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

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Fan_of_Meehl said:
I really wish they'd take the approach of eliminating POSITIONS not PEOPLE. What I mean by that is a lot of people who have clinical licenses and who COULD be providing direct services to veterans (psychotherapy, clinical case management) have, instead, duties that we could do without and that didn't even exist a few years ago. Even the non-clinical and non-licensed people (the clerks or anyone else) could be doing things to more directly support the mission. I definitely need more day-to-day administrative support/help in the form of following up with patients on non-urgent issues, making photocopies of forms/manuals, etc. that would decrease my burnout and increase my productivity. Could the rolls be trimmed down a bit and not hurt operations? Probably. Would we be better off re-allocating duties to be more central to the healthcare mission? Certainly.
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For my colleagues and I, it blows our minds that our SPC and IPVAP provide little to no therapy services. We have to refer out for the SP 2.0 EBPs. Purely administrative. From a clinical standpoint I agree with you, too many of these roles are admin heavy or admin only. From a selfish perspective, I’d love to have one of those roles. VA has killed any joy I had toward clinical work over this last year. The last few weeks have accelerated that exponentially.
 
ccpsych16 said:
For my colleagues and I, it blows our minds that our SPC and IPVAP provide little to no therapy services. We have to refer out for the SP 2.0 EBPs. Purely administrative. From a clinical standpoint I agree with you, too many of these roles are admin heavy or admin only. From a selfish perspective, I’d love to have one of those roles. VA has killed any joy I had toward clinical work over this last year. The last few weeks have accelerated that exponentially.
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What is astonishing to me recently is the absolute fragmentation of care in MH at VA (this may differ from VA to VA). When I was in training, continuity of care as well as the individual cognitive-behavioral therapist being flexible and being able to assess/diagnose, case formulate, and treat (using standard CBT techniques) the vast majority of patients who presented to them for care were givens of competent practice. At VA, what I'm finding is that individual veterans over the course of the past two years may have 'bounced' from provider to provider, from clinic to clinic, with everyone 'specializing' in something and identifying some reason that the veteran needs to be sent to someone else or to some other clinic to address their 'real' issue/diagnosis...it's maddening. And it's rarely 'evidence based.' You have PTSD providers sending people with mild/moderate alcohol use to SUDS prior to seeing them for PTSD. SUDS will send them back to PTSD clinic saying they need to address their PTSD prior to being seen for SUDS. Lots of (perhaps) well-meaning but under-informed therapist will see a history of mTBI/concussion and think the person needs a full neuropsych workup to 'address their TBI' prior to offering some other indicated MH treatment. The list goes on and on. Everyone is trying to find reasons they can't do a course of therapy with a veteran rather than just rolling up their sleeves and being flexible and treating the veteran with what they can offer them. Many of these veterans are cases that represent a 'target rich environment' and multiple potentially viable treatment targets (substance use, emotional dysregulation, cognitive errors, etc.) but everyone wants to 'tag' them with a problem that some other specialty clinic or specialist 'needs to evaluate/address' prior to seeing them.

Very few veterans (especially outside formal protocols like CBT-D or PE/EMDR/CPT) are receiving a course of regular psychotherapy sessions that involve a beginning, middle, and end and that is of any depth whatsoever.

There are veterans who need real courses of therapy who have, ostensibly, had like 8 'specialists' tinkering superficially (over the course of 1-3 encounters) over the course of the past 2 years but they haven't had a single therapist just spend 8-16 weekly/bi-weekly sessions with them to execute a course of CBT (like Judith Beck outlines in CBT: Basics and Beyond). So, at the end of the day, money and resources are being expended that would have been sufficient for them to have received TWO complete courses of CBT with a competent therapist, in depth, but, instead, they've been 'dabbled' with by 8 'specialists' for 1-3 superficial sessions at a time.
 
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butteredtoast27 said:
I know this really is an unanswerable question, but I'm curious to hear any thoughts from current VA psychologists about when may be the time to abandon ship, and what signs you personally are looking for before you would consider making a move. I am having a difficult time ignoring the massive flock of canaries in the coal mine, so to speak.
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Pretty soon I’m going to be the only BHIP provider. Unfortunately for me, I’m in an area where there are no employment alternatives, unable to move (we just started a new lease that’s >12 months), and no financial cushion. Still want to quit every single day.

