psychological work environment that probably contribute the most to my demoralization and burnout:

1) The VA constantly talks 'out of both sides of its mouth' with respect to its policies/procedures and public facing messaging. This results in far more friction in the therapeutic encounter than would otherwise be the case for the provider. For instance, all of the public messaging has been along the lines of 'one suicide is too many,' 'we're here for ALL veterans with mental health needs, ALL the time, and forever.' Essentially sending the message that we are not 'rationing care' and that we are 'here' (#BeThere) for veterans whenever they need us to be. However, behind closed doors, there is pressure to 'maximize' productivity/access and 'get em it, get em out' in some pre-determined number of sessions or to 'make' them engage in therapy (all the while providing motivational interviewing training to therapists with the opposite set of philosophical assumptions) along with the message that veterans who are in therapy 'too long' are wasting time/resources. Now, certainly this may be the case in some areas but, by and large, I haven't seen a lot of 'waste' in that area. In any case, the VA should present a CONSISTENT MESSAGE to both veterans/families as well as providers (internally).

2) Somewhat related to #1, just like all dysfunctional families, the dysfunctional organization is beset with dysfunctional schemas regarding their providers (whom they regard as their 'children'...their 'bad children') and whenever something is 'wrong,' the predominant set of assumptions are that the providers are to blame. They are being 'lazy' or 'incompetent' in some way. Besides being myopic this is clearly self-serving for those in charge. If there is 'an issue' (e.g., access issues), then there are basically three main sources of contribution to the problem: (a) veteran behaviors, (b) provider behaviors, (c) systems issues (which imply lack of appropriate administrative behaviors). Well, obviously, we can't address the problem of veteran behaviors (e.g., no-showing, cancelling last minute, not doing homework, having a different agenda (secondary gain)) because that would not be politically correct and may make people uncomfortable. Likewise, we cannot acknowledge system-level issues (free expensive mental healthcare for life with no penalties (ever) for no-shows or cancellations, internally inconsistent philosophies of care and contradictory policies/procedures) because that would mean that administrators bear some responsibility for the issues and may need to change their behavior. What does that leave? Oh yeah, it's the providers. Every time. It just gets old.

 

[Fan_of_Meehl]

I actually sent an email directly to Steven Lieberman ( VA undersecretary of health) responding to one of his emails about about the REBOOT task force telling him if I get one more email telling me to do yoga or mindfulness, I'd go postal. FWIW, he actually took it well and said he gets it. But I've been disappointed that "more time off" was named as a priority during the focus groups they had, yet is not on the priority list. I've emailed them telling the REBOOT folks that it is gaslighting nonsense to be sending us emails about work/life balance when non-title38 employees start with 13 days off a year. etc.

Regarding the 'more time off' (to prevent burnout) I totally feel that. Seeing heavily burdened (with psychopathology) veteran patients all day long, every day, without end is incredibly draining. One alternative to more time off might be having the burden of seeing veterans for psychotherapy more evenly distributed among all mental health staff licensed (and therefore able) to do so. What I mean is that instead of having people basically divided into two classes: (a) those who see veteran patients for therapy all day, every day and are mapped like 95-100 clinical time; vs (b) those who never see veterans for therapy or who see them extremely infrequently (couple of sessions per week or some ancillary 'support group' once per month) and are almost 100% non-clinical in their labor mapping. **Please note: I am not including actual supervisors/ service chiefs in the (b) category; I definitely realize that they have other duties that make it impossible for them to have caseloads beyond maybe a couple of patients just to keep their 'toes in the water' to keep a bearing on what practice is like in their systems. I am more talking about all of the other ancillary positions that have been proliferating in the past several years. So one possible solution would be to ramp down the amount of clinic time for everyone down to something like 65% - 75% of their work time mapped to clinical encounters/therapy and to divide up the administrative duties more evenly among staff so that staff don't show up to their shift grimly staring down a list of back-to-back-to-back-to-back-to-back-to-back psychiatric trainwrecks until they get to the end of their shifts. Something like back-to-back-to-back, then an afternoon of one additional client and some administrative duties would be far less likely to induce burnout.

