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

[aim-agm]

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Apparently now we aren't allowed to have Teams photos that aren't blank/nothing (our initials) or an official VA photo (which I've never even had the opportunity to get)

At least in my VISN this started months back, before the new administration

 

[Shiori]

I just deleted my whole signature when they started getting huffy about pronouns. I also never had a picture because I couldn't be bothered. I am fine being the faceless bureaucrat they think I am already.

 

[WisNeuro]

I just deleted my whole signature when they started getting huffy about pronouns. I also never had a picture because I couldn't be bothered. I am fine being the faceless bureaucrat they think I am already.

You forgot lazy. Faceless lazy bureaucrat.

 

[DoubtfulDoc]

You sweet summer child - Veterans must be coddled nonstop!

ah yes, I forgot our golden rule 🙂

 

[WisNeuro]

GOP lawmakers advance proposals to reduce federal benefits, gut civil service protections | Federal News Network

One Republican who voted against the cuts to federal benefits cast doubt that the provisions would end up in the final version of the GOP reconciliation bill.

federalnewsnetwork.com

Have fun, folks. These efforts will not stop.

 

[Shiori]

To be fair, it's pretty standard recently for Republicans to propose gutting federal benefits. It was practically a hobby for Paul Ryan.

 

[WisNeuro]

To be fair, it's pretty standard recently for Republicans to propose gutting federal benefits. It was practically a hobby for Paul Ryan.

Only now they have control of Congress and the WH and some of these stand a much higher chance than usual to get pushed through. They also saw that they could run roughshod over federal departments and the public's rancor would be fairly muted and short-lived, so they know they can do this with little blowback now.

 

[Shiori]

Only now they have control of Congress and the WH and some of these stand a much higher chance than usual to get pushed through. They also saw that they could run roughshod over federal departments and the public's rancor would be fairly muted and short-lived, so they know they can do this with little blowback now.

They've had the majority before. It sounds good on paper to cut the bloated federal employee's benefits, but it's ultimately unpopular. That's not to say they won't do it, but they're burning through political capital really quickly. I think they'll prioritize whatever it takes to get the tax cuts and toss whatever freaks out the shakier Republicans.

 

[cara susanna]

GOP lawmakers advance proposals to reduce federal benefits, gut civil service protections | Federal News Network

One Republican who voted against the cuts to federal benefits cast doubt that the provisions would end up in the final version of the GOP reconciliation bill.

federalnewsnetwork.com

Have fun, folks. These efforts will not stop.

Not sure why you're acting like we have control over this? Quitting and finding another job isn't easy or straight forward for everyone. For instance, the largest healthcare system in my area gives very few personal days.

 

[coffee&CBT]

Not sure why you're acting like we have control over this? Quitting and finding another job isn't easy or straight forward for everyone. For instance, the largest healthcare system in my area gives very few personal days.

Agreed. Things are hard enough without outsiders taunting us.

 

[Sanman]

Not sure why you're acting like we have control over this? Quitting and finding another job isn't easy or straight forward for everyone. For instance, the largest healthcare system in my area gives very few personal days.

With the way the VA system is going, I am not sure this a career worth pursuing unless you are willing to work for yourself. The government used to be a good alternative, but I don't think so anymore. We are moving towards a two tier system of healthcare and large systems seem to only be interested in the lower end.

 

[WisNeuro]

Moreso for the people just starting out. But, there's always PP. I'd love to have more providers in the community doing real PTSD tx. Not too mention PTSD IMEs are pretty steady work.

 

[cara susanna]

Moreso for the people just starting out. But, there's always PP. I'd love to have more providers in the community doing real PTSD tx. Not too mention PTSD IMEs are pretty steady work.

Private practice is my backup option if I get RIFed or things get so unbearable that it outweighs my spite, but it's gonna take some time to build up a caseload. Also, I don't love the idea of not getting paid if I have a cancellation or don't schedule someone.

With the way the VA system is going, I am not sure this a career worth pursuing unless you are willing to work for yourself. The government used to be a good alternative, but I don't think so anymore. We are moving towards a two tier system of healthcare and large systems seem to only be interested in the lower end.

Yup, I've decided that, if I have to leave the VA, I am going into a job where I have a lot more freedom. Hence, private practice.

 

[WisNeuro]

Private practice is my backup option if I get RIFed or things get so unbearable that it outweighs my spite, but it's gonna take some time to build up a caseload. Also, I don't love the idea of not getting paid if I have a cancellation or don't schedule someone.



Yup, I've decided that, if I have to leave the VA, I am going into a job where I have a lot more freedom. Hence, private practice.

The raise in pay usually more than makes up for the issue of not having someone scheduled. As for not showing up, no-shows/cancellations, at least for me and other people I know, are FAR LOWER than the VA. As for IMEs, I actually hope they no-show, because I still get paid either way.

