Jump to content

Recommended Posts

I'm separating from the military in 2 months after 3 years of service as a PA in primary care and was recently extended 2 job offers; one with the VA in primary care, the other an occ med job with a non-profit organization run by Catholic Health Initiatives. As I consider what I'm looking for in my next job, factors such as work-family balance, minimal red tape and stress are more important than pay. Both offer good benefits. Can anyone offer any insight to life as a PA with the VA and how that job might compare with a position with a non-profit? Thanks!

Link to post
Share on other sites
  • Replies 57
  • Created
  • Last Reply

Top Posters In This Topic

Top Posters In This Topic

Popular Posts

Hi, I work for the VA in primary care in a community-based outpatient clinic.  I love it and would be very unlikely to go back to the private sector. There are many positive aspects: good pay (better

I can tell horror stories about Duke, Cleveland Clinic, and Johns Hopkins as well.  My general feeling, as is that of many of my colleagues, as that the VA did not prepare for all of the returning sol

I can relate to the Fort Bragg experience; I worked at an Air Force Base primary care clinic, and the emphasis was on keeping everyone deployable.  The big joke was that there was a mysterious room, s

Hi, I work for the VA in primary care in a community-based outpatient clinic.  I love it and would be very unlikely to go back to the private sector. There are many positive aspects: good pay (better than private sector, despite all of the recent hype in the media), regular step increases, lots of time off, regular schedule, good health insurance, and excellent retirement. Most importantly, for me, is the autonomy.  We have moved from "supervision" to "collaborating."  I am responsible for my own panel of veterans, no one is looking over my shoulder.  We also are not expected to crank out patients every 10 minutes to make money for a corporation.  I get one hour with my new patient, half an hour for returns.

 

There are some annoyances, such as mandatory meetings and in-services, which are usually bullshit created by someone who has to justify their job. The other thing is that CME is inconsistent, depending on what VISN, or region, you are in.  Some are generous and pay for everything, some are stingy and will only pay for the actual program cost, no travel, etc.  On the positive side, as a federal employee, you are exempt from paying for your DEA, which is over $700 and sure to go up

 

If you have a family, you will have excellent work-home balance.  If you are really efficient, you will be out the door at 4:30 PM.  I tend to work late because I am very anal  about my work and I like the peace and quiet after the rest of the staff have left. There is no call, no rounding, etc.

 

I have worked for a free clinic in the past.  The pay was very low. Non-profit work can be shaky.  Personally, I think the VA is a better bet, but that is up to you. Veterans, for the most part, are a wonderful, appreciative patient population.

 

Do you mind telling me which VA made the offer?  Feel free to PM me if you have more questions.  Good luck with your decision!

  • Upvote 3
Link to post
Share on other sites

I currently work for the VA, and agree with gleannfia's comments.  I worked in primary care at a community based outpatient clinic, and found the pluses of working with the VA outweighed the minuses.  At present, I work in Compensation and Pension, which can be stress-free and curiously interesting on a good day, or tedious and frustrating on a bad day. 

 

In my experience, the VA will not give the selected candidate a firm salary offer until the very last minute, which can make it difficult if you're juggling multiple job offers.

Link to post
Share on other sites

Weeziana, good to know, they seemed unwilling/unable to provide a firm number even after I expressed salary may be a deciding factor. All they could say is that they would get back to me, meanwhile I've got folks at the other position sending me their offer including salary and benefit details tomorrow.

Link to post
Share on other sites

With experience of several years and being a graduate of an accredited program/NCCPA certified, assume you're at least a grade 12/level 6 (one of our fine contributors has messaged me, telling me that they were offered a 12/10 pay scale on two separate employment opportunities, regardless of degree level).  If you hunt around the web you'll be able to find a table showing the salary amounts for each grade/level in your area.

Link to post
Share on other sites

I can appreciate that.  I did a brief stint at Fort Bragg and did not care for the records system or the way medicine was practiced .  I felt that we were pushed to throw ibuprofen at the soldiers and get them back out there. But that's just me.  I wasn't a good fit for military practice, there is a place for everyone.  Some people love working in prisons as well, and that is not for everyone.

Link to post
Share on other sites

Are there going to be any major changes for PA's in the system with the whole VA debacle right now?

y2jteWY.gif<--- Opening some can of worms ... Some are eager to link the VA event to Obamacare, and more predominantly; a government-run health care. While others praise the strength of the VA holding it as an ideal of what our health care system should look like. More and likely it probably lie somewhere in the middle.  But remember the VA has always been deplorable even during the Vietnam War.

