Veteran's Admin (VA)

[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!

[Hope2PA]

I do not work for the VA, did contract for a short period years ago and have friends and family who work in other professions.  This is what little I understand. It is government, so once you have a job, you will likely keep a position without the change in salary that others are experiencing now.  The VA does not usually send you on nice CME trips, more likely online and VA centered CME.  Many, many years ago, PA's were preferred over NP, but like the rest of the world, PA's have not advocated for themselves, NP's have, and they are making more $$, I think the parity is getting. NP's have independence in the VAMC where PA's turned that option down a few years ago, stupid mistake! However, AAPA Dave Mittman recently sent a letter requesting PA's be reconsidered for independence. Not sure enough PA's care to send follow-up letters to help get this passed, again stupid! EVERY PA, whether working in the VA or not should be writing letters, because if passed, it would bode well for individual states.  Okay, back on benefits, retirement pension, plus being able to save in a 401k type is awesome, there are few pensions out there anymore.  Additionally, health insurance with little to no change after retirement is good.  Once in the system, easier to transfer to different location, different specialty, all while keeping your retirement and seniority in tact. If you chose to advance education to doctorate, guess what, you get paid more for that degree. Patients are not like the used to be.  I hope I do not offend anyone, but the old guys were the best, appreciative, not looking for handout, but that is not unique to VAMC, it is more of a generational mindset.  The VA can suck or be great, just as anywhere else.  However, the VA is not likely going to close its doors.  In some places they are offering care to family members, not just veterans. You really should try to contact a local VA and talk to the PA's there for better info since none appear to be on this site. 

[dburleson]

Thanks for the insight! What speciality did you work in while you were there? Yeah, I was hoping for some more insight from some active VA PA's, but doesn't appear to be a whole lot currently on here :/.Thanks again!

[GetMeOuttaThisMess]

For someone that did it for all of six months I believe it all depends on which department, at which facility, you're in.  I found the clientele that I saw to generally be those who took advantage of the system and felt that they were owed something beyond quality healthcare.  Most of these, as noted above, were of a younger population.  If I had been in a specialty setting then things might have been different.  It is a bureaucracy beyond all other bureaucracies.  In my area residents from the local medical school would rotate through and it was nice to see that this generation was no different than my generation at dumping their patient load.  I also found that they missed a lot of stuff.  I wasn't too keen on the attendings either.  They felt it to be acceptable to work up a CP, with multi risk factors built in, as an out-patient.

[ventana]

Can anyone simplify the benefits of working at the VA??

(yes bumping an old thread)

[EMEDPA]

9 minutes ago, ventana said:

Can anyone simplify the benefits of working at the VA??

(yes bumping an old thread)

Federal pension. Hard to get fired. 

[ventana]

trying to figure out the specifics (looking at CBOC out patient)

1) pension - appears like vest in 5 years but it is a trivial pay out if you are not there 20-30 years

2) health care - any idea at co pays

3) PTO - time off?

4) CME and time off?

5) have heard of "bonus payments" or something like this - any details?

6) education reimbursement?  (thinking DMSc)

7) raises

Anything else

[sas5814]

On 10/23/2022 at 6:57 AM, ventana said:

trying to figure out the specifics (looking at CBOC out patient)

1) pension - appears like vest in 5 years but it is a trivial pay out if you are not there 20-30 years

2) health care - any idea at co pays

3) PTO - time off?

4) CME and time off?

5) have heard of "bonus payments" or something like this - any details?

6) education reimbursement?  (thinking DMSc)

7) raises

Anything else

From the top....

 

Pension is fully vested at 5 years. Total pension is something like 1.1% of the  highest salary x number of years of service. (There is a little more formula than that but that is about what it amounts to.) So when I pull the ripcord in a few years it will be 1.1% of my salary x 23% (approx). Forever. And it doesn't count as income against your social security earnings. You also have a matched fund investment account with a 5% match. If you are former military you can "buy back" your military time and add it to your VA time for your pension. I bought back about 17 years for 9k. Its worth it.

Health care: There are about 18 different plans and 3 tiers of each you can choose from. The one I am on now cost me about $300/month out of pocket for me and my wife. Co-pays and deductibles vary according to which plan you pick.

PTO for PAs is 26 days a year (8 hours per pay period) Sick time is 13 days a year (4 hours per pay period) and 11 Federal holidays.

CME is virtually non-existent. There are tons of free CME opportunities and we us Up To Date a lot which also earns CME.

Bonuses exist and there are several kinds. They are highly dependent on the leadership where you work. They can be an arbitrary amount or can be up to 25% of your annual salary.

Raises are "steps" and come every 2 years based on your performance evaluations. Because I have been a PA for so long I came in the door at max salary for my position so no raises for me.

The hiring process is a maddening, clunky, slow, horrible process that typically takes about 6 months. You have to jump through a hundred hoops and then, after you have done everything, a board meets and determines where you fit on the pay scale. About 2 years ago we finally got our own pay scale and got off the GS scale. You would be PA1 to PA5. 1 through 3 are worker bees and the board determines where you fall based on education and experience. 4 and 5 are leadership positions. 4 being local or regional leadership and 5 being bigger.... more national. Your salary offer will be the very last thing you get at the very end of this long process. Everyone knows its a horrible system and national leadership indicates they are working on it.

 

That is the big stuff. It is a very challenging place to work. The patient are generally very ill and resources can be a challenge. Because it is the government nothing is particularly easy and change comes at the pace of a glacier running uphill. We have the worst EHR I have ever seen but now that I have finally mastered it it works for the most part.

