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

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Well...I reached a whole new level with assertiveness abilities today. I basically brow-beat the VISN Chief of HR in a very strongly worded 3 paragraph email, while CCing my supervisor on it. I called him and his whole division out for their incompetence and a source of substantial unnecessary stressors that contribute to the high revolving door rate. This was all brought about after spending the last 4 months escalating via the chain of command an issue pertaining to the fact my VA took $700 of my money and is refusing to give it back to me.

Funny thing is, my supervisor has been copied on every email (all 15-20) of them with every member of our VISN's HR division since last September. My supervisor told me today "I support you and agree with you on all points you made." In fact, at one point I even stated "the very fact that it took you over a month to respond to my email on the matter is a testament to what I am speaking of and what landed us in this situation - poor communication all around, and is something that could have easily been avoided and resolved with a simple email or TEAMS message."

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Well...I reached a whole new level with assertiveness abilities today. I basically brow-beat the VISN Chief of HR in a very strongly worded 3 paragraph email, while CCing my supervisor on it. I called him and his whole division out for their incompetence and a source of substantial unnecessary stressors that contribute to the high revolving door rate. This was all brought about after spending the last 4 months escalating via the chain of command an issue pertaining to the fact my VA took $700 of my money and is refusing to give it back to me.

Funny thing is, my supervisor has been copied on every email (all 15-20) of them with every member of our VISN's HR division since last September. My supervisor told me today "I support you and agree with you on all points you made." In fact, at one point I even stated "the very fact that it took you over a month to respond to my email on the matter is a testament to what I am speaking of and what landed us in this situation - poor communication all around, and is something that could have easily been avoided and resolved with a simple email or TEAMS message."
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VA took $700 of my money and is refusing to give it back to me.

My past dispute over way less than this amount of my money with the VA from a paycheck led to MONTHS of mailed letters, emails, calls, and a waste of substantial time and resources. As messed up as it is, at least they didn't claim you OWED THEM money, like they did with me. That was another level of incompetence and ridiculousness that I never knew could exist.
 
My past dispute over way less than this amount of my money with the VA from a paycheck led to MONTHS of mailed letters, emails, calls, and a waste of substantial time and resources. As messed up as it is, at least they didn't claim you OWED THEM money, like they did with me. That was another level of incompetence and ridiculousness that I never knew could exist.
And if they do think you owe them money, you'd better believe it won't take them months to collect it. When it comes to VA HR and money owed: collect first, verify accuracy later.
 
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My past dispute over way less than this amount of my money with the VA from a paycheck led to MONTHS of mailed letters, emails, calls, and a waste of substantial time and resources. As messed up as it is, at least they didn't claim you OWED THEM money, like they did with me. That was another level of incompetence and ridiculousness that I never knew could exist.

Actually, at my previous VA they did that - they claimed I owed them $16. So, we spent a lot of time, emails, calls trying to clear that up. It had something to do with the money that was given to employees for COVID pay or whatever, and basically they said it needed to be paid back.
 
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My past dispute over way less than this amount of my money with the VA from a paycheck led to MONTHS of mailed letters, emails, calls, and a waste of substantial time and resources. As messed up as it is, at least they didn't claim you OWED THEM money, like they did with me. That was another level of incompetence and ridiculousness that I never knew could exist.
The VA sent me a bill for health insurance a year and a half after I left the system (intern year); it definitely took some time for them to get sorted. I had to send them proof of residency, a letter from my DCT, etc.
 
And if they do think you owe them money, you'd better believe it won't take them months to collect it. When it comes to VA HR and money owed: collect first, verify accuracy later.
Dealing with this now. I’m owed a refund but they actually deducted from my paycheck. It’s been months with no resolution. Much less money than $700, but still, it’s mine!
 
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The VA sent me a bill for health insurance a year and a half after I left the system (intern year); it definitely took some time for them to get sorted. I had to send them proof of residency, a letter from my DCT, etc.

