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

[cara susanna]

Anyone else had their manager give them the RVU talk lately? Apparently mine are low.

---

Members don't see this ad.

 

[WisNeuro]

Anyone else had their manager give them the RVU talk lately? Apparently mine are low.

We were on the clinical grid system of measuring productivity before I left the system

 

[cara susanna]

We were on the clinical grid system of measuring productivity before I left the system

How does that differ?

 

[WisNeuro]

How does that differ?

Each set aside appointment slot/actual appointments that happened in those slots = X% productivity filled.

This system sucked for neuropsychology, because if we had one no show, it shot our numbers to hell, and they wouldn't let us book extra appointments in extra time slots because they couldn't figure out how to count them in their system.

 

[Ollie123]

Hey, that's our system now too. We're losing money like crazy, getting blamed for low productivity and our efforts to improve productivity are denied because it makes the beans slightly tougher to count.

 

[WisNeuro]

Hey, that's our system now too. We're losing money like crazy, getting blamed for low productivity and our efforts to improve productivity are denied because it makes the beans slightly tougher to count.

They wouldn't let me add pt slots later in the week if I had no shows earlier in the week. And they wanted me to have set aside feedback slots instead of being flexible in offering slots depending on when Vets could come back in. I actually sketched out projections to show them that with their system, I would see fewer patients and have roughly a third or more less productivity than if they let me just have my flexible schedule. It was denied because we had to do it the way someone in regional office said it had to be done.

 

[AbnormalPsych]

"Our professionals don't know what they are doing. Let me put my fingers on this so it looks like I am being busy and important" - VA leadership

 

[Therapist4Chnge]

Productivity problems you say? Well....how about another slogan?! If you need more, I bet they could whip up some new initiatives too. There won't be additional staffing or budgeting, so you'll just need to make it work...

 

[AcronymAllergy]

I'm surprised there aren't yet "productivity champions." There's probably an equivalent of that somewhere, though.

 

[Sanman]

Anyone else had their manager give them the RVU talk lately? Apparently mine are low.

They would have to build me the telephone and VVC clinics I have been asking for forever to have any idea of my productivity. So, not really.

 

[beginner2011]

They would have to build me the telephone and VVC clinics I have been asking for forever to have any idea of my productivity. So, not really.

Why is it so difficult to get clinics made? They seem to be a constant source of frustration.

 

[summerbabe]

Anyone else had their manager give them the RVU talk lately? Apparently mine are low.

Not necessarily RVU related but we have been doing timemapping/diarying recently to account for how we are spending the workday outside of documented clinical encounters (meetings, notes, etc).

Also, I'm sure my RVUs recently have been terrible haha!

 

[AcronymAllergy]

We had phone and VVC clinics created remarkably quickly once all productivity was tied to telehealth. Funny how that works.

Edit: and does it seem ridiculous to anyone else that doctoral-level providers would be asked to keep diaries to justify how they're spending work hours? Thumbs down.

 

[futureapppsy2]

Ain't no medicine like Frontier Medicine...downtown.

 

[Sanman]

I went downstairs and made myself a Red Raider to get through TMS trainings, does that count?

 

[Sanman]

Why is it so difficult to get clinics made? They seem to be a constant source of frustration.

Tough to get good administrative support these days (or really any day at the VA). Also, I am cross appointed to mental health and geriatrics, the MSAs love to point fingers as to who will get the extra work. God bless the government.

 

[Sanman]

We had phone and VVC clinics created remarkably quickly once all productivity was tied to telehealth. Funny how that works.

Edit: and does it seem ridiculous to anyone else that doctoral-level providers would be asked to keep diaries to justify how they're spending work hours? Thumbs down.

Doesn't it seem ridiculous that they would trust me to be honest and not pad my diary with bogus stuff?

 

[cara susanna]

Not necessarily RVU related but we have been doing timemapping/diarying recently to account for how we are spending the workday outside of documented clinical encounters (meetings, notes, etc).

Also, I'm sure my RVUs recently have been terrible haha!

Are you mapping posting on SDN as professional development?

Also, that is freaking ridiculous.

 

[AbnormalPsych]

We had phone and VVC clinics created remarkably quickly once all productivity was tied to telehealth. Funny how that works.

Edit: and does it seem ridiculous to anyone else that doctoral-level providers would be asked to keep diaries to justify how they're spending work hours? Thumbs down.

Are the MDs being asked to do this too?

 

[Fan_of_Meehl]

Tough to get good administrative support these days (or really any day at the VA). Also, I am cross appointed to mental health and geriatrics, the MSAs love to point fingers as to who will get the extra work. God bless the government.

