Veteran's Administration Outpatient Clinic

[gmf04]

Interested in finding out more what it's like working for a VA outpatient clinic. There is one not to far from me and I'm considering looking into it as an alternative to my outpt corporate run FP/IM job. I have been told that benefits such as vacation time are good, but I'm interested in the day to day patient load, types of patients, what is expected at a clinic visit - example is this where patients get PAPs, EKGs, X-rays etc. Are there same day sick visits or is it mostly chronic medical conditions such as diabetes, HTN, etc. 

Thanks!

[Cideous]

I think Reality Check 2 mentioned she works at the VA?  Maybe send a PM.

[Reality Check 2]

All Internal Medicine all the time. With a healthy dose of psych.

80% male/20% female vets.

If doing Primary Care - you are in a PACT - patient aligned care team - provider, RN, LPN, clerk.

30 min and one hour appts - mostly annual exams and then some follow up and acute care. Depending on whether 4 day or 5 day week - 12-14 patients a day. BUT INTENSE.

INTENSE INTERNAL MEDICINE - dm, chf, copd, htn, cad, polypharmacy.

Not for the faint of heart and NOT for new grads.

Operate autonomously, lots to do - lots to know. 

Message me if you want to know more.

It is a good place but has to be the right fit.

[GetMeOuttaThisMess]

I would go so far as to say that if your PACT isn't a good match then you're hosed.

[adin200]

anyone work for ICE or Homeland security?

[CAdamsPAC]

1 minute ago, adin200 said:

anyone work for ICE or Homeland security?

There are some US Public Health PA assigned to CBP/ICE facilities.

[adin200]

1 minute ago, CAdamsPAC said:

There are some US Public Health PA assigned to CBP/ICE facilities.

I applied to a position but I am currently in the Private Sector. Curious to know if anyone else has input.

[CAdamsPAC]

1 minute ago, adin200 said:

I applied to a position but I am currently in the Private Sector. Curious to know if anyone else has input.

I'd give the clinic in one of the detention centers a call and talk to one of the PAs there.

 

[adin200]

Just now, CAdamsPAC said:

I'd give the clinic in one of the detention centers a call and talk to one of the PAs there.

 

5 minutes ago, CAdamsPAC said:

There are some US Public Health PA assigned to CBP/ICE facilities.

I applied to a position but I am currently in the Private Sector. Curious to know if anyone else has input.

[thinkertdm]

My pact was excellent when I started, excellent clerk, superb RN.  Then the clerk retired, the RN left to go back to the ED.  Since then, I’ve had covering RNs daily.  
You may think a half hour appointment is no problem, but the patients literally write down everything that comes to mind over the past six months and just spews it out at the appointment.  Preventative health takes a distant second to chronic pain.  
The other biggest issue is the antique emr the va uses.  Some designer in the past decided that you, the pcp, has to literally look at every single issue that goes on with the patient; they are called “alerts” and go to your work list.  Patient gets orthopedic shoes- you get an alert.  Patient schedules an appointment as a result of a consult you placed- you get an alert.  You get three of these if two phone calls don’t work and a letter is sent.  Refill requested- an alert.  On average I get 100-200 of these a day, and without a consistent rn, I get to do a lot of consult management too.  I asked one of the covering rns to call a patient and her response was “I’m not covering today, have him make an appointment “.  Sheer laziness, and since the nursing manager has his head up his ass...

If you want to see and manage conditions you will never see in the real world, the va is an excellent place.  
 

I have a panel of 1000, and four women; women’s health issues go to women’s health.

[Boatswain2PA]

On 6/9/2019 at 7:19 PM, gmf04 said:

Interested in finding out more what it's like working for a VA outpatient clinic.

I have no first hand knowledge of working for the VA as a provider, however I have a couple of friends who work for them in various roles, and I use the VA for some of my healthcare.

I think there is a HUGE variety between VA clinics, and specialties within the clinics.  There also seems to be relatively low pay, and large turnover.

Some subjective stories I'll share.

1 - For several consecutive years I went for my (required) annual check-up, and never had the "provider" touch me beyond the initial handshake.  During these consecutive years I had a different PCM each year.

2 - For past 2 years I've had the same NP as my PCM, and she has actually impressed me.  I don't think she knows I'm a PA.

3 - I have a friend working in a Boston-area VA who is a maga-hat wearing conservative.  She won several regional awards from the VA, but then she got a new adminiscritter in charge of her unit (??) and has subjected her to incredible bullying.  Lesson learned there - in huge organizations (like the VA), it's the adminiscritters who have the power, not the providers.

4. "Back in the old days" people went into the military to serve their country, to fight, or to gain a skill.  In the past 10-15 years there has been too many people who join the military simply for the benefits.  

5. The times I've looked into working for the VA as a provider I have found the pay to be unbelievably low.  Same thing with the local military base.  Could just be this location.

Good luck!