[cbzagaceta]

I exist

[Unknown Member]

I exist

[suyanebenevides_151]

Striker, haha, I like what you’re doing here.
 
Shhh, keep it on the down low

[suyanebenevides_151]

Do you guys mind if I contact you via PM, IV or HI?

[Unknown Member]

The whole auntminnie. ..only 3 VA rads? Wow

[suyanebenevides_151]

Yep, that’s how stupid AM is
 
[:)]

[Paolaflorian]

I exist

[Unknown Member]

i exist

[suyanebenevides_151]

Anyone have an answer as to why there would be a discrepancy between the top listed salary on USAjobs and what is actually offered on the ground in most places, especially given the new authorization for increase to recruit “better” or induce interest in the VA system.
 
I’ve heard of really random places not even offering the old high point, which I find not only odd but against the interest of the VA. It’s not like they are “saving money” to distribute among a group who would get paid more, like partners in PP. Stupid move on their part imo

[Unknown Member]

Cigar, you are scratching the surface of the entire government contracting process/scam.
 
I have seen multiple VA physician jobs advertised time and time again, only to go unfilled due to “unsuitable candidate submissions”. Based upon my own experiences and several discussions with LT recruiters, it is clear the local VA hospitals are only advertising for staff physicians and LT contracts to satisfy requirements that they search for reasonably-priced competitors to provide services. 
In reality, most of these contracts are promised to friends of the department or administration and service is often marginal at best, while costs are considerably higher, if not exorbitant. Often, the job requirements are written to exclude most all candidates except the current provider.
 
Some notable recent examples include:
Savannah, GA
Syracuse, NY
Palo Alto, CA
Des Moines, IA
San Antonio, TX
Dayton, OH
 
Clearly, the VA hiring authority is not making a remotely legitimate attempt to hire ideal candidates if the job is open for applicant submission for a couple of weeks (I saw one job posting open for 48 hours)…..

[suyanebenevides_151]

I have a lot of thoughts on this subject but due to the fact that some are just anecdotes I don’t want to contribute to any impropriety. In the future I may share these, but for now if interested, anyone can message me privately if they so desire.
 
ICONO, what are “LT” recruiters?

[Unknown Member]

LT = locum tenens

[suyanebenevides_151]

I see those chiefs and admins as Darth Vader when he’s fighting Luke near the carbonite freezing chamber at the end of Empire when they hire their guys with someone else’s money:
 
“All too easy”

[Unknown Member]

Not sure I understand what’s being described, as I don’t work for VA, but if the issue is that VA radiologists who have the power are pre-selecting radiologists they want to hire and then going through the motions of advertising a job opening through the official channels…  I don’t know what is surprising, this happens all the time to varying degrees in many places.
 
In PP, a senior partner plays basketball on weekends with a local rad they’ve known forever and thinks they’d be a good fit for the group, has a chat at the water cooler or over lunch or at the urinal with the group president or partner who does hiring, the guy is then suddenly doing per diem for the group. When there is a group discussion about who to hire when X retires, the new guy’s name rises to the top and somehow all the key players in the group are in consensus that the per diem whose been doing well for the past 4 months should be brought on as an associate. The junior partners leave the meeting having a vague sense that there was a conversation they weren’t part of, but have no real objections since the per diem is a solid radiologist and is a genuinely good guy. 

[Unknown Member]

Quote from Flounce

Not sure I understand what’s being described, as I don’t work for VA, but if the issue is that VA radiologists who have the power are pre-selecting radiologists they want to hire and then going through the motions of advertising a job opening through the official channels…  I don’t know what is surprising, this happens all the time to varying degrees in many places.

In PP, a senior partner plays basketball on weekends with a local rad they’ve known forever and thinks they’d be a good fit for the group, has a chat at the water cooler or over lunch or at the urinal with the group president or partner who does hiring, the guy is then suddenly doing per diem for the group. When there is a group discussion about who to hire when X retires, the new guy’s name rises to the top and somehow all the key players in the group are in consensus that the per diem whose been doing well for the past 4 months should be brought on as an associate. The junior partners leave the meeting having a vague sense that there was a conversation they weren’t part of, [b]but have no real objections since the per diem is a solid radiologist and is a genuinely good guy. [/b]

 
Or may have real objections since the per diem is a weak radiologist with lots of mistakes and bad work ethic. But who cares? 
 

[Unknown Member]

True, they may not care what the junior partners think, but the senior partners in the group are the last ones to want to hire someone who is slow, makes lots of mistakes, or has bad work ethic.
 