Our VA is RUN by MSAs and social workers.

 

[Fan_of_Meehl]

Doesn't it seem ridiculous that they would trust me to be honest and not pad my diary with bogus stuff?

Not to mention the fact that PROVIDERS at the VA (especially mental health providers these days) are clearly among the most busy people at VA right now. In addition to all the scheduled appointments (and associated documentation, prep, followup, etc.) there's tons to do. What about asking some of the non-providers (who never see veterans) to log what they are doing every day?

 

[cara susanna]

I like how this punishes efficient people like me. I guess I could just take longer to do things!

 

[Sanman]

I like how this punishes efficient people like me. I guess I could just take longer to do things!

Efficiency has no place in the VA! How does one appropriately log wait in line for coffee for 1 hour in that diary (during the pre-covid era) because my eyes show me that is common at the hospital.

 

[Ollie123]

Haven't been in a VA since practicum, but I would LOVE a detailed accounting of how HR spends their time. Truly.

8-9 In bed asleep
9-11 Drive to office and sleep there
11-2 Lunch
2-215 Return voicemails apologizing for being too busy to complete requests
215 -315 Happy hour
315 Ehhhh, it's almost 5, right?

 

[summerbabe]

I think you're missing the daily huddle to brainstorm new ways to delay onboarding

 

[Ollie123]

That happens during happy hour. Two birds with one stone.

 

[SmithPsy24]

We had phone and VVC clinics created remarkably quickly once all productivity was tied to telehealth. Funny how that works.

Edit: and does it seem ridiculous to anyone else that doctoral-level providers would be asked to keep diaries to justify how they're spending work hours? Thumbs down.

We had to keep diaries a few months ago, but they gave up after a few weeks.

 

[AcronymAllergy]

We had to keep diaries a few months ago, but they gave up after a few weeks.

It was proposed where a few co-workers are. It was shouted down pretty quickly.

 

[sloh]

This thread reminds me of bull**** jobs

 

[beginner2011]

@sloh

I think that HR isn't really a bullsh_t job. There's tons of stuff that HR is responsible for that is important and has a big impact on other employees' lives. Unfortunately, VA HR is often hard to reach (for unclear reasons) or has their hands tied by policies that are either poorly articulated or just undetermined. I know I've been tremendously frustrated by the fact that VA policy on implementation of the Federal Employee Paid Leave Act hasn't been established nationally, so local HR can't tell me whether or not I'll be covered under this policy as a postdoc.

 

[WisNeuro]

@sloh

I think that HR isn't really a bullsh_t job. There's tons of stuff that HR is responsible for that is important and has a big impact on other employees' lives. Unfortunately, VA HR is often hard to reach (for unclear reasons) or has their hands tied by policies that are either poorly articulated or just undetermined. I know I've been tremendously frustrated by the fact that VA policy on implementation of the Federal Employee Paid Leave Act hasn't been established nationally, so local HR can't tell me whether or not I'll be covered under this policy as a postdoc.

Really, VA HR is pretty much just where incompetence goes to exist until it dies and its useless progeny replaces it. Usually, if you know where to go, or make a habit of going above someone's head, you can get things done with them. It is literally that these people are either ill-informed, willfully ignorant of what they are supposed to do, or simply do not want to do their jobs. And, because it is very hard to be fired from the VA, they can do this indefinitely. It'd be different of they were just bad on newer policies and procedures, but they don't even know basic, well-established things most of the time. After dealing with them for the better part of a decade at different sites, they don't get a pass from me due to policy changes. They're just bad, simple as that.

 

[deleted106747]

Really, VA HR is pretty much just where incompetence goes to exist until it dies and its useless progeny replaces it. Usually, if you know where to go, or make a habit of going above someone's head, you can get things done with them. It is literally that these people are either ill-informed, willfully ignorant of what they are supposed to do, or simply do not want to do their jobs. And, because it is very hard to be fired from the VA, they can do this indefinitely. It'd be different of they were just bad on newer policies and procedures, but they don't even know basic, well-established things most of the time. After dealing with them for the better part of a decade at different sites, they don't get a pass from me due to policy changes. They're just bad, simple as that.

I can't get into details for fear of outing my identity, but the VA HR messed me over BADLY when I left. They were supposed to submit a form that they just didn't submit. It led to months and months of administrative detangling that I'm probably going to be doing for who knows how long. And the VA being the VA, you don't get to talk to anyone who is actually accountable or anyone who cares.