 

[Therapist4Chnge]

Moreso for the people just starting out. But, there's always PP. I'd love to have more providers in the community doing real PTSD tx. Not too mention PTSD IMEs are pretty steady work.

I fell into PTSD IMEs a couple of years ago and it's a good off-shoot niche for me.

 

[Fan_of_Meehl]

I fell into PTSD IMEs a couple of years ago and it's a good off-shoot niche for me.

How does one get into that sort of thing and who generally pays for it? Insurance companies?

 

[aim-agm]

The raise in pay usually more than makes up for the issue of not having someone scheduled. As for not showing up, no-shows/cancellations, at least for me and other people I know, are FAR LOWER than the VA. As for IMEs, I actually hope they no-show, because I still get paid either way.

I remember a discussion where VA therapists in private practice concurrently (or previously) could all count on one hand how many no-shows they have in a year in their private practice, but would have to start using toes to count how many no-shows they had in a week at the VA.

 

[cara susanna]

I'm watching the new ICARE video and since apparently I can't resist poking holes in these: how did she get an appt if she wasn't already enrolled?

 

[Therapist4Chnge]

How does one get into that sort of thing and who generally pays for it? Insurance companies?

Besides the one off lawyer referrals that involved PTSD as part of a larger case, I got most through workers comp. The lawyer ones are random, usually word of mouth bc they know my TBI/catastrophic injury cases.

For the workers comp ones I started w being a 2nd opinion and then I did some utilization review type work where they wanted to know if more treatments were warranted, etc. Sometimes an adjuster would know me from clinical work and call if I’d review their case.

This is actually a good example of why vetting referrals and drilling down to exactly what is being asked before accepting a case is so important. Clinical v workers comp (clinical or quasi-legal) v legal. All require different things and have different rules and ethical considerations.

 

[Shiori]

I'm getting old. It's hard to keep up with all the ways people are "enhancing" themselves. I have gone down the rabbit hole of SARMs, growth hormone analogues, and sketchy TRT. Then people are also basically taking amphetamines as pre-workouts.

I ask about pretty much every other kind of substance. I guess I need to add these to the list.

 

[Sanman]

Anyone see the new warning on the sign-on screen about monitoring on VA computers? Patients seem to be concerned about confidentiality.

 

[DoubtfulDoc]

I fell into PTSD IMEs a couple of years ago and it's a good off-shoot niche for me.

Oh yeah? I get ads for those jobs all the time, which company? How many do they expect you to do each day?

 

[WisNeuro]

Oh yeah? I get ads for those jobs all the time, which company? How many do they expect you to do each day?

Oh, these aren't the C&P DBQs.

 

[Therapist4Chnge]

Oh yeah? I get ads for those jobs all the time, which company? How many do they expect you to do each day?

Not those. There are matchmaking services that find experts for lawyers that will pay your full fee. The spammy IME companies are mostly pass-thru companies that take the majority of $ and pay a very low per case fee. The good companies are more selective of their experts, but they recognize the value of them.

 

[WisNeuro]

Not those. There are matchmaking services that find experts for lawyers that will pay your full fee. The spammy IME companies are mostly pass-thru companies that take the majority of $ and pay a very low per case fee. The good companies are more selective of their experts, but they recognize the value of them.

The question about how many in a day makes me think the poster was referring to the C&P third party contractors as opposed to actual IMEs.

 

[Pragma]

Anyone see the new warning on the sign-on screen about monitoring on VA computers? Patients seem to be concerned about confidentiality.

I mean weren’t some agency workers putting laptops in the fridge at home? I guess there’s no privacy expectation.

 

[Therapist4Chnge]

The question about how many in a day makes me think the poster was referring to the C&P third party contractors as opposed to actual IMEs.

Oh, fair. Yeah, those C&P companies are trash. Disability eval companies can be bad like that too. Basically have to template everything out, and it’s still bad hourly and it’s your liability for the low pay.

 

[DoubtfulDoc]

Oh, fair. Yeah, those C&P companies are trash. Disability eval companies can be bad like that too. Basically have to template everything out, and it’s still bad hourly and it’s your liability for the low pay.

I see now, yes I had things mixed up. But agree with you and @WisNeuro, the DBQ ones pay garbage and seems scammy.

 

[WisNeuro]

I see now, yes I had things mixed up. But agree with you and @WisNeuro, the DBQ ones pay garbage and seems scammy.

Yeah, the DBQ ones that I have seen pay only marginally better than clinical work, and that's still only if you do a poor quality eval. I'll stick with IME/WC/etc that pay my full forensic fees and give me wide latitude on conducting my evals.

 

[cara susanna]

Anyone see the new warning on the sign-on screen about monitoring on VA computers? Patients seem to be concerned about confidentiality.

Wait, what did it say?

