I'm glad you and others have had good experiences in VA training. I recognize the abusive stuff I experienced as a VA trainee is not the norm. I hope @ThatPsyGuy has a good experience and that my recs are unnecessary at the VA they work at. I also hope a variety of viewpoints, which may be contradicting, will help them be prepared (#bestdisneyvillainsong).
I am relishing the thought of one month away when I give my notice for exactly all of the above. Still not sure if I want to give them the satisfaction of telling them I’m going into PP or just kind of say nicely, “None of your damned business.” But….also realize that I could panic and be wishing I had the VA job back after I leave! So many conflicting thoughts and emotions here!
No show calls have not become automated for the same reason as a hundred other efficiency-improving modifications have not been made to address the incredible levels of inconvenience experienced by mental health providers at the VA on a daily basis (most of which are amply documented in this thread).
Good luck with your move and I hope it brings success and greater satisfaction!
I wouldn't even mind being a cog in the machine if they would just throw a little oil our way from time to time.
That's me caring about others' opinions when I leave the VA and go into PP full time.
I would also mention that even if you left and you told them "listen folks, you guys suck for XYZ reasons and I would prefer to not develop an alcohol use disorder if I remain here," they'd still likely hire you back in the future as they will always be hurting for providers and too many leave and they refuse to adjust and address/resolve the issues that drive providers out. Thus, if they are willing to put up with your BS, then you can come back and pick up where you left off with putting up with their BS.
Wow, if those behaviors still warranted the ability to save your job following successful FPPE remediation, then my leash must be even longer than I had previously imagined.
You know, read through the whole thing and I still can't figure out how someone sends "thousands of calls and texts" over a twelve day period. Where do you find the time. I don't even speak to my wife that much.
Maybe you'd be more communicative with a brand new mistress? (Kidding, kidding!)
Agreed. This behavior is appalling. Some people, including some psychologists, are eat up with the *******.
Nah, my mistresses are usually silent and topless and it is usually a short term affair. My wife is pretty understanding of the the extra costs, though she hates the extra driveway space they take up. Currently considering a longer term fling with a Mustang, but I need to make room in the garage first!
They stay classy!
Such has been the (increasing) case for years, unfortunately, but it does seem that the pace of additional administrative burdens was picking up over the past few years.
Out of curiosity, is your site requiring use of Mental Health Suite treatment plans (and 'integration' of med plans), Problems-->Goals-->Objectives-->Intervention treatment planning formats with plan 'expiration' dates, etc.?
Can't say I blame you. I didn't do most as they weren't relevant to my appointments, although would knock them out if pertinent (e.g., fit a C-SSRS into my clinical interview). The downside to not doing them is that someone, somewhere then has to do them later; where I was, it usually it rolled down to primary care or, sometimes, the treating MH provider, depending on the reminder. So I tried to help them when I could.I don't do clinical reminders
The 'strategy' of 'screening' for clinical depression with a couple of yes/no questions was also somewhat flawed, in my opinion, since I was generally 'screening' for depression in a patient I was conducting a full psychiatric interview with and was obviously addressing that clinical issue. In some cases, they were already formally diagnosed with the disorder for which I was ostensibly 'screening' them. In this sense, they make far more sense to use in primary care.
They lie all the time on those things. I doubt the questions are ever even asked 40+% of the time. I've had patients who were 100% s/c for PTSD for whom the primary care folks had documented all 'no's' on the PC-PTSD screener. I've seen cases of patients presenting to urgent care with documented suicidal intent (hospitalized that day) with 'negative' Columbias (all no's) entered into the chart dated the same day of the encounter. The saddest thing is that a number of research studies actually use those screeners as data input for their published papers.
I agree that most of the screening measures are probably most appropriate for primary care, unless they relate to something you might not normally discuss in your appointment. I wish they'd give specialty providers the option of basically opting out of a reminder or substituting a different measure (e.g., if you have the BDI-II, why do you need to also then give the PHQ-9; if there's a PTSD reminder due and you know the person still meets criteria for PTSD, you just check, "still has PTSD," etc.).
The bolded factor, and also the use of diagnoses in the chart and the assumption they're accurate, is why I think it's always important to take VA studies that use chart review/information with a large grain of salt.
I do it as soon as I consider it a no show (15 - 25mins after appt time, depending on clinic) which gives me time to make the call, transfer to MSA and/or enter the RTC. If they don't pick up, I have a plain text file on my desktop where I note last name and last four and keep track of number of times attempted. I hate having things left 'hanging' during my shift so I try to dispense with the task ASAP.
Here we have a written no-show policy that 'allows' the first attempt to be made during the appointment time of the missed appointment and that requires at least two separate phone calls to be placed on two separate dates. The policy does not stipulate that we must call every single business day (after the no show) or even, in fact, stipulate a 'deadline' (days elapsed since the no show) to complete and document all 3 phone attempts plus a mailed letter--although the 'gotcha auditors' vary greatly with respect to their own imposed interpretations of a passed or failed no show follow up audit.
I mean you're pretty sketchy...might have been trying to sell them Amway products or something.
This all sounds suspiciously like a drama TV show I would binge watch.I mean you're pretty sketchy...might have been trying to sell them Amway products or something.
I mean you're pretty sketchy...might have been trying to sell them Amway products or something.
For new patients I call 15 mins in. For established patients I call 5 mins in. I don't like uncertainty.