 

[AcronymAllergy]

I can't get into details for fear of outing my identity, but the VA HR messed me over BADLY when I left. They were supposed to submit a form that they just didn't submit. It led to months and months of administrative detangling that I'm probably going to be doing for who knows how long. And the VA being the VA, you don't get to talk to anyone who is actually accountable or anyone who cares.

This is not surprising, unfortunately. At prior VAs, I've had to show up in-person multiple times to request that forms be submitted while I stood there waiting rather than getting lumped into a pile of papers that was being actively avoided until the end of the week (which is tough to do for forms you didn't know were needed in the first place). And I'd pretty much given up expecting replies to emails until a supervisor had been CC'd.

 

[WisNeuro]

This is not surprising, unfortunately. At prior VAs, I've had to show up in-person multiple times to request that forms be submitted while I stood there waiting rather than getting lumped into a pile of papers that was being actively avoided until the end of the week (which is tough to do for forms you didn't know were needed in the first place). And I'd pretty much given up expecting replies to emails until a supervisor had been CC'd.

Yeah, there was some issue at our postdoc site where I just kept CC'ing the HR service line leader with every e-mail I sent until the problem got fixed. It was that issue where I was only entered in as a 1 year appointment, so I was technically not employed when year 2 rolled around.

 

[cara susanna]

Yeah, there was some issue at our postdoc site where I just kept CC'ing the HR service line leader with every e-mail I sent until the problem got fixed. It was that issue where I was only entered in as a 1 year appointment, so I was technically not employed when year 2 rolled around.

I had that happen, too! It went months before anyone noticed, and then I stopped getting paid even though I was showing up for work. I felt like Milton in Office Space, haha.

 

[WisNeuro]

I had that happen, too! It went months before anyone noticed, and then I stopped getting paid even though I was showing up for work. I felt like Milton in Office Space, haha.

I noticed the first time I didn't get a paycheck. Took about a month and a half to fix, and I got a lump sum of retro pay. Good thing I had plenty of savings to ride out 2 months of no pay.

 

[deleted106747]

I noticed the first time I didn't get a paycheck. Took about a month and a half to fix, and I got a lump sum of retro pay. Good thing I had plenty of savings to ride out 2 months of no pay.

Oh they did that to me too! Twice! At two different VAs. At the second one, I called in to deal with it and the woman on the phone acted like I was completely out of line to be upset that I wasn't paid.

 

[thebalmofhurtminds]

Oh they did that to me too! Twice! At two different VAs. At the second one, I called in to deal with it and the woman on the phone acted like I was completely out of line to be upset that I wasn't paid.

I had the same thing! The people on the phone had an attitude with me like "it'll get fixed when it gets fixed" - um excuse me, I'm working for free right now and need money to live!?

 

[AcronymAllergy]

I had the same thing! The people on the phone had an attitude with me like "it'll get fixed when it gets fixed" - um excuse me, I'm working for free right now and need money to live!?

But you'd better believe they're very quick about recovering any money that's been paid to you in error.

 

[PsychPhDone]

But you'd better believe they're very quick about recovering any money that's been paid to you in error.

... I'm trying to pay back overpayment from 4 years ago.

 

[AcronymAllergy]

... I'm trying to pay back overpayment from 4 years ago.

Wow. I wonder if there's some version of a statute of limitations at that point.

 

[psychRA]

I love the VA system, but HR is just the worst. I've worked at several VAs and have had at least one major HR-related issue at every facility.

Regarding those awful lean model open-plan buildings, I'm hoping that the pandemic will put a stop to future construction of those buildings within VA. Not sure what can be done about the ones that are already operational.

 

[cara susanna]

I think I heard that our VA was actually nationalized, so we don't have anyone locally anymore. I think that's the case, anyway. Honestly I have no idea. We used to have a really good HR person but I have no idea what happened to them.

 

[futureapppsy2]

I am only half joking when I say one of my biggest career accomplishments may be the time I got VA HR to respond to something in a timely, helpful, and logical manner.

 

[PsychPhDone]

I think I heard that our VA was actually nationalized, so we don't have anyone locally anymore. I think that's the case, anyway. Honestly I have no idea. We used to have a really good HR person but I have no idea what happened to them.

I've had nothing but good experiences with the national hr office so far.

 

[AbnormalPsych]

But you'd better believe they're very quick about recovering any money that's been paid to you in error.

When I left VA they overpaid me by a few bucks and also messed up my benefits end dates. I have never been more harassed in my life. I'm pretty sure the mailman thought I was in some deep **** with the amount of government letters mailed to my new place that I just moved into.