 

[summerbabe]

What I mean is that instead of having people basically divided into two classes: (a) those who see veteran patients for therapy all day, every day and are mapped like 95-100 clinical time; vs (b) those who never see veterans for therapy or who see them extremely infrequently (couple of sessions per week or some ancillary 'support group' once per month) and are almost 100% non-clinical in their labor mapping. **Please note: I am not including actual supervisors/ service chiefs in the

The inflexibility of grids and clinical mapping is huge. If you're one of those 95% clinicians, it can be an act of Congress to get even an hour blocked for something incredibly work relevant and burnout reducing, such as a regular clinical consultation group or some type of professional development.

I know people whose supervisors did not allow them to apply to be EBP consultants because it would take too much time away from direct patient care. That's madness!

Access is terrible in many places but the top down messages about productivity that drives an overall lack of flexibility basically forces people to either dislike their job more and more over time or leave for other positions in their facility, other VAs, or the system all-together.

Flexibility can always be abused and some would take more advantage than they should but this rigidity combined with ever increasing administrative burdens has to be playing a major role in the turnover that's happening at much larger degrees than usual at many VA facilities.

 

[Fan_of_Meehl]

The inflexibility of grids and clinical mapping is huge. If you're one of those 95% clinicians, it can be an act of Congress to get even an hour blocked for something incredibly work relevant and burnout reducing, such as a regular clinical consultation group or some type of professional development.

I know people whose supervisors did not allow them to apply to be EBP consultants because it would take too much time away from direct patient care. That's madness!

Access is terrible in many places but the top down messages about productivity that drives an overall lack of flexibility basically forces people to either dislike their job more and more over time or leave for other positions in their facility, other VAs, or the system all-together.

Flexibility can always be abused and some would take more advantage than they should but this rigidity combined with ever increasing administrative burdens has to be playing a major role in the turnover that's happening at much larger degrees than usual at many VA facilities.

The other, in my opinion, ABSOLUTE REALITY that no one ever talks (openly) about is this:

We get pressured to 'fire' (unilaterally terminate) veteran patients who are not engaging in ('evidence-based') protocols or not engaging productively in active treatment. But here's the catch. With very few exceptions, NO veteran who is service-connected for their mental health condition and relying on that income to pay their bills is going to potentially jeopardize that by openly admitting to or discussing with their therapist that they either (a) have tried this therapy thing but have reached their maximal benefit (i.e., it would do them no more 'good' to continue coming to therapy; and/or (b) that they understand that therapy requires self-change and work but they either disagree with the estimation that THEY need to change or they are unwilling/unable to attempt to make that change. The reason is obvious. If and when they talk honestly to their therapist about it, their therapist has a responsibility to accurately chart on the reason that therapy is being terminated even though they are self-reporting severe symptoms of a mental health condition. This is just one of the 'dirty little secrets' of outpatient mental health care in the VA system that no one can ever discuss openly (because we can't have adult conversations at VA) but that is clearly contributing to the problem of veterans being motivated to seek to be in therapy indefinitely. I have worked for decades in mental health care outside the VA and generally had no problem with terminating with patients in a timely manner. I can't say the same about my VA work because of the aforementioned issue and I know that I'm not alone.

 

[cara susanna]

For me, it would be...

- Definitely de-emphasizing productivity and especially RVUs.
- Emphasizing less about initial access and making us feel like we have to race to get people in. I've literally had conversations with new VA pts who had consults placed after their first PCP appt that they were overwhelmed because they were getting all of these calls and referrals at the same time. Sometimes FAST isn't always BEST. AND actually caring about f/u access as much as initial access.
- Less paperwork and administrative requirements (MHS) and ESPECIALLY less reliance on consults. Did you know that we aren't even supposed to place orders for other clinicians if the pt hasn't already met them as a warm handoff? Otherwise it's supposed to be a consult. That is RIDICULOUS.
- More time off would be nice.
- Yes, more flexibility with grids and being able to block clinics.
- I know that BLS is important but doing it every quarter is draining and it takes time that we don't always have. Could the requirements be more flexible? I'm not sure if that's possible, but...
- More of an ability to use community care, especially if it's in the patient's best medical interest, and refer patients out if we're swamped.
- More admin time
- As mentioned, more of an ability to discharge and not see pts who aren't engaging in or don't need therapy without worries about patient advocates, congressionals, or the dreaded accusation that we are "denying care"
- This is more of a local complaint, but we have absolutely no regard for provider safety and care when patients are harassing, abusive, or even violent. We had a patient get physically violent in our clinic and it was a HUGE thing to say that this person couldn't receive care at our facility anymore. Staff had to keep pushing it with upper level admin, even.