Link to post
Share on other sites

It has been my take on the matter that the issue tends to lie primarily with the administrative personnel more so than the actual providers.  I purchased and started to read Wm. Gates non-fiction account of his time as SOD under Bush and Obama (became bogged down in it very quickly) and he himself admitted to the quagmire of the VA system, as well as the DOD as a whole, and the inability to make changes.  One of the more telling revelations was his trying to get the head of Walter Reed out of the picture when Gates himself saw the overall rundown condition of the facility.  Apparently the head of the hospital dismissed some of the concerns from the SOD.  I can only imagine how difficult making common sense modifications can be.

 

Addendum 5/29:  I did just receive a callback in follow up to my email inquiry yesterday as to the pay grade meeting that was scheduled for 5/27.  It was pushed back to tomorrow due to the head of the dept. not having been available.  Should get a call tomorrow afternoon I was told (while I will be on the road).  Guess I'll have to take my notebook with the salaries for each grade/level with me to reference.

Link to post
Share on other sites

I can tell horror stories about Duke, Cleveland Clinic, and Johns Hopkins as well.  My general feeling, as is that of many of my colleagues, as that the VA did not prepare for all of the returning soldiers after we sent them off to war. Current veterans have survived injuries that killed those in earlier conflicts.  I am not going to get into a political dispute here, but the sequester cut 21 million from the VA budget. One huge problem is co-managed care and double-dippers.  The VA has opened up care to non service connected veterans who may or may not be combat vets.  We see many middle and upper middle class vets who want the VA to pay for their Viagra. When I was working in oncology, we saw many well-off veterans whose insurance would not pay for novel chemotherapy agents (And, yes, this was occurring well before Obama was even a Senator)

Many of us think that the VA should set up a mail-order pharmacy, much like Express Scripts, where vets who only want prescriptions and are eligible can have their scripts from outside docs mailed in and filled.  There is no need for us to see them unless they have service connected problems.

If we could limit appointments to those who are truly service-connected or who have no other resources, there would be no problem with getting vets in for their appointments in a timely manner.  Unfortunately, we are seeing people who want what they can get, even if they have good insurance/Medicare and are not service-connected. They take up appointments that should be reserved for those truly in need.

 

And yes, don't blame the providers.  Look to the administrative people, the bean counters, such as the Phoenix director.  I didn't blame Bush for Walter Reed and I don't blame Obama or Shinseki for the current situation.  It is far more entrenched than these people.

 

Still, I think this will blow over, and most vets would not choose privatization.  Instead of using this crisis for political gain, all should be working together to solve the problems and provide excellent care to our veterans.

  • Upvote 2
Link to post
Share on other sites

No offense, but most of my patients would beg to differ with you.  When is the last time your doctor spent an hour with you?  I spend an hour  (or more) with new patients, 30 minutes with returns.  That would not fly in the cha-ching of corporate health care.

Link to post
Share on other sites

I can tell horror stories about Duke, Cleveland Clinic, and Johns Hopkins as well.  My general feeling, as is that of many of my colleagues, as that the VA did not prepare for all of the returning soldiers after we sent them off to war. Current veterans have survived injuries that killed those in earlier conflicts.  I am not going to get into a political dispute here, but the sequester cut 21 million from the VA budget. One huge problem is co-managed care and double-dippers.  The VA has opened up care to non service connected veterans who may or may not be combat vets.  We see many middle and upper middle class vets who want the VA to pay for their Viagra. When I was working in oncology, we saw many well-off veterans whose insurance would not pay for novel chemotherapy agents (And, yes, this was occurring well before Obama was even a Senator)

Many of us think that the VA should set up a mail-order pharmacy, much like Express Scripts, where vets who only want prescriptions and are eligible can have their scripts from outside docs mailed in and filled.  There is no need for us to see them unless they have service connected problems.

If we could limit appointments to those who are truly service-connected or who have no other resources, there would be no problem with getting vets in for their appointments in a timely manner.  Unfortunately, we are seeing people who want what they can get, even if they have good insurance/Medicare and are not service-connected. They take up appointments that should be reserved for those truly in need.

 

And yes, don't blame the providers.  Look to the administrative people, the bean counters, such as the Phoenix director.  I didn't blame Bush for Walter Reed and I don't blame Obama or Shinseki for the current situation.  It is far more entrenched than these people.

 

Still, I think this will blow over, and most vets would not choose privatization.  Instead of using this crisis for political gain, all should be working together to solve the problems and provide excellent care to our veterans.

The problem with the VA, and the rest of the federal government, isn't lack of funding.  The problem is the "blob" of bureaucracy that prevents even the best of people, like Shinsecki, from fixing things.  Watch the movie "Waiting for Superman" for an example of how the same "blob" prevents anyone from fixing the problems with our public schools.  It's not a money problem, it's a bureaucracy problem.