Fan_of_Meehl said:
What is astonishing to me recently is the absolute fragmentation of care in MH at VA (this may differ from VA to VA). When I was in training, continuity of care as well as the individual cognitive-behavioral therapist being flexible and being able to assess/diagnose, case formulate, and treat (using standard CBT techniques) the vast majority of patients who presented to them for care were givens of competent practice. At VA, what I'm finding is that individual veterans over the course of the past two years may have 'bounced' from provider to provider, from clinic to clinic, with everyone 'specializing' in something and identifying some reason that the veteran needs to be sent to someone else or to some other clinic to address their 'real' issue/diagnosis...it's maddening. And it's rarely 'evidence based.' You have PTSD providers sending people with mild/moderate alcohol use to SUDS prior to seeing them for PTSD. SUDS will send them back to PTSD clinic saying they need to address their PTSD prior to being seen for SUDS. Lots of (perhaps) well-meaning but under-informed therapist will see a history of mTBI/concussion and think the person needs a full neuropsych workup to 'address their TBI' prior to offering some other indicated MH treatment. The list goes on and on. Everyone is trying to find reasons they can't do a course of therapy with a veteran rather than just rolling up their sleeves and being flexible and treating the veteran with what they can offer them. Many of these veterans are cases that represent a 'target rich environment' and multiple potentially viable treatment targets (substance use, emotional dysregulation, cognitive errors, etc.) but everyone wants to 'tag' them with a problem that some other specialty clinic or specialist 'needs to evaluate/address' prior to seeing them.

Very few veterans (especially outside formal protocols like CBT-D or PE/EMDR/CPT) are receiving a course of regular psychotherapy sessions that involve a beginning, middle, and end and that is of any depth whatsoever.

There are veterans who need real courses of therapy who have, ostensibly, had like 8 'specialists' tinkering superficially (over the course of 1-3 encounters) over the course of the past 2 years but they haven't had a single therapist just spend 8-16 weekly/bi-weekly sessions with them to execute a course of CBT (like Judith Beck outlines in CBT: Basics and Beyond). So, at the end of the day, money and resources are being expended that would have been sufficient for them to have received TWO complete courses of CBT with a competent therapist, in depth, but, instead, they've been 'dabbled' with by 8 'specialists' for 1-3 superficial sessions at a time.
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We’ve been pretty successful with a shift toward EBPs and away from never ending “therapy”. Doesn’t stop some folks from being mad about it and fire VA as a whole, which, none of us are too upset about. With the dwindling # of staff, it’ll be hard for those of us remaining to get support from leadership (psychiatrists who don’t understand and probably don’t respect what psychologists do) to continue with EBPs.
 
ccpsych16 said:
We’ve been pretty successful with a shift toward EBPs and away from never ending “therapy”. Doesn’t stop some folks from being mad about it and fire VA as a whole, which, none of us are too upset about. With the dwindling # of staff, it’ll be hard for those of us remaining to get support from leadership (psychiatrists who don’t understand and probably don’t respect what psychologists do) to continue with EBPs.
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Leadership and clinicians once tried to close a never-ending "therapy" group (was basically just a coffee club) at a former VA that had been going on for decades after the person who led it retired. They were forced to start it back up after what was probably a ridiculous number of congressional complaints.

And yeah, it always struck me as nonsensical that the SPC wasn't actually doing any clinical work related to, you know, suicide.
 
AcronymAllergy said:
Leadership and clinicians once tried to close a never-ending "therapy" group (was basically just a coffee club) at a former VA that had been going on for decades after the person who led it retired. They were forced to start it back up after what was probably a ridiculous number of congressional complaints.

And yeah, it always struck me as nonsensical that the SPC wasn't actually doing any clinical work related to, you know, suicide.
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If I didn’t know VA so well I’d say you and I work at the same place. Something similar happened with a group like this. Ended up being transferred to peer support I believe, not sure if it’s still running.
 
ccpsych16 said:
Pretty soon I’m going to be the only BHIP provider. Unfortunately for me, I’m in an area where there are no employment alternatives, unable to move (we just started a new lease that’s >12 months), and no financial cushion. Still want to quit every single day.


We’ve been pretty successful with a shift toward EBPs and away from never ending “therapy”. Doesn’t stop some folks from being mad about it and fire VA as a whole, which, none of us are too upset about. With the dwindling # of staff, it’ll be hard for those of us remaining to get support from leadership (psychiatrists who don’t understand and probably don’t respect what psychologists do) to continue with EBPs.
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This is...rough.

