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  • Avatar trebizond 
    Participant
    Status: Resident
    Posts: 131
    Joined: 12/31/2017

    Probably a good idea to compute what the federal pension comes to. After prolonged service, i.e. 30+ years at a salary of 300+ (that’s what the senior aging cardiologists were making at my residency’s VA, so I’m guessing derm would be similar), seems like your yearly pension would be on the order of 100K+? Could be higher if there’s more years done or your ending salary is higher. In addition to that you get the TSP (basically the 401K) and then also Roth + SS.

    Idk how the estimated retirement comes to from working in PP and being more aggressive with taxable investments, but I would think a 100K+ annuity would be the equivalent of several million saved up in taxable accounts?

    For my part, can’t imagine working there. The inefficiency and ineptitude of much of the support staff was bad. It felt like it was on the doctor to pick up the slack for the failures of nursing, phlebotomy, scheduling, etc. Many of the more exotic labs were impossible to order. When patient’s complexity was beyond the capacity of the hospital, it was a gigantic pain to facilitate all these hospital transfers, documentation, etc. And I hated CPRS, much prefer a better EMR like Epic.

    But many seasoned attendings liked working at the VA, liked CPRS and felt like it made them more efficient than the newer EMRs out there, and were able to do a lot of (clinical) research. I don’t know many basic scientists but I think even some of them did their clinical work at the VA rather than the main academic hospital. It must have its virtues. A lot of smart people choose to work in this system.

    #231451 Reply
    IntensiveCareBear IntensiveCareBear 
    Spectator
    Status: Physician
    Posts: 235
    Joined: 12/22/2018

    The pursuit of money and good intellectual work are fundamentally incompatible. Realize that.

    Which one are you primarily trying to accomplish? There is you answer as to whether typical hospital/group/private or academic/govt work is “better.”

    They will all feature “work” for at least a percentage of the day (EMR and paperwork mainly, according to doc surveys), but different docs value different qualities and derive purpose for their work in different ways. If one sees purpose in the high standard of living he can provide his family, cool. If one finds purpose in doing research and teaching students, cool. If one derives purpose in helping people without payers and billing/collections as barrier to care, cool. They are all doing purposeful work, and that’s the important thing.

    A positive attitude can create purpose in any work for awhile… but if you choose one that’s pretty incompatible with your value system, spitty work is eventually spitty work with little or no purpose and even less satisfaction. “Burnout” is just a modern term for being in a job where the worker doesn’t buy into the philosophy and doesn’t find purpose. So, know thyself and choose wisely. GL

    "Hmm, that sounds risky." - motto of the middle class

    #231595 Reply
    Avatar Jack_Sparrow 
    Participant
    Status: Physician
    Posts: 72
    Joined: 01/09/2019
    Payout is 1% x years of service x avg high 3 salary (again, there have been talks of changing it to high 5).

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    Am i reading this right? So if you work for 5 years and you got paid 200k every year you worked.

    The pension is only going to pay = 0.01 * 5 * 200k = $10,000 a year in benefits?

    #231599 Reply
    Avatar Anne 
    Participant
    Status: Physician
    Posts: 1159
    Joined: 11/07/2017
    Payout is 1% x years of service x avg high 3 salary (again, there have been talks of changing it to high 5). 

    Click to expand…

    Am i reading this right? So if you work for 5 years and you got paid 200k every year you worked.

    The pension is only going to pay = 0.01 * 5 * 200k = $10,000 a year in benefits?

    Click to expand…

    Yes, if you only work for 5 years and make 200k that would be the amount you derive from the FERS pension.  Hopefully that’s not someone’s entire plan for their retirement savings lol.

    #231601 Reply
    Hank Hank 
    Moderator
    Status: Attorney
    Posts: 1394
    Joined: 03/27/2017

    Of course if you wait until age 62 and have 20 years of service or more the FERS multiple increases to a whopping 1.1% of high 3 base salary times years of service.

    #231754 Reply
    CM CM 
    Participant
    Status: Physician
    Posts: 1168
    Joined: 01/14/2017
    I value time and good relationships with patients, and my own personal time, much much much more than money.

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    Anne, do you think it’s true that any VA specialist will have a more reasonable workload and fewer hours relative to private practice? I’m interested in non-invasive cardiology.

    I saw 11 patients today and 10 said thank you.

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    Is 11 patients per day a typical day?

    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried bags for Cyd Charisse (gracious). Hosted epic company parties after Friday night rehearsals.

    #234301 Reply
    Avatar Anne 
    Participant
    Status: Physician
    Posts: 1159
    Joined: 11/07/2017

    CM I think it is generally true that you will see less patients in the VA than in PP.  But your practice setting is generally more inefficient. Some docs roll with that better than others.   I’m not sure how many patients our non-invasive cards see in a typical day–it’s not a clinic I interface with much but I can ask one of them and find out.

    I do a lot for my patients–that number includes EMGs, injections, primary E&M, figuring out where in the system their request for very high level DME is getting caught up, identifying needs for assistance, etc.  On the outside, if you request an EMG, you get an EMG.  Bing bang done.  At least the way I run my clinic, when a patient is sent to me for an EMG, I do an H&P to ensure the EMG is indicated (sometimes it’s not), do the EMG if appropriate, explain the findings and arrange necessary f/u and consults, and often end up taking care of other msk c/o that the patient identifies, all on the same visit.  So while I see less patients per day than I would in PP I think I do more for them in a single visit than I would/could in PP, and my day can be very full.   I also document well and in my specialty I think it is helpful for the patient to have thorough documentation.  I am scheduled 40 hours a week, sometimes I end up staying late finishing stuff up but I could easily not do quite as much with each patient–I generally cover everything the patient asks me to cover that is within my scope of practice (which is broad), not just what the consult asks for–again this probably would not go over well in PP but it works well in the VA.

    #234320 Reply
    Liked by Hank, CM
    Avatar Doc Spouse 
    Moderator
    Status: Small Business Owner, Spouse
    Posts: 215
    Joined: 10/20/2017
    I generally cover everything the patient asks me to cover that is within my scope of practice (which is broad), not just what the consult asks for–again this probably would not go over well in PP but it works well in the VA.

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    VA really is hit or miss, but I’ve seen massive improvement (as a patient) over the last 15 years.   The above quote is one of the great things about my visits to the VA as opposed to a normal hospital/clinic visit. Every time I’ve been so far *knock on wood*, the physician has made sure to answer all my questions, even asking leading questions of their own to make sure I’m clear about what’s going on and what’s the next step. I had a neuro appointment which lasted over an hour, with half of that just being Q&A and him chasing down forms to get some old MRI results from another VA facility.  Even helped me fill it out which was greatly appreciated.

    Thanks for being one of the good ones, Anne!

    #234438 Reply

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