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    VA courts private clinics, but physicians hard to get for government employment

     

    The U.S. Department of Veterans Affairs (VA), in a report released Thursday, says that 56,000 veterans have waited more than 90 days for initial appointments.. The VA contacted 70,000 patients currently waiting for care in attempts to schedule them for care at private clinics.

    “There is still much more work to be done,” says Sloan D. Gibson, acting Secretary of Veteran’s Affairs. The department says that it will also release twice-monthly reports to increase transparency and is establishing a patient satisfaction program. “Trust is the foundation for everything we do. VA must be an organization built on transparency and accountability, and we will do everything we can to earn that trust one veteran at a time,” Gibson says.

    The VA has been under scrutiny since news reports released in May detailed that up to 40 veterans may have died waiting to receive care from a Phoenix VA clinic. Reports of cover-ups, long wait times and corruption have surfaced at several other clinics. The FBI has opened a criminal investigation into the agency, starting with the Phoenix clinic. Eric Shinseki resigned as the secretary of the VA on May 30 because of the controversy. He had served in the position since 2009.

    The VA has continued to cite the primary care physician shortage as one reason for the delays in care. The New York Times reported in May that the VA has 400 primary care physician vacancies.

    But filling those positions might not be easy. A new survey from the Medicus Firm, a national physician staffing agency, found that few physicians are interested in working for the government. In its 2014 Practice Preference and Relocation Survey, the firm surveyed more than 2,200 physicians in a variety of specialties. Of those surveyed, only 2.5% of practicing physicians and 1.9% of training physicians indicated government or military employment as the practice setting most appealing to them.

    Jim Stone, president of the Medicus Firm, said that the low percentages might indicate that physicians feel that working for the government may satisfy fewer of their professional priorities and needs.

    “Whether the physician survey respondents’ opinions of government employment are based on perception, or reality, we don’t know. But, when recruiting and attempting to attract qualified candidates to any particular employer, perception is reality,” said Stone. “Demand for physicians is outpacing supply, particularly in rural areas and certain specialties such as primary care. Therefore, a healthcare organization’s brand as an employer is key to successful physician recruitment, and the recent news from the VA will most likely make their recruiting efforts even more challenging.”

    The U.S. Senate passed a bill June 11 that would expand the VA’s contracts with private practices and hospitals, and hiring more medical professionals. The American Medical Association has asked state and local medical societies to create registries of providers who are willing to treat veterans. In 2013, the VA spent $4.8 billion on care at non-VA hospitals and clinics, according to the Washington Post.

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    • Anonymous
      VA medicine is an excellent example of socialized medicine in its finest. It is not incentivized, people are rewarded for their silence, it is a bureaucracy that hires good people at a low salary and then makes them work in an inefficient environment that saps the life blood from their experience. Caring for veterans is an honorable job that demands the best our country can offer. Many VA physicians are excellent in what they do often because they also work at university medical centers that demand excellence. Our veterans would be far better off to get vouchers to seek care in the private section and not wait in long lines for the care they deserve. In our hospital we treat Somali and Nepal refuges within 2 weeks of the consult, while our VA clinic down the street has 3 to 6 month waiting periods for soldiers with similar need from injuries associated with service in Afghanistan and Iraq. I served many years in the Army Medical Corps which I believe is exemplary medical care, however, I'm saddened to see the penny wise and dollar foolish way our veterans are treated. The VA must treat these heroes within 30 days or refer them out without retribution to those doing the referral.
    • Anonymous
      VHA has problems, their hiring is very time consuming sometimes takes more than 6 months. A physician/employee will not know the salary he gets until he is hire. A pay panel sits after a decision is made to hire (almost 6 months) then he/she will come to know the salary. If the physician refuses the salary then the process starts all over again. I believe some people in administration who are based in smaller clinics and ample time should also be seeing patients. There are some clinic which is half staffed and if VHA or the administrative people set to set unrealisitc goals to see new patients within 14 days. The pressure then falls on the few in the clinic and they burnout. This will probably lead them to quit and in the end very few left in clinic. Goals should be set keeping in mind the no. of physicians in that specific clinic. There should be maximum patient load for each physician and once be he/she reaches that load there should be plans to get in a new physician and let that physician start seeing new patients and also take some load of the other physician. In some clinic the physicians have already exceeded the load and they still have to to see about 25 new pts/month. There is extreme stress on physician working in outreach clinics because of understaffing and increased no. of walk-ins. May be they will be glad to work extended hours if they are compensated as production bonuses as it is done in private world. Salary should also be increased keeping in view of the no of patients ssen by the physician. it is not fair for a physician seeing or dealing with 10 pts/day to get paid same as a physician who sees/deals with 15-15/day. There is lot more to be done, VHA cannot compare themselves to physicians in private practice as the whole dynamicas and documentation is different.
    • Anonymous
      Having worked in the front lines at the VHA for the last 25 years, one (of several) barriers to retaining (and attracting) superior physicians is the marked administrative non-clinical bureaucracy that "mandates" how you should practice - otherwise your performance will be less than "fully successful." Even the administrative physicians have gone over to the dark side and make your life hell if you do what is in the best interest of our Veterans. The administrative managers and supervisors game the system at the expense of our Veterans yet our frontline physicians witness these games but cannot speak up because of the impotent "No Fear Act." Yes, the pay sucks comparatively because it is a capitated system of healthcare delivery and not indemnity. However, your performance is measured largely based on indemnity metrics (and how much you kiss up and keep quiet)!
    • Dr. Felix
      Hey, I'd be happy to work at the VA, but they won't even consider me because I got a ding on my record for a stupid comment I accidentally put into an electronic progress note four and a half years ago. This resulted in a disproportionate s***storm of board actions and Databank reports that make it look like I'm a "bad doc." Government agencies won't touch me now. What a waste!! Maybe someone should take a hard look at the VA's physician exclusion criteria if they are so short of physicians.
    • Anonymous
      I am A VA doc, and the benefits are great/the salary could be better. Nobody has more appreciative patients!! The trick to doing it is finding the resources your patient needs within the system. NOT ALWWAYS available in our location, so i have to bend the bureacracy to give me whay my patient needs. This is often, not easy. I welcome the increased surveillance of the VA issues, as I truly believe it will result in better care. The "top brass" must now be agreeable to sit down and talk candidly with those of us on the front line. Up until now there has been a culture of not wanting to know our problems, THAT has got to change. There is inefficiency at the top, and I have always gotten "my way" by discussing with the department heads, that, if they don't listen my senators and congressman will!!

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