 

You are completely right about the problems associated with opening the VA up to non-service connected vets.  It was not, and should not be, the purpose of the VA to provide comprehensive health care to anyone who ever served a day.  However don't you see the correlation between THIS and the 50 year push for complete government-provided health care for everyone?  Our bureaucrats want to get more and more people onto gov'ment healthcare (CMS, VA, etc), yet the quality of gov'ment healthcare declines (fewer and fewer docs taking medicaid, VA waiting lists, etc).

 

 

Link to post
Share on other sites

No offense, but most of my patients would beg to differ with you.  When is the last time your doctor spent an hour with you?  I spend an hour  (or more) with new patients, 30 minutes with returns.  That would not fly in the cha-ching of corporate health care.

That is your n=1. 

 

My n=1 with VA family practice medicine has been three visits, including two annual physicals, where my barely english speaking doc has never touched me beyond shaking my hand. 

Link to post
Share on other sites

I can relate to the Fort Bragg experience; I worked at an Air Force Base primary care clinic, and the emphasis was on keeping everyone deployable.  The big joke was that there was a mysterious room, somewhere, with a mountain of Motrin in it!  Provider were discouraged from labeling active duty members with depression, and advised to diagnose them with adjustment disorder.  I didn't like the style of medicine practiced there; sick call brevity at best, which of course may have its place in another setting.

 

The demands on the VA system have increased, as previously noted, by the influx of veterans who have served in recent, endless conflicts.  Now, I'm not making a statement on the general quality of today's military, but a lot of these folks were, quite frankly, marginally employable prior to service, and when they get out, they either can't find a job or aren't qualified for anything.  As a provider who has worked both in primary care and compensation and pension, I have to say that there is a big rush to get on the VA bandwagon.  Between the double dippers with insurance and the unemployed/uninsured, primary care clinics are bursting at the seams.  Providers may get a big more time with patients than in the civilian world, but each patient is the proverbial "train wreck", with multiple problems/issues, who gets seen once or twice a year. 

 

There is a hue and cry about the delay in processing disability claims.  In my opinion, this is a big racket for many claimants.  Now, of course, there are so many deserving vets who are injured, broken, from their service, either physically, mentally or both, and warrant as much help as we can give them.  But then again, it is well known in VA circles that the name of the game is getting a check.  C & P is clogged with frivolous claims, generated by vet reps who comb through charts looking for potential service connections, however medically implausible.  It is not unusual to have to review years of medical records to process a claim for 15 or 20 possible conditions, so it's not like we can see 20 vets a day and take care of their claim.  VA disability payments are a source of income, and many vets keep pushing for a greater percentage of service connection.   It is sad to see stoic vets, who never complained a day in service, who come in with injuries that will plague them lifelong, struggle to get compensation without supporting evidence, while other vets spend their entire enlisted period in sick call, racking up documentation of complaints, because they know that's what they'll rely on after separation to get them a service connected disablilty. 

 

In general, vets get excellent care once they get in the system.  The system is indeed burdened with a lot of dead weight, employees that can't be gotten rid of.   Specialties have no incentive to see patients, as they get paid the same whether they see more or less, so some cherry pick their patients and find ways to decline referrals.  Primary care is an endless job, with complicated patients and endless "view alerts" to answer daily.  I have to say, though, that most people, both clerical and medical, prioritize the care of the veterans, and give them the best care possible.