I left the VA years ago due to, I'm sure, similar frustrations with volume/access, process/flow, policy, etc. But even more than that, it's just NOT something (work-wise) I wanted to continue to do for 20 more years. Ph.D. and frontline provider for 20-30 years don't go together where I came from unless it was your own.... and you were just absolutely killing it. I know things have gone downhill since COVID, but man....

No other opps??? Really? Relatively rural VA/CBOC?
 
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Fan_of_Meehl said:
What is astonishing to me recently is the absolute fragmentation of care in MH at VA (this may differ from VA to VA). When I was in training, continuity of care as well as the individual cognitive-behavioral therapist being flexible and being able to assess/diagnose, case formulate, and treat (using standard CBT techniques) the vast majority of patients who presented to them for care were givens of competent practice. At VA, what I'm finding is that individual veterans over the course of the past two years may have 'bounced' from provider to provider, from clinic to clinic, with everyone 'specializing' in something and identifying some reason that the veteran needs to be sent to someone else or to some other clinic to address their 'real' issue/diagnosis...it's maddening. And it's rarely 'evidence based.' You have PTSD providers sending people with mild/moderate alcohol use to SUDS prior to seeing them for PTSD. SUDS will send them back to PTSD clinic saying they need to address their PTSD prior to being seen for SUDS. Lots of (perhaps) well-meaning but under-informed therapist will see a history of mTBI/concussion and think the person needs a full neuropsych workup to 'address their TBI' prior to offering some other indicated MH treatment. The list goes on and on. Everyone is trying to find reasons they can't do a course of therapy with a veteran rather than just rolling up their sleeves and being flexible and treating the veteran with what they can offer them. Many of these veterans are cases that represent a 'target rich environment' and multiple potentially viable treatment targets (substance use, emotional dysregulation, cognitive errors, etc.) but everyone wants to 'tag' them with a problem that some other specialty clinic or specialist 'needs to evaluate/address' prior to seeing them.

Very few veterans (especially outside formal protocols like CBT-D or PE/EMDR/CPT) are receiving a course of regular psychotherapy sessions that involve a beginning, middle, and end and that is of any depth whatsoever.

There are veterans who need real courses of therapy who have, ostensibly, had like 8 'specialists' tinkering superficially (over the course of 1-3 encounters) over the course of the past 2 years but they haven't had a single therapist just spend 8-16 weekly/bi-weekly sessions with them to execute a course of CBT (like Judith Beck outlines in CBT: Basics and Beyond). So, at the end of the day, money and resources are being expended that would have been sufficient for them to have received TWO complete courses of CBT with a competent therapist, in depth, but, instead, they've been 'dabbled' with by 8 'specialists' for 1-3 superficial sessions at a time.
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This...this is just bizarre.

This HAS to be "culture thing" gong wrong at your VAMC? Yea?

My experience at VA (2012-2018) was opposite of that....with some rare exceptions. And that was right in the middle of a HUGE surge/demand for services from returning service (OEF/OIF) men and women. How understaffed and/or overwhelmed are you guys? Is there an internship or practicum there for students? In my experience, VA providers (staff, students/interns) wanted to "treat" everything absolutely to death (both psychologists and LCSWs) even when it wasn't indicated... or the best time to do so.
 
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Shiori said:
My tolerance for jokes is also at an all time low. Yes, I'm still here. However, even without direct firings, we lost people because of this. Welcome to longer wait times. We already have half the number of staff we need for our hospital size.
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Make America Wait Again!
 
Shiori said:
My tolerance for jokes is also at an all time low. Yes, I'm still here. However, even without direct firings, we lost people because of this. Welcome to longer wait times. We already have half the number of staff we need for our hospital size.
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I know that has to be demoralizing. It sucks. Little things like having to handle more of your own scheduling, cleaning your own office, buying your own office supplies, etc., build up over time and weigh on you. Which, unfortunately, sounds like it's all part of the larger plan.
 
AcronymAllergy said:
I know that has to be demoralizing. It sucks. Little things like having to handle more of your own scheduling, cleaning your own office, buying your own office supplies, etc., build up over time and weigh on you. Which, unfortunately, sounds like it's all part of the larger plan.
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Honestly, while I am angry about the state of things, it is better for it to happen this way than the death by a thousand cuts over time. At some point there is going to have to be a reckoning and people are at least paying attention to what is happening right now. The people making excuses for their actions and inactions will have nothing left to hide behind.
 
futureapppsy2 said:
As a probationary VA employee (DRP-exempt but non-essential during shutdowns), I just want to know if I’ll have a job next week. It makes planning so hard.
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Unfortunately, I imagine it is day to day (as it for all of us really). It is also a bit of moot point. Whether they fire you outright or attempt to make you so miserable you quit, I imagine many of us will wrestle for with the question of "when" rather than "if" we are getting a new job.