Rather, I’d wager the senior partners place greater emphasis on proven work ethic, real world accuracy, and practice building skills, whereas the younger radiologists are more likely value institutional pedigree and people they know from residency who are noon conference hotshots but have never worked a job.
 

[Unknown Member]

Quote from Flounce

True, they may not care what the junior partners think, but the senior partners in the group are the last ones to want to hire someone who is slow, makes lots of mistakes, or has bad work ethic.

Rather, I’d wager the senior partners place greater emphasis on proven work ethic, real world accuracy, and practice building skills, whereas the younger radiologists are more likely value institutional pedigree and people they know from residency who are noon conference hotshots but have never worked a job.

 
That’s true. 
 

[suyanebenevides_151]

Another of the issues at the VA is that “experience” is compared and bantered about for things like salaries. This is only truly applicable for private practice, as “experience” leads to quicker recall and knowledge of action/handling things quickly and or efficiently. In the VA one typically doesn’t have anywhere near the volume. What does this mean? Younger people who know more because they trained with real high CT volumes, fellowship status, MRI should be desired and paid more. Why else should they be paid as much or more? They have higher loans, aren’t grandfathered, and in general jumped through far more hoops.
 
I doubt things will change but in summary, “experience” for the VA, which is the main determinant for salary, is actually the worst measure, because it means in general you are a dinosaur, and with low volumes, this means nothing. (note – It might not matter to local VAs. If they have an average guy with general, ok reads they might prefer that for older docs, the main point is that the suggestion is higher levels of training, which the old docs don’t have and aren’t accountable for, especially in that union type setting).

[Singhp21987]

I think experience (as well as training) is valued at the VA for much the same reasons it is in PP.  You are hiring someone who has dealt with referring docs, administration harassment, and other practice hassles that new guys have yet to encounter.  Most of us, when we emerge from training, have the attitude to trying to deny exams.  Also, no matter how busy you’ve been in the ED, you likely have not had that final responsibility that can absolutely freeze decision making in a young radiologist.  When I was in a position of hiring, I  favored rads with at least 5 years experience, for these reasons. I didn’t want someone on the edge of retirement (unless it was to fill a niche position or remote location).  Its always tough stepping out of residency or fellowship to adjust to practice – takes most of us 2 to 3 years to really start hitting our stride.  My exception to this was interventional where I could accept the start-up problems  to gain the very most recent training.
 
Some of my best hires were those rads in their 40s and even early 50s who had been exposed to other practices and hospital systems and maybe learned that the grass isn’t always greener.
 
Cigar, I hope you aren’t stuck in a PP job when senior rads are abusing the younger help.  From your posts, it sounds like that might be the case.  If so, grit your teeth for a few years – pray that the job market improves – and look for another job.  (I interviewed at a couple of such practice in my career and learned by talking to former group members and younger associates that the senior partners would always be senior and I would always be junior if I joined the group).  Changing from a miserable job situation to a good one can be life prolonging.

[cbzagaceta]

Retirement question.

I am currently maxing out my TSP.

Any suggestions on maximizing tax advantaged saving within the FRS?

Thanks

[paul.stanley_364]

What the hell is ‘real world accuracy’?
 
There’s only accuracy.

[Donpacini77_632]

I exist

[carlosadube]

I exist

[carlosadube]

My experience is that the highest salary listed is what is offered … not sure why they put a salary range in there?

[ruszja]

Quote from FlyNavy

My experience is that the highest salary listed is what is offered … not sure why they put a salary range in there?

When in doubt: because a regulation says so.

[Unknown Member]

The Seattle VA Hospital is currently searching for a Chief in Radiology.
The deadline to apply is 3/4/2015 (two days).
Please feel free to spread the word. You can contact [[email protected]][email protected][/email] or 206 658 4268.
Please let me know if you would like any further information, and please feel free to pass this on to other radiologists who might be interested.

[markyjod_497]

I exist

[suyanebenevides_151]

Has anyone had experience with Fee Basis positions?
 
Is there a max you can make per year doing that? Would you recommend the job if feasible?

[Singhp21987]

I’m working fee-basis and was capped at 150K but this year that was bumped to 300K. 20 bucks for each plain film, 65 for CT and more for MRI and Pet/CT. Sweet!

Btw, I was hired because of my experience, ability and credentials to read all studies

Signed, Not a Dinosaur

[suyanebenevides_151]

Can I PM you, Bobbo, if I have any questions?

