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  • Avatar Eye3md 
    Participant
    Status: Physician
    Posts: 72
    Joined: 12/01/2017

    i tried doing a search to see if this had been discussed before and could not find anything.

     

    Any docs oc here work for the VA?  If so, how do you like it and how long have you worked there?

    Any docs that have transitioned from the private world to working at the VA?

    I know the pay is not as good as the private world but how are the benefits (especially health insurance)?

    What happens to your health insurance after you retire?  Do you get to continue you it since you had been a federal employee?

     

    I have not worked at a VA since my days in residency. During that time, I thought the VA was hit or miss with regards to quality of people I worked with. Now, in private practice, we see some VA patients on a contract basis and these guys are some of my favorite patients. Also, the VA folks (mostly other docs) I deal with are top notch and very helpful. All of this has me thinking about looking into working at the VA once I’m a little closer to FI.

    #103178 Reply
    Avatar StarTrekDoc 
    Participant
    Status: Physician
    Posts: 2055
    Joined: 01/15/2017

    Depends on your institution and leadership. Also depends on how you operate as a w2 employee with essentially no administrative control.

    Worked for va for 14 years before moving across the street to UC system. Bar none, our vets are the best and most deserving cohort I have had the honor of taking on their care.

    Some have considerable challenges, but the fall back I have always kept me grounded was that they stepped forward–draft or no draft.

    It was the insane political administrative decisions that drove me out when I got involved in admin duties. If you keep your nose down and do the daily grind…you’ll be fine.

    Later career is great. Benefits are good. 5 year vesting time. 1% per year and 36 month average for pension calculation. 10 fed holidays 26 leave days with 14 sick days. TONS of leave that you have to factor on salary

    Insurance is good. 70% covered by va. Rest premium is.yours and plenty of choices.

    Check out opm.gov for information. Tsp great low.cost index funds.

    #103188 Reply
    Hank Hank 
    Moderator
    Status: Attorney
    Posts: 1404
    Joined: 03/27/2017

    Were you a VA employee during residency?  If so, that time should count towards your five years for retirement.

    #103269 Reply
    Liked by Eye3md
    Avatar Anne 
    Participant
    Status: Physician
    Posts: 1174
    Joined: 11/07/2017

    I’ve worked for VA for the past 7 years.  There is a saying in the VA, “if you’ve seen one VA, you’ve seen one VA”…i.e. they can be wildly different in how they are run and how competent the administration is.  The administration at mine is pretty good now after a steady improvement over the past 6 years.  I have some administration work in my position which allows me to have some influence which I like.  The pace of work is very reasonable and my burn out risk is very low.  Although I do get bored from time to time seeing similar cases…but I think that is true anywhere.  I make about 15-20% less than my colleagues in my town doing similar jobs, but I see less patients per day, rarely stay late, take an actual lunch break on most days, never work weekends or holidays, etc.  (some jobs in the VA have call and work weekends/holidays, obviously, just not mine…but even in those they get another day off during the week to compensate…and call tends to be light from what I’ve heard.)

    26 days of annual leave (with generous carryover policy–at my VA several doctors have taken 4 week vacations), 13 days of sick leave (which can be accrued indefinitely and added to your total time for retirement if you work there until retirement age), 10 federal holidays.  CME money is low (capped at $1000/year).  Federal health insurance options are great, and if you are on health insurance for 3 years prior to retirement you can take your policy for you and your spouse with you when you retire…i.e. the federal govt keeps paying their portion.  Retirement is years of service X avg high 3 year salary X 1%.   You can calculate your minimum retirement age on opm.gov (depends on when you were born)

    The doctors I work with are very good (esp specialists).   The patients are fantastic.  I feel like we have a lot more options when it comes to resources then I did in the community.  There are some headaches and frustrations of course but overall the good far outweighs the bad for me.

    #103285 Reply
    Hank Hank 
    Moderator
    Status: Attorney
    Posts: 1404
    Joined: 03/27/2017

    Federal health insurance options are great, and if you are on health insurance for 3 years prior to retirement you can take your policy for you and your spouse with you when you retire…i.e. the federal govt keeps paying their portion.

    Click to expand…

    Not sure if VA is different.  For other federal employees, it’s five years of continuous federal employee health benefit coverage prior to an immediate annuity (retirement).

    #103345 Reply
    Liked by Eye3md
    Avatar Anne 
    Participant
    Status: Physician
    Posts: 1174
    Joined: 11/07/2017

    My bad.  Meant to say 5.

    #103378 Reply
    Avatar Brains428 
    Participant
    Status: Physician
    Posts: 400
    Joined: 11/09/2017

    I know that you get capped on pay if you’re in a high earning subspecialty. No government employee can be paid more than the president, so $400K will be the cap. They apparently just stop paying you for the year once you hit that cap.