Hold my beer -

My husband was a resident at the West Palm Beach VA. As a resident he had BCBS plan 106 for both of us. When he completed residency and assumed his job with a local medical school where he got on Aetna, we started experiencing problems with Aetna claiming we had a concurrently active plan with BCBS (which we didn't). My husband even noted that he advised HR to cancel his benefits and they confirmed they would prior to when he finished. When we moved to Ohio for my residency, I enrolled both of us into BCBS plan 106 - a month later I get a letter indicating my husband was removed as they showed him still active with BCBS from when he was at WPBVA. Evidently, they had a lot of turn over and there was an oversight in cancelling his benefits when he left there. We could not find any contact info to get ahold of someone to resolve this, so after calling several other VAs to get us a POC for WPBVA, we spoke to someone who advised us of their error. They stated they would resolve the issue. Perfect. So then I go back to enroll my husband back onto my BCBS and then weeks later we were notified he was taken off yet again, this time with BCBS indicating they showed my spouse as deceased. We followed up with WPBVA who told us one of their newer benefits staff members erroneously marked my husband as deceased to close out his benefits.
 
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Hold my beer -

My husband was a resident at the West Palm Beach VA. As a resident he had BCBS plan 106 for both of us. When he completed residency and assumed his job with a local medical school where he got on Aetna, we started experiencing problems with Aetna claiming we had a concurrently active plan with BCBS (which we didn't). My husband even noted that he advised HR to cancel his benefits and they confirmed they would prior to when he finished. When we moved to Ohio for my residency, I enrolled both of us into BCBS plan 106 - a month later I get a letter indicating my husband was removed as they showed him still active with BCBS from when he was at WPBVA. Evidently, they had a lot of turn over and there was an oversight in cancelling his benefits when he left there. We could not find any contact info to get ahold of someone to resolve this, so after calling several other VAs to get us a POC for WPBVA, we spoke to someone who advised us of their error. They stated they would resolve the issue. Perfect. So then I go back to enroll my husband back onto my BCBS and then weeks later we were notified he was taken off yet again, this time with BCBS indicating they showed my spouse as deceased. We followed up with WPBVA who told us one of their newer benefits staff members erroneously marked my husband as deceased to close out his benefits.
Sounds about right. "Just mark him as dead, that's the fastest way to close out the account. What's the worst that could happen?"
 
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Sounds about right. "Just mark him as dead, that's the fastest way to close out the account. What's the worst that could happen?"
It took my VA 2 years to fire an employee who stopped showing up because the timekeeper kept entering authorized absence instead of AWOL (because that person did not know how to enter an AWOL).
 
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I’m in shock at these stories. They would be funnier if they weren’t so flabbergasting.
 
Y'all need to go talk to your union....I had $500 taken from my paycheck, but thankfully had a clinic admin who was willing to take up the fight and deal with it on my behalf after I'd exhausted a couple avenues. Sure would be nice if they tried to talk to you about it and resolve the issue before sending a generic letter and then just taking the money before HR/payroll has any real opportunity to sort it out.
 
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Y'all need to go talk to your union....I had $500 taken from my paycheck, but thankfully had a clinic admin who was willing to take up the fight and deal with it on my behalf after I'd exhausted a couple avenues. Sure would be nice if they tried to talk to you about it and resolve the issue before sending a generic letter and then just taking the money before HR/payroll has any real opportunity to sort it out.

I am not a union member, nor care to be one. I highly doubt I will be getting my $700 back. It was fun dressing down the chief of HR for our VISN while CCing my supervisor on the email. I felt empowered. :)
 
I greatly support our union and am a member, but some local branches are useless when it comes to stuff like this.
 
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I greatly support our union and am a member, but some local branches are useless when it comes to stuff like this.
I reached out to union reps when I first started and never heard back. I wasn’t at the meeting during NEO because they told providers (including psychologists) to leave early as the union didn’t apply to us. Of course it does.
 
I reached out to union reps when I first started and never heard back. I wasn’t at the meeting during NEO because they told providers (including psychologists) to leave early as the union didn’t apply to us. Of course it does.

Yeah, our NEO person said joining the union was pointless. I shot that statement down right in front of them (fortunately I came from a VA with a very strong union so I had been informed about all that they do for us), and later notified our union president that new employees were getting this message.
 