[Singhp21987]

PM ok for sure

[suyanebenevides_151]

If anyone else can PM me about fee basis stuff that would be cool; I have a few questions regarding anyone’s experience or anecdotes
 
Thanks

[ybreuben_594]

I exist

[suyanebenevides_151]

Bobbo, please reply when you get a chance
 
Thanks

[Unknown Member]

I don’t “exist.” Just wanted to congratulate Wrigleyville!  🙂

[Unknown Member]

To those who work for the VA, I Saw a VA job post that was for “Physician (TeleHealth-Radiologist)”. Is this a strict telerad job? This system has VA hospitals in 3 adjacent counties which will require eve/night and weekend/holiday coverage. Thnx

[mferg47_176]

I exist.

[Unknown Member]

I exist
 

[kzingon_615]

I exist

[suyanebenevides_151]

Can anyone verify fee basis max now extends to 300 and not 150? Or is it dependent on location/particular system allowances?
 
Thanks

[x_sighted_2_315]

I’m a trainee getting reading for the job search. I would like to hear from VA radiologists about their work. Can I PM any of you?

[suyanebenevides_151]

VA radiologists responding to this board (and in PM) are as lackadaisical as their job is said to be (with the exception of 2 that I’ve corresponded with), as far as answering questions

[Unknown Member]

Could be that they hardly ever log on or that they don’t even realize they have a PM.

[Unknown Member]

Newrad2015 and anyone else can pm me and I will answer whatever questions you have.  

[suyanebenevides_151]

striker is a very informed and reliable poster/answerer
 
nomorenaitchin has been good in the past too

[carlosadube]

sure, no problem

[Unknown Member]

.

[Unknown Member]

I exist
 

[Tiwarita]

I exist.

[niko.snijders_591]

Can anyone a comment on mammo performed at va ‘s that offer it? Do those of you share it w general rad responsibilities ? Pla comment about your experience if possible

[niko.snijders_591]

Sorry for spelling mistakes bit clumsy this am..have a great day

[abbaspour.1j]

i am also curious about breast imaging at the VA. How is the volume and what type of studies are done? Tomo, breast mri?

Also on average how is VA workforce different from a typical private practice ( other than more military experience)?

[ybreuben_594]

Our VA has a dedicated breast imager and another radiologist who does it part time.  There is a separate waiting area for these patients with the usual waterfall, peaceful music, etc.  They do mammo, US, stereo and US biopsies.  I think breast MR is outsourced.
 
  Edit:  I think there is zero military experience among the docs.  Heavy military experience for nurses, techs etc.

[yoyo_medicine_958]

From what I understand there is no way currently to get above the aggregate pay limit right? We just have to wait and see if the careers bill is passed?

[Donpacini77_632]

The answer for early 2023 is…maybe.

The PACT act passed last year, and from what our sources say, there is the [i]potential [/i] for recruitment and retention bonus pay.  The exact dollar amount, as you may expect from a government bureaucracy, is less than clear, but I’ve heard max amounts of either $25K or $50K.  The exact amount would be determined locally, and there are lots of conditions and red tape involved to receive the bonus on an ongoing, annual basis (i.e. no guarantee).  Furthermore, the bonus would not count in high 3 calculation for retirement annuity purposes.
 
I don’t have any details on the “Careers” bill yet. I see it was just introduced and is intended to “level the playing field as the agency seeks to compete with the private sector in recruiting doctors and other staff.”  We’ll see.

[yoyo_medicine_958]

Thanks for 411, much appreciated

[toumeray]

Most VAs still think that a base salary (which is base pay+ market pay in VA language) for a rad is around 350k so even with 15k retention and 15k productivity your still not above 400k cap for most rads.  I could be wrong but believe careers bill just makes it so that retention and productivity do not count towards cap, so theoretically you could make 400k base then an extra 25-30 with bonuses.  However, I doubt many rads in the VA are getting 400k base.  Would love to here what VA rads are making.  

[mgmacielendocrino_912]

Does anyone know how short staffed the VA is relative to private or academics these days?  I imagine with their lower salaries, they must be struggling even more than other groups.

[buckeyeguy]

Quote from ultimaterads

Does anyone know how short staffed the VA is relative to private or academics these days?  I imagine with their lower salaries, they must be struggling even more than other groups.

 
Depending on location, definitely. Like I said, lots of those sites are listed on the .gov and have been there for years. I also know at least 3 VA locations were the Chiefs are incompetent people.