While all of us have a lot of our identity wrapped up in our career, myself included, it has been good to take a step back and prioritize my personal relationships right now. Because at the end of the day, this is just a job and there will be others.
 
Sanman said:
Unfortunately, I imagine it is day to day (as it for all of us really). It is also a bit of moot point. Whether they fire you outright or attempt to make you so miserable you quit, I imagine many of us will wrestle for with the question of "when" rather than "if" we are getting a new job.

While all of us have a lot of our identity wrapped up in our career, myself included, it has been good to take a step back and prioritize my personal relationships right now. Because at the end of the day, this is just a job and there will be others.
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This is probably the healthier approach. I have been living by the notion that I can do all things through spite, which strengthens me.
 
Fan_of_Meehl said:
"Whatever doesn't kill me...empowers me to kill those who failed to kill me first."
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Unrelated, but I finally watched office space (it came out when the same year as my birth) and Milton has been way too damn relatable given the EOs and NIH freezing. I imagine his character resonates with everyone powering through the VA right now.
 
The Cinnabon said:
Unrelated, but I finally watched office space ( it came out when the same year as my birth) and Milton has been way too damn relatable given the EOs and NIH freezing. I imagine his character resonates with everyone powering through the VA right now.
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I feel as if the bolded statement is a personal attack on my youth and I do not approve. You're too young to be an adult because I cannot be that old.
 
The Cinnabon said:
Unrelated, but I finally watched office space (it came out when the same year as my birth) and Milton has been way too damn relatable given the EOs and NIH freezing. I imagine his character resonates with everyone powering through the VA right now.
Click to expand...
"Ooookay...but...I could...set the building...on fire..."

The 90's were a LOT of fun, by the way
 
docloufan said:
This...this is just bizarre.

This HAS to be "culture thing" gong wrong at your VAMC? Yea?

My experience at VA (2012-2018) was opposite of that....with some rare exceptions. And that was right in the middle of a HUGE surge/demand for services from returning service (OEF/OIF) men and women. How understaffed and/or overwhelmed are you guys? Is there an internship or practicum there for students? In my experience, VA providers (staff, students/interns) wanted to "treat" everything absolutely to death (both psychologists and LCSWs) even when it wasn't indicated... or the best time to do so.
Click to expand...
We see a bit of everything at my clinic. A few people doing a course of something specific with a beginning, middle and end, several who over treat and probably make things worse iaterogenically, people who refer for assessment because their dozens and dozens (or years) of nothing-burger therapy hasn’t been working and they believe their is a “hidden” diagnosis instead of self critically evaluating the care offered and discussing outcomes, goals, etc with the Veteran. We have really lost the ability to simply do a functional analysis of some problems, identify what’s maintaining their concerns, and treat using simple behavioral and cognitive techniques. Identifying some straightforward goals about intensity, frequency or quality of life and developing a course of care. A lot of people aren’t trained in it with the poor quality control across training programs and state licensure boards, others convince themselves they’re special and that their talents are better suited to unusual therapeutic practices that magnify their particular notions about mental health, and of course—we have a had a good amount of turnover in the last few years, particularly for psychologists.
 
Fan_of_Meehl said:
What is astonishing to me recently is the absolute fragmentation of care in MH at VA (this may differ from VA to VA). When I was in training, continuity of care as well as the individual cognitive-behavioral therapist being flexible and being able to assess/diagnose, case formulate, and treat (using standard CBT techniques) the vast majority of patients who presented to them for care were givens of competent practice. At VA, what I'm finding is that individual veterans over the course of the past two years may have 'bounced' from provider to provider, from clinic to clinic, with everyone 'specializing' in something and identifying some reason that the veteran needs to be sent to someone else or to some other clinic to address their 'real' issue/diagnosis...it's maddening. And it's rarely 'evidence based.' You have PTSD providers sending people with mild/moderate alcohol use to SUDS prior to seeing them for PTSD. SUDS will send them back to PTSD clinic saying they need to address their PTSD prior to being seen for SUDS. Lots of (perhaps) well-meaning but under-informed therapist will see a history of mTBI/concussion and think the person needs a full neuropsych workup to 'address their TBI' prior to offering some other indicated MH treatment. The list goes on and on. Everyone is trying to find reasons they can't do a course of therapy with a veteran rather than just rolling up their sleeves and being flexible and treating the veteran with what they can offer them. Many of these veterans are cases that represent a 'target rich environment' and multiple potentially viable treatment targets (substance use, emotional dysregulation, cognitive errors, etc.) but everyone wants to 'tag' them with a problem that some other specialty clinic or specialist 'needs to evaluate/address' prior to seeing them.