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Yeah, our NEO person said joining the union was pointless. I shot that statement down right in front of them (fortunately I came from a VA with a very strong union so I had been informed about all that they do for us), and later notified our union president that new employees were getting this message.
I’m glad you said something. Which one applies to us? There are two unions here but I’m not sure which one psychologists fall under. Or if we’re eligible for both. That’s what I asked both reps in my earlier emails.
 
They split us up by profession during our NEO and psychologists signed up for NFFE.
 
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I’m glad you said something. Which one applies to us? There are two unions here but I’m not sure which one psychologists fall under. Or if we’re eligible for both. That’s what I asked both reps in my earlier emails.

I only know about one, AFGE. That's the one I'm a member of.
 
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Is there anything more nerve wracking than that 15 min wait to NS an appt? ;)
 
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I alternate between intensely loving my job and wanting to quit. This is the kind of relationship I would want my clients to explore more deeply.
 
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I alternate between intensely loving my job and wanting to quit. This is the kind of relationship I would want my clients to explore more deeply.

This is a daily thing for me. I sat through yet another pointless meeting that was basically an echo chamber/soap box for people to air grievances with nothing to show for it. Oh, and the point of the meeting was to have everybody go around describing their "scopes of practice" and psychologists and psychiatrists didn't get a chance to as the other folks just took over much of the meeting time for their own BS. Then others went on to describe about a veteran who recently died via suicide and basically went on to say "we all failed them" etc.
 
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This is a daily thing for me. I sat through yet another pointless meeting that was basically an echo chamber/soap box for people to air grievances with nothing to show for it. Oh, and the point of the meeting was to have everybody go around describing their "scopes of practice" and psychologists and psychiatrists didn't get a chance to as the other folks just took over much of the meeting time for their own BS. Then others went on to describe about a veteran who recently died via suicide and basically went on to say "we all failed them" etc.

I found your problem.
 
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I guess a couple of other things that steam my clams are the following:

1. When I first started, people decided to take it upon themselves to address me by my first name, rather than "Dr.", yet, they will say "Dr." for our psychiatrists.

2. People who have been at my current VA longer than me, who are in peer support or "addiction counselor" or LCSW roles find it okay to dress me down, and basically say and/or imply that I need to earn their respect before they will view me as a legit psychologist. I had one LCSW yesterday just take it upon herself to assume I knew nothing of the VA and that I was new. Granted, to this VA, I am about 5 months in, so sure, I am "new" to this VA, but this is my third VA, so I am pretty used to the VA BS. They approached their conversation with me like "listen little boy and let me tell you what I relevant, I've been doing this longer." In fact, she pretty much said that to me "nevermind that, I've been doing this a while and know the veteran, so trust me."

I think in the grand scheme of things, these two things are relatively minor, but they are layers added onto other layers that ultimately, just make for a piss poor experience. It's constant, it doesn't stop.

In the end I just don't feel respected or valued as a member of their team. I don't want to stick around for that.
 
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I guess a couple of other things that steam my clams are the following:

1. When I first started, people decided to take it upon themselves to address me by my first name, rather than "Dr.", yet, they will say "Dr." for our psychiatrists.
It is cultural based on the institutional history and you will not change this.
2. People who have been at my current VA longer than me, who are in peer support or "addiction counselor" or LCSW roles find it okay to dress me down, and basically say and/or imply that I need to earn their respect before they will view me as a legit psychologist. I had one LCSW yesterday just take it upon herself to assume I knew nothing of the VA and that I was new. Granted, to this VA, I am about 5 months in, so sure, I am "new" to this VA, but this is my third VA, so I am pretty used to the VA BS. They approached their conversation with me like "listen little boy and let me tell you what I relevant, I've been doing this longer." In fact, she pretty much said that to me "nevermind that, I've been doing this a while and know the veteran, so trust me."
Why does their respect matter? If they know better, let them take on the liability. If it is my liability, you follow my game plan.
I think in the grand scheme of things, these two things are relatively minor, but they are layers added onto other layers that ultimately, just make for a piss poor experience. It's constant, it doesn't stop.