 

Happy to answer any other questions I  can. I work in primary care and have been here 20 months.

Edited October 24, 2022 by sas5814
more info

[Reality Check 2]

We got 2.7% COLA last year to our salaries.

I think we get 4% coming 2023.

Those don't happen in private world.

My insurance is about like Scott's - only about $350 for 3 people. We chose Kaiser - the devil we know.

Lots to choose from.

The benefits are awesome.

We supposedly have access to $500 for CME - it is a reimburse process - very weird - hard to navigate.

I have used it once - it worked but nothing was easy and few instructions.

VA sent me to training at their expense and I got CME to boot. 

I like what I do but, as Scott, says - very challenging. Internal Medicine to the extreme.

[ventana]

IM to the max is my dream!!

this week I am getting trampled by a herd of zerbra's... not just one (these are all patients that are my PCP patients where I am the ONLY one responsible for their care.  I consulted outside specialists, and ran all these cases independently.  did discuss the two MRI neuro brain mri with a partner.  I literally am being trampled by zebras this week    most amazing week in 20 years....  Yup I can handle the VA medicine

Critical subclavian stenosis with cool hand - ER and transfer out urgently

Dx                                      who was consulted

New Dx Lung CA (on LDCT on new patient that old pcp never ordered) - surgery and onc

New lymphoma Dx  (on LDCT on new patient that old pcp never ordered) - surgery, onc, cards, vascular, inpatient

Vestibular Neuroma growing into the deep brain - presented with shoulder weakness - neuro surg and ENT

Aortic Root Graft Infection from surgery 8 months ago - also new patient with vague complaints, ID, Vascular Surgeon, labs and ID follow up

Some type of Corpus CallosumT2 enhancing lesion on MRI - sending to neuro after lab work up

new onset schizophrenia in heavy cannabis user - MH

taking over T supplement on a patient fired by Uro 8 months ago - all me....

 

this is all on top of the regular run of the mill PCP issues with DM, CHF, MH, and the likes.....

 

 

One question is where I would come in on the salary scale

20 years actual working as a PA, masters education with a second masters

4 years AD

PA3 for sure, but do I come in at the top step??

[sas5814]

11 hours ago, ventana said:

IM to the max is my dream!!

this week I am getting trampled by a herd of zerbra's... not just one (these are all patients that are my PCP patients where I am the ONLY one responsible for their care.  I consulted outside specialists, and ran all these cases independently.  did discuss the two MRI neuro brain mri with a partner.  I literally am being trampled by zebras this week    most amazing week in 20 years....  Yup I can handle the VA medicine

Critical subclavian stenosis with cool hand - ER and transfer out urgently

Dx                                      who was consulted

New Dx Lung CA (on LDCT on new patient that old pcp never ordered) - surgery and onc

New lymphoma Dx  (on LDCT on new patient that old pcp never ordered) - surgery, onc, cards, vascular, inpatient

Vestibular Neuroma growing into the deep brain - presented with shoulder weakness - neuro surg and ENT

Aortic Root Graft Infection from surgery 8 months ago - also new patient with vague complaints, ID, Vascular Surgeon, labs and ID follow up

Some type of Corpus CallosumT2 enhancing lesion on MRI - sending to neuro after lab work up

new onset schizophrenia in heavy cannabis user - MH

taking over T supplement on a patient fired by Uro 8 months ago - all me....

 

this is all on top of the regular run of the mill PCP issues with DM, CHF, MH, and the likes.....

 

 

One question is where I would come in on the salary scale

20 years actual working as a PA, masters education with a second masters

4 years AD

PA3 for sure, but do I come in at the top step??

Probably. As near as I can tell time wise you'd peak at 12-14 years experience but that is just a guess. Your hiring authority can push some in that regard but, at the end of the process, it is about the rating the standards board gives you.

The interview matters not just in getting hired but in your rating as well. The interviewers aren't allowed to deviate from the questions picked for your particular interview and each person on the interview assigns a score to your answers. They are those sort-of-weird kind of questions like "tell us a time about when you failed and what you did about it" or "tell us about a work conflict you had and how you handled it"...that sort of thing. The scores are aggregated and help determine who gets hired and where you fall on the rating scale (along with experience and education.)

I haven't sat on an interview committee yet so I may not be 100% correct in every detail but that is my understanding.

[Joelseff]

I got hired by my local VA in 2019 for the Neurology/Sleep Med dept. I was to see sleep Pts, order CPAPs which were all fine but they also added "will supervise nursing, medical assistants, and other subordinate staff" and offered me 110K with no raises as I would be at the top of the scale already. They did mention possible COLA raises if applicable. Benefits were pretty good. The Retirement was what I was in for and what SAS5814 mentioned above it is 1.1% of "High 3" salary x years of service including military service with a 5 year vesting period.  It was literally 8 minutes from my house.  I turned it down and chased a job paying more that I got laid off from during COVID...Now I'm kinda kicking myself lol. I went back to Primary care at my first IM/PCP PA job but I am so done with community Primary Care (for reasons anyone in Primary Care can attest-pt entitlement, flood of patients with complaints ranging from "WTH?" to "this patient is going to die soon", admin paperwork, etc. etc...). I just accepted a GI/Hep Job (specialty I picked instead of the VA in 2019 and I have experience in) and I start Nov 14th. It has great bennies and pay is WAY more than VA and my PCP job but retirement is only a 403B. 

 

Wish you the best in your job hunt!

Edited to add: Oh yeah the hiring process was a nightmare! It was a little over 4 mos for me from start to the offer involving panel interviews, background checks etc.

Edited October 26, 2022 by Joelseff