Btw, have you guys had to change your voicemails to include the "not for urgent reasons" line? Yeah, THAT'LL stop suicide.

 

[summerbabe]

AND actually caring about f/u access as much as initial access.

Couldn't agree more. I see so many scrambles to get 'high risk' vets crammed into intake slots and then for them to get booked for a therapy f/u in 2 months, as if we operate on a psychiatry model of care. While other vets linger in MH to have apts for the sake of having apts when their needs can almost certainly be met by having a brief psychiatry apt every 2 months or so.

Did you know that we aren't even supposed to place orders for other clinicians if the pt hasn't already met them as a warm handoff?

We are able to place these RTCs at my current and previous VAs. That sounds like a crappy local decision.

I know that BLS is important but doing it every quarter

Ugh. I can't remember how often mine comes up but I feel like my full manican training is every 2 years or so? And maybe an online only refresher in between?

- This is more of a local complaint, but we have absolutely no regard for provider safety and care when patients are harassing, abusive, or even violent. We had a patient get physically violent in our clinic and it was a HUGE thing to say that this person couldn't receive care at our facility anymore. Staff had to keep pushing it with upper level admin, even.

I remember being on postdoc and hearing about leadership trying to figure out a plan to serve a veteran who was getting out of jail after being convicted for making terroristic threats towards this VA and possession of illegal weapons that would have been used as part of that plan. I finished postdoc so I don't know the outcome but I'm sure the jail stint eliminated whatever complaints this veteran had.

 

[cara susanna]

Couldn't agree more. I see so many scrambles to get 'high risk' vets crammed into intake slots and then for them to get booked for a therapy f/u in 2 months, as if we operate on a psychiatry model of care. While other vets linger in MH to have apts for the sake of having apts when their needs can almost certainly be met by having a brief psychiatry apt every 2 months or so.

We are able to place these RTCs at my current and previous VAs. That sounds like a crappy local decision.

Ugh. I can't remember how often mine comes up but I feel like my full manican training is every 2 years or so? And maybe an online only refresher in between?

I remember being on postdoc and hearing about leadership trying to figure out a plan to serve a veteran who was getting out of jail after being convicted for making terroristic threats towards this VA and possession of illegal weapons that would have been used as part of that plan. I finished postdoc so I don't know the outcome but I'm sure the jail stint eliminated whatever complaints this veteran had.

No, it's not local. I was on a national call and they were telling us. We also place RTCs like that all of the time, but apparently we're not supposed to per national guidance. Will I keep doing it until they make me stop? Heck yeah.

 

[psycho1391]

I know that BLS is important but doing it every quarter is draining and it takes time that we don't always have. Could the requirements be more flexible? I'm not sure if that's possible, but...

Totally agree here. Plus, the bugging issues are horrid. I went to do mine on Wednesday and the system wasn't working.

 

[texanpsychdoc]

some things I’d actually want:

-more flexible leave policy (45 days or else you jump through a million hoops? come on.)
-leave accrual on par with doctors and nurses (i.e. more hours per pp right off the bat).
-similarly end of year “bonuses” on par with them.
-increase in pay
-bulk hire more staff in every single area
-de-emphasize productivity benchmarks—we shouldn’t be worried about no shows etc affecting performance reviews due to low RVUs

These are mostly issues that I (obviously) haven’t personally dealt with but I’ve seen over the past 3 years as a trainee. Every supervisor I’ve had talks about wanting these things. Not yoga at 7pm on Wednesdays via Zoom.