Then, it wouldn't be VA without this kicker. I paid them back the few bucks after weeks of trying to figure out the easiest way to give them money and make this all stop. And they said I paid too much....(the amount they stated). Re-start weeks and weeks of letters and benefeds account error letters. Im pretty sure they spent several Sizzler meals worth of $ in postage mailing letters to me and probably some HR person's weekly salary in time communicating via mail, phone, and email for months over a few bucks.

 

[thebalmofhurtminds]

When I left VA they overpaid me by a few bucks and also messed up my benefits end dates. I have never been more harassed in my life. I'm pretty sure the mailman thought I was in some deep **** with the amount of government letters mailed to my new place that I just moved into.

Then, it wouldn't be VA without this kicker. I paid them back the few bucks after weeks of trying to figure out the easiest way to give them money and make this all stop. And they said I paid too much....(the amount they stated). Re-start weeks and weeks of letters and benefeds account error letters. Im pretty sure they spent several Sizzler meals worth of $ in postage mailing letters to me and probably some HR person's weekly salary in time communicating via mail, phone, and email for months over a few bucks.

If that isn't VA in a nutshell.

 

[sloh]

Kafka-esque. This entire thread haha

 

[Terri Dactyl]

Sorry for ghosting!!! I forgot I don't have notifications set up and work/life balance is out-of-wack and haven't had time to respond...

Regarding testing... thanks for the responses and the DEnormalization that we're in fact in a crappy situation smh ... in brief...

1. No, there is no advocacy for the clinical relevance and necessity of psychological testing. I've been with the VA for... oh God, approaching 4 years in November, and within my first year I began advocating/demanding for psychological testing duties considering 30% is supposedly allocated for that. Aside from one psychologist in the PCBH who does pre-surgical evals and our neuropsychologist who answers a gamut of referral requests (not joking), no one was doing testing. So I became it... took two years to have time approved... and was only given 3hrs a week for testing. Another psychologist joined our team in 2019, also trained forensically, wanted testing time but was only given 1hr a week and she just has to "find" the time to complete reports elsewhere. Given, she has no therapy slots- is a walk-in provider so basically does triaging and there's no way to predict the volume of patients seen- even has teleworking.

2. So no we're not given enough time for testing, much less report writing, hence yes, that's why it takes so long for us to complete an assessment and there is delayed billing We. Have. No. Time.... Previously I've worked with one day devoted to psych assessment and could churn out a report a week. It's impossible here. We keep meticulous record of our time spent during these assessment times to prove we're utilizing that time.

3. Yes the chief knows. Plot twist... the chief was the one who designated the arbitrary and nonsensical 3hrs and 1hr assessment times because "there's no demand" so why lose 4 hrs that could be therapy slots.

4. And yes, the chief knows the value of testing as chief was a forensic psychologist in a previous life.

5. just keep swimming.... just keep swimming...

 

[Fan_of_Meehl]

Sorry for ghosting!!! I forgot I don't have notifications set up and work/life balance is out-of-wack and haven't had time to respond...

Regarding testing... thanks for the responses and the DEnormalization that we're in fact in a crappy situation smh ... in brief...

1. No, there is no advocacy for the clinical relevance and necessity of psychological testing. I've been with the VA for... oh God, approaching 4 years in November, and within my first year I began advocating/demanding for psychological testing duties considering 30% is supposedly allocated for that. Aside from one psychologist in the PCBH who does pre-surgical evals and our neuropsychologist who answers a gamut of referral requests (not joking), no one was doing testing. So I became it... took two years to have time approved... and was only given 3hrs a week for testing. Another psychologist joined our team in 2019, also trained forensically, wanted testing time but was only given 1hr a week and she just has to "find" the time to complete reports elsewhere. Given, she has no therapy slots- is a walk-in provider so basically does triaging and there's no way to predict the volume of patients seen- even has teleworking.

2. So no we're not given enough time for testing, much less report writing, hence yes, that's why it takes so long for us to complete an assessment and there is delayed billing We. Have. No. Time.... Previously I've worked with one day devoted to psych assessment and could churn out a report a week. It's impossible here. We keep meticulous record of our time spent during these assessment times to prove we're utilizing that time.

3. Yes the chief knows. Plot twist... the chief was the one who designated the arbitrary and nonsensical 3hrs and 1hr assessment times because "there's no demand" so why lose 4 hrs that could be therapy slots.

4. And yes, the chief knows the value of testing as chief was a forensic psychologist in a previous life.

5. just keep swimming.... just keep swimming...

'she had to "find" the time to complete reports elsewhere'

LOL. So VA.

"I'm sorry...I'm a psychologist...not a time lord"