    I don’t work for the VA, I have a friend who works there and told me this.

    #103380 Reply
    Liked by Eye3md
    Avatar G 
    Participant
    Status: Physician, Small Business Owner
    Posts: 1799
    Joined: 01/08/2016

    Keeping an eye on this thread.  Have had a number of friends and colleagues work at our local VAMC and none have stayed more than a few years.  Some only a few months.  Most common positive: great patients.  Most common negative: incompetent/untrustworthy administrators (point well taken since I know their yardstick).  Interesting to hear Anne say that they are all different–this would imply to me that ours can change for the better!

    All of this has me thinking about looking into working at the VA once I’m a little closer to FI.

    Click to expand…

    I’m right there with you, I feel like I can help now and not worry that take-home would be 1/3 of market value.  I know they could use the help…too bad it’s not just bankers’ hours when they need that help….

    #103383 Reply
    Liked by Eye3md
    Avatar GPGP 
    Participant
    Status: Physician
    Posts: 186
    Joined: 05/02/2017

    I worked at the va in my community for a year. I had a panel with a lot of doc turnover (5 docs in 6 years) so I think I had a challenging group. I wrote a ton of narcotics — 70 patients/month. Generally patients were complex. My primary care colleagues were great. Administration not so much. Ortho department would not see a patient if they were not a surgical candidate for joint replacement so that was irritating. Great pharm d support. But I didn’t like the model — I saw patients once or twice a year regardless of complexity and did an uncomfortable amount of phone medicine. Like others have said, va’s differ dramatically site to site.

    #103395 Reply
    Liked by Eye3md
    Vagabond MD Vagabond MD 
    Participant
    Status: Physician
    Posts: 3477
    Joined: 01/21/2016

    I know a couple guys who finished their careers at the local VA, and they liked it a lot. One is still finishing and keeping my seat there warm. (I wish he would leave already.) I have thought about that as a potential wind down job.

    "Wealth is the slave of the wise man and the master of the fool.” -Seneca the Younger

    #103398 Reply
    Avatar ellenb 
    Participant
    Status: Physician
    Posts: 23
    Joined: 12/21/2017

    I was in an academic physician group practice prior to joining the VA. I was told then that VA benefits were terrific, but I found out that this is not necessarily the case. The main advantages in my view for the VA are more vacation/sick days, 40 hour work week, and pension.  These are important factors for may physicians.

    Items that I think are disadvantages are: expensive life insurance, fuzzy disability coverage, no 457 option (only TSP – which is a good program).

    My university had a better 403b match and provided emeritus faculty with health insurance. Plus, the university offered me free life, health, and LTC insurance. Lastly, be aware that the current administration just submitted a proposal to adjust vacation/sick days (with family leave paid), increase FERS pension contribution by employee, and increase retiree health insurance contribution by employee.

    #103436 Reply
    Liked by q-school, Eye3md
    q-school q-school 
    Participant
    Status: Physician
    Posts: 2629
    Joined: 05/07/2017

    I know a couple guys who finished their careers at the local VA, and they liked it a lot. One is still finishing and keeping my seat there warm. (I wish he would leave already.) I have thought about that as a potential wind down job.

    Click to expand…

    what factors do they like?  I would think the 40 hour work week is the primary one at the tail end of the career.  I can like anything for forty hours.  it’s the eighty hours and the nights and weekends that can make one irritable at times.

     

    #103505 Reply
    Liked by hatton1, MochaDoc
    Avatar Eye3md 
    Participant
    Status: Physician
    Posts: 72
    Joined: 12/01/2017

    Yeah, I would take a HUGE pay cut but I would not consider working at the VA until I was FI. And because I’d be FI, I would consider the work at the VA to be an opportunity to provide care to the vets (without much concern for the big pay cut)

    #103622 Reply
    Avatar Eye3md 
    Participant
    Status: Physician
    Posts: 72
    Joined: 12/01/2017

    Im an ophthalmologist and have watched the number of ophthalmologists at the local VA dwindle over the years. When I first started, in private practice, I believe the VA had 5-6 cataract surgeons. Now, I believe they are down to one and almost all of the cataract surgery is having to come out in to our local private eye practices. The VA is trying to recruit but it’s hard when every single ophthalmology practice within 100 miles is also trying to hire another cataract surgeon. As far as other specialties go, I’m not certain about the retention or recruitment rate…..at my local VA

    #103624 Reply
    Avatar StarTrekDoc 
    Participant
    Status: Physician
    Posts: 2055
    Joined: 01/15/2017

    VA doesn’t do high volume churn well.  Though expensive contracting, it probably pencils out cheaper to contract the cataract surgeries and post care while concentrating on the complex cases.  We saw that trend occur more and more with the limited surgeons and OR time that was had.

    #103635 Reply

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