[yoyo_medicine_958]

From my knowledge you are not off. Low pay from what I have seen in VA is 300s, mid 350s salaries, higher is 370s+, every rad in my HCS has hit the cap for a few years. I know at least a handful of other HCS’s rads at cap but there arent a whole lot. My understanding of the careers bill is per secretaries discretion, local difficult to recruit and retain areas may be authorized for certain specialties to allow for market pay to cause salaries to exceed current 400k cap as well as recuit/retention/relocation incentives to go above 400k cap. It doesnt seem like their will be a broad language and I doubt anyone not at cap will soon go over but I do believe it will lift overall tide by some going over cap and others trying to compete. I have looked into this about as deeply as possible I could. There is a meeting this Wed of 3pm of VA senate committee with only careers bill on agenda. Fingers crossed.

[yoyo_medicine_958]

Also I have found if you are at cap your bonuses etc are required to be reimbursed in total the first year you are below the cap, retire or end VA employment so any money currently received above the cap is not permanently lossed. More like in a savings account with no interest that you will probably have to annoy people to get when the appropriate time comes. And by OPM and my knowledge, your annual raises and step raises can allow you to get paid above the cap, just not performance incentives and other incentives. Also relocation reimbursement is not counted to cap as well as EDRP.

[Donpacini77_632]

I’m at a VA where multiple staff are at cap.  
No one has received any pay above cap.  
No one.  
 
In past years, any bonus pay above cap is “deferred and may or may not be payed at a future date” according to leave and earnings statement comments.  Now, this year, even that comment has been deleted.  Our sources in DC tell us that there is no mechanism to pay any deferred pay at this time, even at retirement.  
 
EDRP is for younger rads and doesn’t apply to most of us “seasoned” rads.  Relocation pay is a one time deal.
 
We are not optimistic that we will see any ongoing, significant pay increase from any program.  

[yoyo_medicine_958]

Have you heard about The Careers Act? On agenda for senate committee meeting tomorrow at 3pm.

My pay stub says same thing but for this year it hasnt changed. OPM says they are required to pay out deferred pay. From my limited experience in the VA, you can usually get stuff like that if you put in the extended effort but I dont know anyone who has tested it either way also.

[yoyo_medicine_958]

[link=https://www.fedweek.com/issue-briefs/administration-lists-changes-its-seeking-in-federal-employee-benefits/]https://www.fedweek.com/i…ral-employee-benefits/[/link]

Says president recommends removing fed dr pay cap.

Has anyone worked from home in the VA to tell me what it is like? Sorry if this has already been over and I am unaware.

[g.giancaspro_108]

The text is baffling to me, would someone be so kind as to explain if this really will result in lifting the pay cap on doctors?  Does anyone feel the VA will provide market rate compensation for doctors?
 
“This proposal would repeal the aggregate limitation on pay under 5 U.S.C. 5307 for all employees who receive payments under title 5, United States Code. This change would bolster agency retention efforts and would increase the pool of employees willing to seek promotion to the Senior Executive Service (SES). The aggregate limitation on pay caps the total amount of title 5 allowances, differentials, bonuses, awards, and other similar payments an employee may receive in a calendar year, when combined with the employees basic pay. The aggregate limitation on pay is currently set at EX-I ($226,300 in 2022) or the Vice Presidents salary ($261,400 in 2022) for SES/SL/ST employees in certified performance appraisal systems. The proposal would also move the performance appraisal system certification provisions for members of the SES and senior-level employees paid under 5 U.S.C. 5376 (SL/ST) currently found in 5307(d) to a new subchapter III of chapter 43. This new subchapter III of chapter 43 would provide the Director of the Office of Personnel Management sole authority to certify and decertify SES and SL/ST performance appraisal systems and issue regulations regarding certification criteria and procedures.”

[rgiles912_432]

I’m not reading any Physician pay raises in the article. This blurb is only talking about Title 5 employees(read Admins).  All physicians (and providers for that matter) are paid under Title 38. The Careers act sitting in the senate is the move to raise physician pay beyond the 400K limit.

[g.giancaspro_108]

Right.  I couldn’t find anything about Title 38.
In my jaundiced view this is saying admin can see pay raises but not doctors.  So admin could potentially be paid “market rates” which around us is 7 figures, while doctor pay remains far below market rates and the VA continues to struggle to recruit and maintain staff.  

[yoyo_medicine_958]

The act is title includes clinician recruitment and retention, if it passes I am sure it will apply to clinicians.

[g.giancaspro_108]

Any insight into how they will determine their physician salaries if not limited by the cap?  Our VA must be short 6 physicians at least and would love to replace several.

