Announcement

Collapse
No announcement yet.

VA docs, change to hourly from salary

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • #16
    To be clear I am not complaining about my specific situation. It's just the policy in general, I am confused as to how it can be legal if we are hourly employees but not afforded the benefits of hourly employees . . . If this policy were actually played out as stated, I could work 24/7 with no time to eat or sleep or pee and that would be just fine? Doesn't seem right to me.

    Comment


    • #17
      Urgent care doc here doing shift work. Work through lunch and dinner. Every specialist/PCP under the sky has sent their post surgical/treatment on us. I've been hourly for 19 years. Am I missing something here?

      Comment


      • #18
        The 24/7 is stated but I've never seen it used. Agree the way it's written doesn't make sense, but I don't see it as a big deal in practice. At the end of the day, if you feel you are being taken advantage of, you should find another job.

        Unfortunately whenever there is some leeway in a system there are always some bozos who ruin it for everyone else.

        GPGP, I'm guessing you are primary care. Primary care is overworked and underpaid at the VA. Agree with the if you've seen one VA you've seen one VA, but I think primary care getting dumped on is probably true at all VAs, but I also think it's true everywhere.

        Comment


        • #19
          It's not an issue in practice for me because we have a reasonable supervisor who I'm sure would allow us to work late rather than taking leave for a doctor's appointment, if requested. Or let us come in late the next day, or whatever. And I am sadly under worked at this point in time. I just wonder how it's *legal * as written. As I am certain there are docs who are overworked and will have this policy enforced to an unreasonable degree ( but which is totally within the stated policy). My understanding has always been that hourly employees have certain protections, such as being paid overtime, being given breaks and meal time based on the number of hours worked in the day. Is this not the case?

          Comment


          • #20




            The 24/7 is stated but I’ve never seen it used. Agree the way it’s written doesn’t make sense, but I don’t see it as a big deal in practice. At the end of the day, if you feel you are being taken advantage of, you should find another job.

            Unfortunately whenever there is some lee way in a system there are always tome bozos who ruin it for everyone else.

            GPGP, I’m guessing you are primary care. Primary care is overworked and underpaid at the VA. Agree with the if you’ve seen one VA you’ve seen one VA, but I think primary care getting dumped on is probably true at all VAs, but I also think it’s true everywhere.
            Click to expand...


            The phrase 'per service agreement' drove me to bonkers.

            Comment


            • #21
              It's going to drastically reduced the VA's ability to hire and retain subspecialists.   As it is the VA pays about a third or less than private practice in many specialties.   In the past, however, sub specialists were often given a compressed tour so that they worked 4 longer days instead of 5 regular days.   This meant that in the past they had to use 4 days of vacation instead of 5 to take a week off.   Now that has changed, essentially cutting down the vacation and sick time.   I honestly can't see any reason for a sub specialist to be a full-time employee of the VA.   I might consider working for them as a fee-basis contractor where they pay per patient seen.  Just to give you an idea of the discrepancy -- as a contractor, paid-per-patient, the VA would pay me as much in one day per week of work  as I would make as a full-time employee.

              Comment


              • #22




                It’s going to drastically reduced the VA’s ability to hire and retain subspecialists.   As it is the VA pays about a third or less than private practice in many specialties.   In the past, however, sub specialists were often given a compressed tour so that they worked 4 longer days instead of 5 regular days.   This meant that in the past they had to use 4 days of vacation instead of 5 to take a week off.   Now that has changed, essentially cutting down the vacation and sick time.   I honestly can’t see any reason for a sub specialist to be a full-time employee of the VA.   I might consider working for them as a fee-basis contractor where they pay per patient seen.  Just to give you an idea of the discrepancy — as a contractor, paid-per-patient, the VA would may me as much in one day per week of work as I would make as a full-time employee.
                Click to expand...


                Yeah, I heard that was going to be an issue,  also for docs that work 12 hour shifts rather than the 8 hour shifts I work.  Essentially you cut your vacation by a third by switching to hourly.

                 

                It just seems to me that this is a change that affects thousands of doctors and the fact that I heard nothing about it from any doctor organizations seems like a problem. Why wasn't this a bigger deal and why weren't we as doctors involved in making sure this change was more reasonable? Again, the issue is not about me personally,  I have a good set up. The problem is how this could negatively impact so many physicians and there was no way to lobby for an alternative. It just seems to me that once again physicians have no voice at the table with decisions that impact them. And this isn't just about the VA either. I see this happening in all types of practices, in all kinds of issues. It feels like a real problem to me.

                Comment


                • #23


                  Why wasn’t this a bigger deal and why weren’t we as doctors involved in making sure this change was more reasonable?
                  Click to expand...


                  This could be the tagline for basically anything in this country medically related.

                  Comment


                  • #24
                    wideopenspaces, this happened over a period of years. You are just hearing about it now because you are new to the VA and it occurred just as you were starting.