Very few veterans (especially outside formal protocols like CBT-D or PE/EMDR/CPT) are receiving a course of regular psychotherapy sessions that involve a beginning, middle, and end and that is of any depth whatsoever.

There are veterans who need real courses of therapy who have, ostensibly, had like 8 'specialists' tinkering superficially (over the course of 1-3 encounters) over the course of the past 2 years but they haven't had a single therapist just spend 8-16 weekly/bi-weekly sessions with them to execute a course of CBT (like Judith Beck outlines in CBT: Basics and Beyond). So, at the end of the day, money and resources are being expended that would have been sufficient for them to have received TWO complete courses of CBT with a competent therapist, in depth, but, instead, they've been 'dabbled' with by 8 'specialists' for 1-3 superficial sessions at a time.
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Echo this sentiment for sure.
 
The Cinnabon said:
Unrelated, but I finally watched office space (it came out when the same year as my birth) and Milton has been way too damn relatable given the EOs and NIH freezing. I imagine his character resonates with everyone powering through the VA right now.
Click to expand...

When I was a post doc, they mistakenly had me down as doing a one year fellowship, and so my second year they essentially took me off of the payroll and everything. They eventually fixed it, but I kept making Milton jokes the whole time.
 
cara susanna said:
When I was a post doc, they mistakenly had me down as doing a one year fellowship, and so my second year they essentially took me off of the payroll and everything. They eventually fixed it, but I kept making Milton jokes the whole time.
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Yeah, same thing happened to a colleague (although luckily/somehow not me). Took a service chief from outside mental health walking over to HR personally to get it fixed after at least a few weeks of back-and-forth when the psych TD didn't get anything accomplished.
 
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AcronymAllergy said:
Yeah, same thing happened to a colleague (although luckily/somehow not me). Took a service chief from outside mental health walking over to HR personally to get it fixed after at least a few weeks of back-and-forth with the psych TD didn't get anything accomplished.
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The irony is that this issue will not be fixed once Trump is done making government great again.

Why do something useful when you can do something political.
 
AcronymAllergy said:
Yeah, same thing happened to a colleague (although luckily/somehow not me). Took a service chief from outside mental health walking over to HR personally to get it fixed after at least a few weeks of back-and-forth with the psych TD didn't get anything accomplished.
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I wonder who that colleague was 🙂
 
I just read that VISN 2 healthcare providers have been told to change their templates to remove “banned” words. Mueller She Wrote (Allison Gill) reported this in her latest newsletter:

I never thought I would see the day where the government would dictate what health care providers could put in the medical records of their patients, but that is exactly what’s happening in at least one health system within the Veterans Integrated Service Network (VISN) 2 right now. VISN 2 covers New York and New Jersey and includes VA hospitals and outpatient clinics in dozens of locations including Manhattan, Brooklyn, East Orange, Buffalo, and Syracuse.

Health providers at at least one location within VISN2 have been instructed to remove certain words in templated notes within the electronic health record, according to an email I’ve reviewed. All staff have been instructed to review all templated medical record notes in their areas and remove the following references:

  1. Gender
  2. Transgender
  3. Trans
  4. Cisgender
  5. Person, when used as an alternative to man or woman, as in “pregnant person”
  6. Non-binary
The instructions do not say whether a health care provider can use these terms when manually entering notes in a patient’s chart as opposed to using templated notes. Nor do we have specifics about what percentage of charting is done using templated notes. What I do know is that removing these terms is going to have a chilling impact on provider-patient care, and might run afoul of certain questions providers are required to ask veterans under law - like questions about sexual assault.

They are trying to erase the identities of Veterans. The same Veterans who need medical attention because they volunteered to protect the rights of those who voted for this administration.

If you have any other news you’d like me to share anonymously, please send it to me on Signal at MuellerSheWrote.23 or [email protected].

~AG
Click to expand...
 
Fan_of_Meehl said:
I'm amused to see that the act of having to literally "lay siege" to the local VA HR office to get them to address an issue is a necessity not confined to my own VA experience.
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In my experiences across multiple VAs, finding a pleasant, competent, motivated HR employee was like hitting the lottery and made pretty much every part of the job so, so much easier.
 