In the end I just don't feel respected or valued as a member of their team. I don't want to stick around for that.
You might not be respected as a member of their team. You can choose to earn their respect or not. You can also choose to care if you earn their respect or not.

As I say to clients and team members alike, I get paid whether you use me or you don't. It is up to you if you want the help, I am here.
 
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Currently feeling salty about the VA pushing EFT and I read that there was supposedly an RCT showing that EFT works. Here it is. Psychological Trauma Symptom Improvement in Veterans Using... : The Journal of Nervous and Mental Disease

Yeah, not impressed by the quality of this research.

Wow, am I reading this correctly? That is the most garbage study I have ever seen. So subjects received a bunch of standard treatments at the same time as our mumbo jumbo treatment. However, we can't be bothered to track that because it is hard. Those undergoing our mumbo jumbo treatment along with whatever standard treatment we were not keeping track of improved over those on a waitlist getting no treatment. Therefore, our mumbo jumbo treatment must work. What else could possibly be the reason for their symptom improvement?
 
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It is cultural based on the institutional history and you will not change this.

Why does their respect matter? If they know better, let them take on the liability. If it is my liability, you follow my game plan.

You might not be respected as a member of their team. You can choose to earn their respect or not. You can also choose to care if you earn their respect or not.

As I say to clients and team members alike, I get paid whether you use me or you don't. It is up to you if you want the help, I am here.

You know I'm a psychologist too right? I know these things you mentioned, it's certainly things I thought of long ago, I get it. It still is something that is being experienced, and doesn't make it any less irritating. After all, this is a venting thread. Most of us come on complaining about stuff we very well know no changes will be happening.
 
You know I'm a psychologist too right? I know these things you mentioned, it's certainly things I thought of long ago, I get it. It still is something that is being experienced, and doesn't make it any less irritating. After all, this is a venting thread. Most of us come on complaining about stuff we very well know no changes will be happening.

You're a psychologist too? I thought I was the only one here!

Seriously though, chill. It was just some free advice. Take it or don't. Maybe print it out and leave it on the desk for the next guy/gal that takes the job.
 
You're a psychologist too? I thought I was the only one here!

Seriously though, chill. It was just some free advice. Take it or don't. Maybe print it out and leave it on the desk for the next guy/gal that takes the job.

I'm fine...no need to tell me to chill. I am just pointing out that while your advice, as "sage" as it may be, is maybe not what I was looking for. Sometimes, people just need to vent....hence, the thread.
 
I'm fine...no need to tell me to chill. I am just pointing out that while your advice, as "sage" as it may be, is maybe not what I was looking for. Sometimes, people just need to vent....hence, the thread.

No idea if it sage or not, just gets me through the day. No one is saying you can't vent. Feel free.
 
Currently feeling salty about the VA pushing EFT and I read that there was supposedly an RCT showing that EFT works. Here it is. Psychological Trauma Symptom Improvement in Veterans Using... : The Journal of Nervous and Mental Disease

Yeah, not impressed by the quality of this research.

Well, the VA has paid for acupunture and aromatherapy for some time, why not add some more pseudoscience to the mix. I'm sure within a few years they'll be hiring people to be national trainers for Brainspotting. Maybe Daniel Amen is on the shortlist to be the new head of CAM in the VA.
 
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Nevermind, I mis-read -- saw RCT and this stuff but it was about EFT.

Anyways, I have an old MFT colleague who was into aromatherapy and used in PP. I was very surprised to hear this was happening at a VA clinic.

Acupuncture has medical benefits at least.

I hear reading tea leaves will be making a come back soon.
 
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Nevermind, I mis-read -- saw RCT and this stuff but it was about EFT.

Anyways, I have an old MFT colleague who was into aromatherapy and used in PP. I was very surprised to hear this was happening at a VA clinic.

Acupuncture has medical benefits at least.

Which ones? Last I saw, there was no difference in adequate sham condition studies. Granted, I haven't exhaustively gone through the literature, but my read was that there is mostly very poor work that does not control for placebo, or equivalence to sham conditions.
 