 

[Sanman]

Wait, what did it say?

That using VA computers comes with no expectation of privacy and that all data are subject to monitoring, recording, copying, inspecting, etc. And that logging on constitutes acceptance of these terms.

Question is, does with include access to VVC telehealth sessions and CPRS?

 

[futureapppsy2]

That using VA computers comes with no expectation of privacy and that all data are subject to monitoring, recording, copying, inspecting, etc. And that logging on constitutes acceptance of these terms.

Question is, does with include access to VVC telehealth sessions and CPRS?

Hasn’t it always said that?

 

[Sanman]

Hasn’t it always said that?

Not for us at least. It didn't until the most recent software update.

 

[Grenth]

I was shocked that my leadership addressed the NYT piece. It wasn't news to us but usually the ignore all the media and advise us all to do the same. Although one said it was "a bad spotlight" and told us basically to not speak to the media.

 

[cara susanna]

What is apparently a hot take here: OPMH shouldn't have to do depression screenings

 

[tn15an]

Horrifying seeing Collins in the hearing yesterday flat out lie claiming shared space for MH telehealth is not happening.

 

[WisNeuro]

Horrifying seeing Collins in the hearing yesterday flat out lie claiming shared space for MH telehealth is not happening.

Nearly every time an official from this organization answers questions they lie about easily verifiable things, is this any different? Just the other day Trump claimed to have more trade deals with countries than there are actual countries in the world. This is just the world we live in now. A world where many of our citizens will happily gobble up lies and ask for seconds.

 

[cara susanna]

My job is way too complicated for this new email signature format

 

[Sanman]

In today's game of "How can this job get any worse", the folks back in offices that are not on site need to turn on their cameras every morning and show they are in the office.

Now that they are taking attendance again, when are they reinstating the pledge of allegiance? I am personally working getting Saturday detention.

 

[futureapppsy2]

I wish they would just announce the RIF plan already, tbh.

 

[cara susanna]

In today's game of "How can this job get any worse", the folks back in offices that are not on site need to turn on their cameras every morning and show they are in the office.

Now that they are taking attendance again, when are they reinstating the pledge of allegiance? I am personally working getting Saturday detention.

What? Show to who? Do they need to keep them on?

 

[AcronymAllergy]

In today's game of "How can this job get any worse", the folks back in offices that are not on site need to turn on their cameras every morning and show they are in the office.

Now that they are taking attendance again, when are they reinstating the pledge of allegiance? I am personally working getting Saturday detention.

I think I've confused myself--back in office but not on-site? Are they now having VA personnel in offices that aren't in VA facilities or something?

 

[Sanman]

What? Show to who? Do they need to keep them on?

I think I've confused myself--back in office but not on-site? Are they now having VA personnel in offices that aren't in VA facilities or something?

So, this is for those housed at CBOCs or other off-site facilities. Apparently you need to turn your camera on for a daily check-in with your supervisor to prove that you are at your assigned office and not working from home.

 

[AcronymAllergy]

So, this is for those housed at CBOCs or other off-site facilities. Apparently you need to turn your camera on for a daily check-in with your supervisor to prove that you are at your assigned office and not working from home.

Wow. That's not infantilizing at all.

"We don't care if you're a doctor and tell us that you're at your office. We need you to prove it."

Pretty soon they'll start requiring you to show pictures of a thermometer reading and/or of yourself at home in bed, looking miserable, anytime you take sick leave.

 

[Sanman]

Wow. That's not infantilizing at all.

"We don't care if you're a doctor and tell us that you're at your office. We need you to prove it."

Pretty soon they'll start requiring you to show pictures of a thermometer reading and/or of yourself at home in bed, looking miserable, anytime you take sick leave.

There needs to be a new Ferris Bueller movie where he is a federal employee, it would be choice!

 

[cara susanna]

I can't be the only person who thought of Speed and looping the video footage

(disclaimer: I am joking. Also I was never remote so this doesn't apply to me anyway)

 

[Sanman]

I can't be the only person who thought of Speed and looping the video footage

(disclaimer: I am joking. Also I was never remote so this doesn't apply to me anyway)

No, but Teams does allow for custom backgrounds...

 

[cara susanna]

No, but Teams does allow for custom backgrounds...

From what I read on Reddit, some supervisors are saying you can't use a custom background

 

[futureapppsy2]

I can't be the only person who thought of Speed and looping the video footage

(disclaimer: I am joking. Also I was never remote so this doesn't apply to me anyway)

It’s called The Bus That Couldn’t Slow Down.

 

[Pragma]

Wow. That's not infantilizing at all.

"We don't care if you're a doctor and tell us that you're at your office. We need you to prove it."

Pretty soon they'll start requiring you to show pictures of a thermometer reading and/or of yourself at home in bed, looking miserable, anytime you take sick leave.

Should pick a golf course background