                    Several years ago when they first wanted to do it a lot of doctors (largely people on compressed schedules) spoke up and they put a halt to it. I have no idea what happened between now and then that they made the change. But from my perspective, it was equally unfair that I get 26 days off of 8 hour days while someone with a compressed schedule gets 26 days off of 12 hour days. So now it's more equitable. For me I like that I can now take a half day if I want. There are pros and cons to everything.

                    Comment


                    • #25




                      wideopenspaces, this happened over a period of years. You are just hearing about it now because you are new to the VA and it occurred just as you were starting.

                      Several years ago when they first wanted to do it a lot of doctors (largely people on compressed schedules) spoke up and they put a halt to it. I have no idea what happened between now and then that they made the change. But from my perspective, it was equally unfair that I get 26 days off of 8 hour days while someone with a compressed schedule gets 26 days off of 12 hour days. So now it’s more equitable. For me I like that I can now take a half day if I want. There are pros and cons to everything.
                      Click to expand...


                      Yes, my newness could be part of the issue but I have many friends who have been there for years and they seemed equally surprised when they heard this was happening.  The fact that it was initially halted by then somehow still got put into effect is the real problem.  How did that happen?

                       

                      I agree it is more fair to those of us working normal hours but like dusn mentioned, for those higher paying specialists, this is a perk being taken away that might make it much harder to hire now. This hurts everyone- patients and employees. A transparent process where all voices are heard would have benefitted us all. I don't think it's helpful to let other docs hang out to dry because the end result is good for you individually( and I mean the collective you, not you as in Anne), or to say well just find another job if you don't like it. It's only a matter of time before you get screwed by a similarly hidden and mysterious decision making process where the physician voice was not at the table. That ( along with the fact that this still doesn't seem legal to me)is my problem with this whole thing.

                      Comment


                      • #26
                        Well I know that several years ago there was the opportunity to write and speak up, some did, some didn't. I hate to say it but if your friends who were there and say they didn't know about it...were they paying attention or just in their own little world ? Because i distinctly remember mass emails sent out to us about it, and I remember a few people made a fuss. Most probably didn't pay attention or were like me and didn't care too much one way or the other. I thought about it at the time but could see pros and cons to both ways. I have no idea about the legalities. To me it seems fair. Yes the VA has difficulty recruiting certain highly paid specialists to some areas. I really don't think this policy changes that fact all that much. If a specialist that I want my patient to see isn't available I send them out to be seen by the necessary specialty.

                        Do you really think a huge bureaucracy can entertain the input from thousands of doctors and weigh them all out? What if all the lower paid docs like primary care wanted it the new way but the specialists who have a compressed schedule want it the old way? Should you weight the specialists opinion higher because there is the perception that they are more difficult to recruit? Or weight primary care input higher because they are the backbone of the system? Personally I see everyone making a big deal about specialists when I think they should put more effort into making primary care happier, because when they aren't happy everything breaks down.

                        Comment


                        • #27
                          I will also add that people generally don't like change and there is a cognitive bias towards the way something used to be--people will see the pros of how something was and the cons of what it is changing to rather than the other way around. This is true in so many situations. So if the old system is better for this with compressed schedules but the new system is better for those with regular schedules those with compressed schedules are being "hung out to dry". Whereas if it had started with everyone getting equal time off and now those who worked compressed schedules suddenly got 30% more time off whereas those who worked a regular schedule didn't, the ones who worked the regular schedule would feel like they were the ones who were getting hosed.

                          Comment


                          • #28
                            I see this as a correction of an unintended consequence of moving from the original 24/7 reform that was done way back when you counted the weekends.

                            As Anne mentioned, the system does what it does.  What got me during the pay reform with tiers and bands -- there was supposed to be a local committee that would determine using local data on pay bands.   That is, until CO came out with explicit definitions of those pay bands to be within certain limits -- guess what --- amazingly all the pay bands matched up.  Perfectly.   Even in VHCOL Bay Area.

                            It is what it is.  VA has its benefits and warts just like any other large system.   The politics higher up just make it more 'interesting' on how the tail wags the dog.

                            This, though, really isn't much IMHO.  It's more a correction than a change.

                            Comment


                            • #29
                              It is unbelievably expensive it is to send a patient out to see a specialist because that specialist was not available at the VA.  At our VA the cost to send patients out to a surgical retina specialist to treat retinal detachments alone (a fairly small number of patients) costs about 2 million a year.  You could hire a lot of doctors for that amount.  I wonder if the plan is to get specialists to leave to speed up the privatization of the VA.

                              Comment


                              • #30
                                Anne does bring up a good point that sometimes policies are discussed years in advance and maybe we can stop them if we speak up.

                                The next change seems to be obvious: independent practice CRNAs replacing anesthesia and independent NPs replacing primary care doctors and others.


                                (I’d also add that for many specialists the benefits of the compressed schedule were among the benefits sold to them when they were hired . .. which is partly why so many are pissed.)

                                Comment

                                Working...
                                X