[yoyo_medicine_958]

If this bill passes it seems very vague and site dependant.

[drvel]

I exist

[yoyo_medicine_958]

A chief position in central AL just got posted for max salary 500k. A recruitment incentive and PCOS are also offered. There is now direct radiologist VA precedent for going above the cap with salary and incentive.

[tcooper_76]

That site in AL is one of the worst VA’s in the country. I know they had numerous chiefs and rads leave over the course of the last six years. 

[rgiles912_432]

[b]Here’s how it was presented to us by our COS:[/b]
[i]The PACT Act provides new authorities for augmenting pay for physicians and dentists. [/i]
[i] Basic Pay (base plus market) may not exceed $400,000.   Only Basic Pay counts toward retirement The medical center director may approve a bonus of up to 25% of Basic Pay ($500,000 max) using the 3 Rs (relocation, recruitment, and retention) The network director may approve a bonus of up to 50% of Basic Pay ($600,000 max) using the 3 Rs.  Critical Skills Incentives are specific to occupations that are critical to VAs mission or occupations where shortages create skills gaps.  Critical Skills Incentives may be changed as often as monthly. They may not exceed 25% of Basic Pay ($500,000 max).  Bonuses may not be applied retroactively for work accomplished (e.g. extra shifts).  Retention bonuses must be renewed annually.  An offer letter is not required, but a likelihood that staff would leave is.   DFAS will be ready to process pay above the aggregate limit of $400,000 on Aug 17, 2023[/i]
 

[yoyo_medicine_958]

Thanks for the info! I had heard rumors of the 50% but hadnt seen it anywhere in writing. I have also heard rumors that incentives can now be up to 5-6 years. I had not heard of critical skills incentives yet.

[buckeyeguy]

Now if they just let a natural born citizen read remotely from overseas … they might even get better service to their people.

[yoyo_medicine_958]

For real though if anyone takes that chief job in bama holler at me to come work for you

[ghuang920]

Hi, We’re struggling to get out leadership at our VA to move forward on the PACT Act for increased pay above 400k cap.  I saw one post that looked as if more pay is coming their way August 17, 2023 through DFAS. Any VA rads having any luck with that?

[buckeyeguy]

Quote from RenaissanceRad

Hi, We’re struggling to get out leadership at our VA to move forward on the PACT Act for increased pay above 400k cap.  I saw one post that looked as if more pay is coming their way August 17, 2023 through DFAS. Any VA rads having any luck with that?

 
Who’d a thunk? The jealousy and fiefdoms are huge at these old, crusty .govs. They hate reality and pricing, far more than they love some communist ideal for all the “workers” there, or the idea to increase quality and access for patients by getting more skilled people.

[ghuang920]

NErad 8. Hi!  I think everyone is on vacation this week, except me. So far, its been a tough crowd on here as usual. Im not getting the info I was hoping. Maybe next week when everyone is back at work!?

[yoyo_medicine_958]

So i am aware of chiefs getting blanket approval from COS’s for 25% incentives. I know of at least one rad already with approval on Eopf for an incentive over cap. Have heard rumors of places potentially offering 50%, but still investigating on that. Renaissance can pm for more info but not sure how you can use it other than say it is out there. From my experience only direct pressure seems to work unfortunately.

[yoyo_medicine_958]

Almost every VA seems to have an opening, lots on usjobs, not a lot of applicants, pp is offering bonkers. but the VA locations dont seem to feel the pressure. Ntp has been backing up well so most seem to be ok relying on ntp and air.

[ghuang920]

Gladraddad, yes, it certainly seems to be an uphill battle. Our admin says theyre trying to do all that they can, but then of course they do nothing.  The part I dont understand is, its not as if its their money. Most likely its just the effects of inertia and apathy. 

[yoyo_medicine_958]

I have found often it is wait until there is a fire type problem before attention is given. To be fair upper management positions seem very, very, very busy.

[1324mahtab]

Quote from gladraddad

Almost every VA seems to have an opening, lots on usjobs, not a lot of applicants, pp is offering bonkers. but the VA locations dont seem to feel the pressure. Ntp has been backing up well so most seem to be ok relying on ntp and air.

 
I’m ignorant — what are ntp and air?

[jaypratap_326]

Anyone willing to discuss jobs at the VA via DM? Curious to get some more perspective on working there and what the job is like.

[ruszja]

Quote from radiation girl

I’m ignorant — what are ntp and air?

 
NTP is National Teleradiology Program. The VAs internal telerad division.