All of this.

The VA I just transferred to increased its pay for psychologists to keep competitive with the neighboring medical centers. I guess they wanted to attract and retain more providers who were leaving to those medical centers. I'm thinking I will tough it out with the VA for another 4 years so that I can take advantage of the EDRP, then I may look elsewhere. I also agree with what was mentioned earlier - we need to have psychologists receiving the same benefits on par with our physician colleagues. Even the damn parking lots for "physicians only."

 

[WisNeuro]

All of this.

The VA I just transferred to increased its pay for psychologists to keep competitive with the neighboring medical centers. I guess they wanted to attract and retain more providers who were leaving to those medical centers. I'm thinking I will tough it out with the VA for another 4 years so that I can take advantage of the EDRP, then I may look elsewhere. I also agree with what was mentioned earlier - we need to have psychologists receiving the same benefits on par with our physician colleagues. Even the damn parking lots for "physicians only."

Did they increase their pay, or did the locality adjustment just increase? Because the VA is very limited in what it can do salary-wise for the hybrid employees.

 

[Sanman]

Did they increase their pay, or did the locality adjustment just increase? Because the VA is very limited in what it can do salary-wise for the hybrid employees.

Several VA psych depts have gotten significant bonuses approved for next year as part of retention effort following COVID. It will be paid out over the course of 2023 I believe. It is not permanent but it can be renewed in 2024.

 

[WisNeuro]

Several VA psych depts have gotten significant bonuses approved for next year as part of retention effort following COVID. It will be paid out over the course of 2023 I believe. It is not permanent but it can be renewed in 2024.

Ah, ok. So, it is completely dependent on the results of the 2022 midterm elections.

 

[texanpsychdoc]

Did they increase their pay, or did the locality adjustment just increase? Because the VA is very limited in what it can do salary-wise for the hybrid employees.

The way HR and our supervisors described the recent pay increase, is it's called "SRS" or "SSR" pay. So, instead of receiving base plus locality pay every year, we will receive base plus the SSR/SRS pay instead every year as long as we remain at the duty station it was approved for. Evidently not all CBOCs associated with our main VA were approved for this, so, only those psychologists at the main building plus select CBOCs will be receiving this new pay structure. They take 64% of our base and add that back onto our base.

For example, the pay for a GS-12 here is $91K - under this new pay a GS-12 psychologist will get $112,010. Next year when I bump up to GS-13 I will get $133K (likely a bit more). They also announced a 4.1% base pay increase effective January. So these amounts I just quoted will increase.

 

[WisNeuro]

Probably SSR, Special Salary Rates. Must be having some retention issues.

 

[texanpsychdoc]

Probably SSR, Special Salary Rates. Must be having some retention issues.

That's my guess. Alternatively, some colleagues of mine also told me they had been funded to fill like 30ish psychologist slots. They claimed it was not due to turnover, but due to genuine need of the facility. So...IDK. This is my 3rd VA now, I've learned much of the politics, and I've learned to set reasonable expectations about the work-life balance and quality of life at the VA. I am a realist.

 

[Fan_of_Meehl]

Several VA psych depts have gotten significant bonuses approved for next year as part of retention effort following COVID. It will be paid out over the course of 2023 I believe. It is not permanent but it can be renewed in 2024.

We sure didn't...lol

 

[summerbabe]

We sure didn't...lol

Maybe a voucher to redeem a meal (valued at $5.99 or less) at your canteen will appear soon

 

[Fan_of_Meehl]

Maybe a voucher to redeem a meal (valued at $5.99 or less) at your canteen will appear soon

The 'You Deserve a Break Today' Happy Meal grand prize for winning the 'Mental Health Suite' compliance contest (highest percentage of MHS plans not 'out of date').

 

[JeyRo]

We sure didn't...lol

We got gifted with a massive special cost of living increase last year. That's how I ended up with making approximately 175K as a GS13/9.

Still somehow doesn't make up for all the nonsense, but I guess grass is always greener.