Hi all! I'm debating applying for a program manager/supervisory psychologist position that just opened up at my VA, but I'm feeling pretty ambivalent about it for a few reasons. First, I'm not sure I'd actually be able to affect meaningful change within the program (which is the only reason I'm even thinking about promoting to a program manager role!). Second, I'm worried I'd be miserable managing other staff (particularly staff who aren't psychologists or social workers) with in the program (but maybe I'd do okay with that part... I don't know).

Has anyone here made the transition from staff psychologist to program manager/supervisory psychologist? If so, what are/were the pros and cons of making this transition?
 
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Hi all! I'm debating applying for a program manager/supervisory psychologist position that just opened up at my VA, but I'm feeling pretty ambivalent about it for a few reasons. First, I'm not sure I'd actually be able to affect meaningful change within the program (which is the only reason I'm even thinking about promoting to a program manager role!). Second, I'm worried I'd be miserable managing other staff (particularly staff who aren't psychologists or social workers) with in the program (but maybe I'd do okay with that part... I don't know).

Has anyone here made the transition from staff psychologist to program manager/supervisory psychologist? If so, what are/were the pros and cons of making this transition?

Is this a GS-14 position?

If so, how many students and staff are you responsible for managing in the program?

How many additional staff will you be required to supervise outside of the program (complete eperformance evaluations and such)?

What clinical load, if any, will you be required to maintain?

Management positions are tricky, imo. Some are worth it and some are not.
 
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Sanman's questions are good ones. I also considered applying for a PM position, but ultimately decided I'd probably have been pretty miserable and the extra work wasn't worth the pay bump. There was also an insufficient time offset for administrative duties, IMO; I think it was maybe 50%, with the remaining being continued clinical work.

I think being in both positions (i.e., supervisory psychologist and PM) would be tough, but I know folks who've done it and enjoyed it. They definitely had to learn how to pick their battles, though. But they were, at times, able to help psychologists out.
 
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Which ones? Last I saw, there was no difference in adequate sham condition studies. Granted, I haven't exhaustively gone through the literature, but my read was that there is mostly very poor work that does not control for placebo, or equivalence to sham conditions.

From what I recall some mild cardiovascular and chronic pain benefits. Never got into the literature myself but this is my recall fom a hospital lecture series a few years back led by some MDs. I think there are also some cultural components to this as well that make it a helpful piece of some tx plans.
 
What clinical load, if any, will you be required to maintain?
This is especially important IMO. I’ve seen/heard of positions that run anywhere from 30% to 70% (small PTSD clinic + RRTP) and one case of 0% (only supervisor for all of BHIP at a smaller VA).

Setting seems important. If this is a speciality service where you already have a good idea of what’s going on and the clinical load seems reasonable and you’re interested in admin, it could be a good fit.

But if this is BHIP at a VA with access issues, you’ll be eyeballs deep triaging cases everyday and providers will be unhappy when you keep assigning patients when they are already booked out for months and upper leadership will be unhappy when you refer too many to the community (even though they are responsible for backfilling positions and advocating for larger budgets).

But BHIP for CBOCs in the same system might be fine if those sites aren’t battling with access and provider turnover.

Me personally, the only GS-14 promotions that I would consider is training because that’s something I’m passionate about and it’s more removed from hospital functions.
First, I'm not sure I'd actually be able to affect meaningful change within the program (which is the only reason I'm even thinking about promoting to a program manager role!).
You sound like exactly what VA should have for GS-14 roles and thus potentially destined to be unhappy in that role due to constant pressure to improve the SAIL metric/priority of the month, dealing with personnel issues, etc.

However, if your facility/mental health service line has a good workplace culture and your coworkers are largely pleasant and competent people, you might have a fighting chance of achieving some desired clinical goals.
 
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From what I recall some mild cardiovascular and chronic pain benefits. Never got into the literature myself but this is my recall fom a hospital lecture series a few years back led by some MDs. I think there are also some cultural components to this as well that make it a helpful piece of some tx plans.

Only thing that I saw, that was replicated in adequate studies was a very small effect with sleep onset in like lavender or something. I'm always skeptical of MD lit reviews, they're the reason people think donepezil has en effect :)
 
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