Therapist4Chnge said:
I just read that VISN 2 healthcare providers have been told to change their templates to remove “banned” words. Mueller She Wrote (Allison Gill) reported this in her latest newsletter:
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Yeah, this is one of the hills I'd probably die on. Regardless of the specific words chosen, I have trouble with anyone, let alone a political administrative entity devoid of any actual clinicians, dictating what language I am "allowed" to use in a patient's chart in all but the most extreme situations.
 
cara susanna said:
I always use my own templates anyway (I mean, they're the official ones, but I keep them in my own file so I don't have to use the stupid dialogue box)
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Same. If they're saying the VISN 2 folks need to remove the language from the official VA templates, it's still stupid, but that maybe isn't quite as egregious as saying that individual providers need to remove the words from their personal templates.
 
Trans patients are a fraction of our patients. I seriously doubt there are more than a handful of standardized templates across the entire VA that even hint at gender because it would be labor intensive to capture that data with any regularity. It's a significant part of my job and I have one template that I created for my own use that has any of the forbidden words in it. They're being ridiculous.
 
AcronymAllergy said:
Same. If they're saying the VISN 2 folks need to remove the language from the official VA templates, it's still stupid, but that maybe isn't quite as egregious as saying that individual providers need to remove the words from their personal templates.
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My facility doesn't allow personal templates, so I have to use autohot key scripts or notepad files, like a sucker
 
cara susanna said:
My facility doesn't allow personal templates, so I have to use autohot key scripts or notepad files, like a sucker
Click to expand...
Oh wow. I had Word documents that I used for reports, just because it was easier to write in Word than CPRS, but I had various templates for the initial appointment note, feedback appointments, etc.
 
AcronymAllergy said:
Oh wow. I had Word documents that I used for reports, just because it was easier to write in Word than CPRS, but I had various templates for the initial appointment note, feedback appointments, etc.
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Oh, trust me, I complain about it to anyone who'll listen. I looooved personal templates at my previous VAs.
 
AcronymAllergy said:
Yeah, this is one of the hills I'd probably die on. Regardless of the specific words chosen, I have trouble with anyone, let alone a political administrative entity devoid of any actual clinicians, dictating what language I am "allowed" to use in a patient's chart in all but the most extreme situations.
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I mean, I routinely include the juiciest of curse words (in quotations) if it's a direct quote from a veteran describing, say, a traumatic incident or describing exactly how they feel. Admittedly, I have resisted the urge--once or twice--to write something like, 'Dr. X's diagnosis of PTSD in this case is the absolute dumbest f&*(^ing piece of s&#* case of clinical a22baggery that I've ever seen in my career'...but I have never actually given into those urges (yet).
 
Yeah, this makes zero sense, particularly for folks who were hired directly into fully-remote roles, if the goal were actually to maximize access and patient care. But that's obviously not the goal. The only positive I can see is that at least there's a little advance notice.

And yeah, I can already imagine what's going to happen come July 29:

"There's no office space available for me."

"You'll just have to share an office with three of your colleagues"

"But where are any of us supposed to see patients?"

"Not my problem. If you can't figure it out on your own or just see them in your provided space, you can quit."

That, and/or when managers respond to the RTO order that they have nowhere near enough space for providers, they'll be told to "trim the fat" until they have enough space.
 
AcronymAllergy said:
Yeah, this makes zero sense, particularly for folks who were hired directly into fully-remote roles, if the goal were actually to maximize access and patient care. But that's obviously not the goal. The only positive I can see is that at least there's a little advance notice.

And yeah, I can already imagine what's going to happen come July 29:

"There's no office space available for me."

"You'll just have to share an office with three of your colleagues"

"But where are any of us supposed to see patients?"

"Not my problem. If you can't figure it out on your own or just see them in your provided space, you can quit."

That, and/or when managers respond to the RTO order that they have nowhere near enough space for providers, they'll be told to "trim the fat" until they have enough space.
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Looks like 'group therapy' for everyone, then.

Line up groups of 12 veterans for 2 mins of 'anger management therapy.' Bring in 1st cohort of 12 angry veterans, hand each one a laminated card depicting an 'angery...grr!' emoticon on one side. Instruct veterans to look at the card. Say, 'see that? Don't do that. When you're feeling angry, just 'flip the script and 'flip but don't 'FLIP!'' [demonstrates flipping the card to the opposite side which depicts a 'calm' emoji]. Any questions? Great. Bring in the next cohort while I close out these consults.

Gawd, I hate this org sometimes.
 
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