 

[Fan_of_Meehl]

We got gifted with a massive special cost of living increase last year. That's how I ended up with making approximately 175K as a GS13/9.

Still somehow doesn't make up for all the nonsense, but I guess grass is always greener.

Congratulations. That's awesome!

Maybe if word gets out (to all the other VA psychologists at facilities who didn't get such a raise), they'll all apply to come to that VA. And then, maybe when the VA's (that they came from) are experiencing a shortage of psychologists (because they went to another VA that is paying much higher salaries for the same GS-level position), their leaders can articulate a reason to raise THOSE salaries (at that VA) and maybe some of the psychologists can return to their original VA's.

That...or they could just, you know, give everyone in the same job position and with the same GS-level raises.

Edit: And just to be clear, I definitely understand that there are different cost-of-living adjustments made to salaries in the Federal system based on living in metro areas vs. small town areas. I get it. But this just seems WAY beyond that. At my facility (which is at the 'bottom' of the pay scale in terms of cost-of-living adjustments) a GS-13 step 9 salary is 119K. 119K / 175K = .68. There is no justification--even considering differences in cost-of-living--that can justify one psychologist getting paid 68 cents on the dollar for doing the exact same job. Is that actually commensurate with the cost of living differential (truly)? I mean, I could buy like a 20K or even a 30K differential between rural and metro settings but, c'mon. Maybe I'm just that out of touch since I haven't lived in a 'big city' for a couple of decades now.

 

[texanpsychdoc]

Congratulations. That's awesome!

Maybe if word gets out (to all the other VA psychologists at facilities who didn't get such a raise), they'll all apply to come to that VA. And then, maybe when the VA's (that they came from) are experiencing a shortage of psychologists (because they went to another VA that is paying much higher salaries for the same GS-level position), their leaders can articulate a reason to raise THOSE salaries (at that VA) and maybe some of the psychologists can return to their original VA's.

That...or they could just, you know, give everyone in the same job position and with the same GS-level raises.

Edit: And just to be clear, I definitely understand that there are different cost-of-living adjustments made to salaries in the Federal system based on living in metro areas vs. small town areas. I get it. But this just seems WAY beyond that. At my facility (which is at the 'bottom' of the pay scale in terms of cost-of-living adjustments) a GS-13 step 9 salary is 119K. 119K / 175K = .68. There is no justification--even considering differences in cost-of-living--that can justify one psychologist getting paid 68 cents on the dollar for doing the exact same job. Is that actually commensurate with the cost of living differential (truly)? I mean, I could buy like a 20K or even a 30K differential between rural and metro settings but, c'mon. Maybe I'm just that out of touch since I haven't lived in a 'big city' for a couple of decades now.

They should really come down to Houston. That's where the big payday is for VA psychologists.

 

[texanpsychdoc]

Congratulations. That's awesome!

Maybe if word gets out (to all the other VA psychologists at facilities who didn't get such a raise), they'll all apply to come to that VA. And then, maybe when the VA's (that they came from) are experiencing a shortage of psychologists (because they went to another VA that is paying much higher salaries for the same GS-level position), their leaders can articulate a reason to raise THOSE salaries (at that VA) and maybe some of the psychologists can return to their original VA's.

That...or they could just, you know, give everyone in the same job position and with the same GS-level raises.

Edit: And just to be clear, I definitely understand that there are different cost-of-living adjustments made to salaries in the Federal system based on living in metro areas vs. small town areas. I get it. But this just seems WAY beyond that. At my facility (which is at the 'bottom' of the pay scale in terms of cost-of-living adjustments) a GS-13 step 9 salary is 119K. 119K / 175K = .68. There is no justification--even considering differences in cost-of-living--that can justify one psychologist getting paid 68 cents on the dollar for doing the exact same job. Is that actually commensurate with the cost of living differential (truly)? I mean, I could buy like a 20K or even a 30K differential between rural and metro settings but, c'mon. Maybe I'm just that out of touch since I haven't lived in a 'big city' for a couple of decades now.