  • Upvote 2
Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


  • Similar Content

    • By hlmort11
      Hi All,
      I was wondering if there are any places taking students for rotations starting in Jan 2021? 
      I would love a rotation in San Diego sometime between January and April as my husband is mobilized there with the NH Army National Guard.
      Other areas of geographical interest are the Midwest, New England, Alaska and Hawaii for Jan 2021-Dec 2021. Specifically rotations located in the following places:
      Western SD, Cheyenne, WY, Casper, WY, Western Nebraska, Denver, CO area inc. the foothills, Sioux City, IA, Topeka, KS, Indianapolis, IN, Palmer, AK, Hawaii, Minnesota, NH, VT, ME, and/or MA
      Thank you in advance!!
    • By ChristineB
      Hi everyone!
      I am a graduating PA and am currently looking for outpatient jobs, particularly in primary care. From what I have heard and seen, many primary care clinics are going through hiring freezes, and the few positions I have seen have required 2-5 years of experience. I have applied to them anyway in case they take a look at my CV and consider me, but they have either not contacted me or told me that I do not have enough experience.
      I had a good first and second interview for an endocrine PA position. I do like endocrine, however I believe at least 90% of my time will involve working only on diabetes management. If I am offered this position--or if I am offered a position in another specialty that I do not see myself in long-term--should I take it to get experience (and a paycheck)? Should I wait it out hoping for a primary care position? If I take a specialty position will I be less desirable as a future applicant for primary care positions? The job market is difficult, generally, for any new grads, but the pandemic seems to have made things a bit harder as well. 
    • By dburleson
      I was wondering if anyone has been hired by the VA recently and what their opinion was of it? Knew PA vs NP salaries at one point were lacking parity, but didn't know how the rest of the benefits were. Thanks!
    • By cgunn1800
      Just wondering if anyone has connections to PA, MD, or DO's in the state of Hawaii that might be interested/willing to take on PA students for clinicals, especially in primary care. My wife and I are both in PA school and applied and interviewed with the MEDEX program set to start in Kona. We didn't get into that program, but did get into another and we would still love the opportunity to help with the healthcare shortage in the state. Any tips or suggestions are greatly appreciated.
    • By taecson
      I don't really comfortable speaking this frankly to my colleagues. None of my close friends or family are in the medical field so they don't truly understand.  I am still a somewhat new PA and I am already considering a new career path. I went to PA school 2 years after graduating college, so I don't have any experience in any other fields besides healthcare. But I've been having serious thoughts about quitting my job and quitting the medical field altogether. A little background about me, I am in my late 20s and I have been a practicing PA for about 4 years. During this time I have been at the same practice, a specialty and internal medicine office. There are several physicians, but I am employed by one. I see patients in the clinic, in several acute care hospitals, and at nursing homes. Although I like the variety and the types of patients I see are very interesting to me, there are downsides to the job that just become more apparent every day. I work M-F 9-5 and 2 weekends per month. I have to take round at the hospitals and take calls on those 2 weekends, plus take calls 3 weekdays out of the week. I often work 3 weekends a month, and occasionally even 4 when my contract technically says 2. 
      My supervising physician is retirement age and he refuses to retire and instead delegates more and more tasks to me. For example, sometimes if he is too tired / lazy he will tell the staff to just transfer patient appointments to my schedule. Patients are understandably upset when they made an appointment with the doctor they've known for years and get switched to the schedule of a PA they don't know. I feel like "as the PA", and an employee of the doctor, I pretty much get saddled with all the grunt work and undesirable tasks that he doesn't want to do. I know in other settings PAs are treated with a little more respect and not just given the busy work to do. There are some upsides, I do like my SP, we work well together, and I feel like I can honestly and freely discuss patients with him without judgment. I also know that he may retire in a few years so this job won't be permanent either. I don't know if getting a new job will help.
      I applied for two separate jobs that I did not get. One was a family practice M-F with no call/weekends and the other was an allergy practice M-F with no call/weekends. Getting rejected for both of those jobs really discouraged me and made me feel trapped at this job. It won't be easy to find a new position.
      I get frustrated with patients too. It just feels like there are so many patients who are med seeking. Some providers in my area were recently sentenced to prison time for overprescribing narcotics. They were reckless with their prescribing and I am quite careful, but the fact that jail time is in the realm of possibility for our profession constantly looms over my head. 
      Patients also often want to be on disability when they clearly do not need to. There are so many patients wanting DMV disability placards and getting irate when I tell them they don't qualify. In addition, patients whose licenses get revoked want me to sign off on them being safe to drive when there was a clear reason the licenses were revoked. Again, I am on the receiving end of the brunt of their frustration and anger when I say they need a specialist clearance. There is just so much liability in our career field and so much stress involved. Liability is always there medically too. YOUR decision can affect whether a patient LIVES or DIES and it's so much stress that I have actually developed my own health issues secondary to the stress. 
      I have had a patient stalk me and become obsessed with me. He wrote me unhinged letters and made many calls to the office describing my car, etc. We had to get the police involved and I considered filing a legal restraining order. I know this is possible in any profession, but it feels like healthcare can be personal and intimate and patients can get the wrong idea. I again contemplated quitting the profession at this time.
      I have looked into other careers such as being a pharmaceutical representative, working in research, being an accountant, ANYTHING other than this. I have contemplated quitting and just living off my savings until I figure it out. I have talked to some colleagues to an extent, many are much older and have been PAs longer than me. I sometimes question if I'm just being an entitled millennial who wants life-work balance early on in their career until I realize that it's not normal or common to work 24-25 days in a row. It's not normal to only get 4 days off a month (if that. Some days I would get 2 days off a month.) I actually finally told my SP I was considering leaving because I was too burnt out. He trivialized my concerns and said "Why are you burnt out? You're young. I have been doing this for 40 years." Which is true, but this wasn't the life I envisioned for myself. After talking, he did acknowledge my concerns, and he hired an NP who can help me with the workload and guaranteed that I will only have to work the 2 weekends a month as outlined in my contract and I did get a raise. (I still feel like I'm underpaid which is a whole separate story.)
      Sorry for the essay, I just really needed somewhere to air out my frustrations with other people in my career field. Thanks in advance for reading.
×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More