I hear ya - and I get it. As a GS-12 in Columbus, Ohio I was making $82K, now I am making $112K. As a GS-13 in Columbus, I would make probably $100K come next year; at my new VA, I would make over $133K. There are cost of living differences, tax differences, etc. But as I mentioned in a previous post, this particular VA I am at had approved (by central office) for the SSR pay to take the place of the locality pay. They did this in an effort to be more competitive with the neighboring medical centers. It's one of the reasons I moved here...the pay was much better and I keep more of my money vs. what I was getting paid in Ohio. I was also offered the opportunity to be an assistant professor at a medical school here, so that enticed me as well.

 

[AcronymAllergy]

It's good to hear that at least some VAs are making headway in increasing psychologist pay. At my last VA, we lost at least a couple potential hires due to their being offered significantly better salaries elsewhere.

And better pay for some psychologists is, in the grand scheme, better for all psychologists. The more common higher-paying jobs become, the more those salary numbers become the norm, and the harder it is for facilities offering poor compensation to fill positions. The trick is finding the sweet spot between desirable compensation and driving employers to hiring non-psychologist therapists.

 

[Fan_of_Meehl]

It's good to hear that at least some VAs are making headway in increasing psychologist pay. At my last VA, we lost at least a couple potential hires due to their being offered significantly better salaries elsewhere.

And better pay for some psychologists is, in the grand scheme, better for all psychologists. The more common higher-paying jobs become, the more those salary numbers become the norm, and the harder it is for facilities offering poor compensation to fill positions. The trick is finding the sweet spot between desirable compensation and driving employers to hiring non-psychologist therapists.

Very good points...especially the part about hiring non-psychologist therapists. I'm waiting for the day that they just, as an organization say, 'to heck with it...just fire all the psychologists and hire social workers to do their jobs and drop everyone a GS level.' Except, at our facility, the social workers are placed in all of the administrative, fluff, and program manager positions and all of the psychologists carry caseloads and provide services. Some of us have even joked about going back to school to get our LCSW's since we'd get better jobs at VA (at least in terms of amount of work/stress per dollar earned).

 

[texanpsychdoc]

Very good points...especially the part about hiring non-psychologist therapists. I'm waiting for the day that they just, as an organization say, 'to heck with it...just fire all the psychologists and hire social workers to do their jobs and drop every one a GS level.' Except, at our facility, the social workers are placed in all of the administrative, fluff, and program manager positions and all of the psychologists carry caseloads and provide services. Some of us have even joked about going back to school to get our LCSW's since we'd get better jobs at VA (at least in terms of amount of work/stress per dollar earned).

I want Texas to revoke the provision that LPAs can practice independently. I think we gave more slack to folks than we should have, and they are running with it. All the while, we complain that our field is not flourishing compared to physicians and nurses. We need to be more territorial lol.

 

[stilllooking]

Just out of curiosity, for initial clearance did you all have to fill out SF-85 (about 12 pages) or SF-85p (about 95 pages)?

 

[ccpsych16]

Just out of curiosity, for initial clearance did you all have to fill out SF-85 (about 12 pages) or SF-85p (about 95 pages)?

Just looked up this form. It looks like that form is included in the online e-QIP (background check). The questions look familiar. Are they having you fill it out on PDF/paper and not e-QIP? That’s new.

 

[Shiori]

I am reaffirming my preference for teleworking. I am enjoying my first day as a real psychologist except for getting harassed every time I walk outside. I can generally brush off the polite-ish stuff. I was walking in an area where there were several people on both sides of me commenting on my appearance as I walked by. I had forgotten how uncomfortable that feels. I haven't missed it.

 

[PsychPhDone]

I am reaffirming my preference for teleworking. I am enjoying my first day as a real psychologist except for getting harassed every time I walk outside. I can generally brush off the polite-ish stuff. I was walking in an area where there were several people on both sides of me commenting on my appearance as I walked by. I had forgotten how uncomfortable that feels. I haven't missed it.

That's gross. I'm sorry. It shouldn't happen.

 

[Therapist4Chnge]

I am reaffirming my preference for teleworking. I am enjoying my first day as a real psychologist except for getting harassed every time I walk outside. I can generally brush off the polite-ish stuff. I was walking in an area where there were several people on both sides of me commenting on my appearance as I walked by. I had forgotten how uncomfortable that feels. I haven't missed it.

I'm sorry that is happening, though I'm not that surprised. Unfortunately, this kind of behavior continues to be ignored, despite it impact many.

 

[deleted1038433]

I am reaffirming my preference for teleworking. I am enjoying my first day as a real psychologist except for getting harassed every time I walk outside. I can generally brush off the polite-ish stuff. I was walking in an area where there were several people on both sides of me commenting on my appearance as I walked by. I had forgotten how uncomfortable that feels. I haven't missed it.

I almost took a fully virtual position in part to reduce the frequency of comments about my appearance and harassment.

 

[Pragma]

I am reaffirming my preference for teleworking. I am enjoying my first day as a real psychologist except for getting harassed every time I walk outside. I can generally brush off the polite-ish stuff. I was walking in an area where there were several people on both sides of me commenting on my appearance as I walked by. I had forgotten how uncomfortable that feels. I haven't missed it.

It was very much like this where I used to work, I had lots of resources available for my female trainees. Yet another reason not to isolate healthcare to a specific population.

 

[Shiori]

It wasn't just patients in my case. There are resources for non-Veterans at this location. I've been here before, but this is the worst I've experienced. I used to walk around the campus to decompress after rough cases. I would feel more uneasy about that after what happened yesterday. I also don't get the impression this was a one-time experience. I guess I'll just have to track down new routes to walk and be extra vigilant as it gets dark.

I'm feeling a little deflated today. Some opportunities I was hoping to do aren't going to happen for the foreseeable future. At least my office is nice and has a window. I'll make it cozy and hide in here while playing Break My Soul by Beyonce on repeat. It is nice that this is just a job now. No more hoops.

 

[Sanman]

It wasn't just patients in my case. There are resources for non-Veterans at this location. I've been here before, but this is the worst I've experienced. I used to walk around the campus to decompress after rough cases. I would feel more uneasy about that after what happened yesterday. I also don't get the impression this was a one-time experience. I guess I'll just have to track down new routes to walk and be extra vigilant as it gets dark.

I'm feeling a little deflated today. Some opportunities I was hoping to do aren't going to happen for the foreseeable future. At least my office is nice and has a window. I'll make it cozy and hide in here while playing Break My Soul by Beyonce on repeat. It is nice that this is just a job now. No more hoops.

There will be as many more hoops as you want (EBP training, becoming a trainer, board certification, etc). The trick is figuring out what you want and saying no to many of the other things they want to throw at you.

 

[Shiori]

There will be as many more hoops as you want (EBP training, becoming a trainer, board certification, etc). The trick is figuring out what you want and saying no to many of the other things they want to throw at you.

That's true! The licensure hoops are over at the moment, which is nice. Right now, I'm saying no to anything I'm not voluntold to do.

 

[texanpsychdoc]

Indeed. I just moved to Texas, so I am working on getting my second license here in Texas (I swear getting licensed in Ohio was so much easier and straightforward). I am also in the process of applying for board certification. I just dissolved my LLC in Ohio and filed for my PLLC here in Texas. I'm doing all of this while acclimating to my new position(s) with the VA and the medical school I am faculty with.

 

[Shiori]

MHS looks janky.

 

[cara susanna]

As I forward yet another testing consult to community care: is anyone else's facility having trouble finding neuropsychologists? I know that my VISN is having that issue, but was wondering if it's an issue nationwide.

 

[WisNeuro]

As I forward yet another testing consult to community care: is anyone else's facility having trouble finding neuropsychologists? I know that my VISN is having that issue, but was wondering if it's an issue nationwide.

Many of us are not in the choice program, and, around here, most practices are currently booking late spring/early summer 2023.

 

[Sanman]

As I forward yet another testing consult to community care: is anyone else's facility having trouble finding neuropsychologists? I know that my VISN is having that issue, but was wondering if it's an issue nationwide.

We have trouble finding everything for community care. Mostly because there are easier and better paying choices in the region.