[pbernard_996]

Anyone else feel like VA jobs are much worse than they used to be? Between the massive increase in volume, stagnant salaries, reliance on low quality mid levels who shotgun even basic stuff (my patient has years of back pain so I need MRI of C/T/L/bilateral hips/bilateral knees with and without contrast), and general VA bureaucracy, I feel like VA jobs are much worse than even a few years ago.

Yes, volumes still lower than PP, but my PP colleagues get 2x the salary and lots of tax benefits that I cant get on a W-2 income.

[buckeyeguy]

Quote from LKT

Anyone else feel like VA jobs are much worse than they used to be? Between the massive increase in volume, stagnant salaries, reliance on low quality mid levels who shotgun even basic stuff (my patient has years of back pain so I need MRI of C/T/L/bilateral hips/bilateral knees with and without contrast), and general VA bureaucracy, I feel like VA jobs are much worse than even a few years ago.

Yes, volumes still lower than PP, but my PP colleagues get 2x the salary and lots of tax benefits that I cant get on a W-2 income.

 
Volumes are up everywhere, but are VA volumes up significantly too? Also, do you actually have to do all of those cases? Serious question.

[alex.nieto_484]

Quote from Dream Run

Quote from LKT

Anyone else feel like VA jobs are much worse than they used to be? Between the massive increase in volume, stagnant salaries, reliance on low quality mid levels who shotgun even basic stuff (my patient has years of back pain so I need MRI of C/T/L/bilateral hips/bilateral knees with and without contrast), and general VA bureaucracy, I feel like VA jobs are much worse than even a few years ago.

Yes, volumes still lower than PP, but my PP colleagues get 2x the salary and lots of tax benefits that I cant get on a W-2 income.

Volumes are up everywhere, but are VA volumes up significantly too? Also, do you actually have to do all of those cases? Serious question.

 
Volumes at the VA are not up. I was at the VA for 2 years and it was a joke. Our RVU goal was 5.5k. VA complexity is not that high either.
 

[y.rajshekar]

Are you able to send to NTP overflow cases? We were not able for a long time

[buckeyeguy]

Quote from RadCog

Quote from Dream Run

Quote from LKT

Anyone else feel like VA jobs are much worse than they used to be? Between the massive increase in volume, stagnant salaries, reliance on low quality mid levels who shotgun even basic stuff (my patient has years of back pain so I need MRI of C/T/L/bilateral hips/bilateral knees with and without contrast), and general VA bureaucracy, I feel like VA jobs are much worse than even a few years ago.

Yes, volumes still lower than PP, but my PP colleagues get 2x the salary and lots of tax benefits that I cant get on a W-2 income.

Volumes are up everywhere, but are VA volumes up significantly too? Also, do you actually have to do all of those cases? Serious question.

Volumes at the VA are not up. I was at the VA for 2 years and it was a joke. Our RVU goal was 5.5k. VA complexity is not that high either.

 
Having worked in fee basis previously for a VA, I saw a lot, and little of it made sense, intuitive or otherwise. I figured the sites would be split 50-50 on a range of work, given how bad the chief is (most are awful). With a union and still that 5.5 number, I figured it couldn’t really be all that bad. The point of the job in general is a quasi retirement gig into the sunset, anyway. The only reason young people got in was because it wasn’t break your back work like in PP without any guarantee for future partner or really big money, so they just took the low stress, lower salary but guaranteed gig.

[abstone38_669]

^^ low stress but you still spend a lot of time there. The little time off -5 weeks or so is a killer for me. Not to mention they are restrictive on going part time as well.

[pankajkaira1982_700]

Different strokes for different folks. Its a different world at the VA.  Did high volume/high complexity for years before I saw the light.  No more call, no weekends, no holidays. Vacation and money obviously less. 
 
Best of all, little to no litigation.

[buckeyeguy]

Quote from astone38

^^ low stress but you still spend a lot of time there. The little time off -5 weeks or so is a killer for me. Not to mention they are restrictive on going part time as well.

 
I totally agree. To make 100k or more compared to a part time, although easy, isn’t worth it especially if you are single and tax bracket issues with w2.  The cubicle-ization and not being able to get away or do what you wanna do is a big negative. But, for that reason, it is perfect for a guy doing a routine easily with a family – wake up, go to work, come home, good time slots.

[kellybyers123_914]

Serious answer from a VA rad: volumes are up 60-80% since 2013, depending on modality.  Increasing reliance on in-house imaging (instead of “community care”) for PET, MR, LDCT for LCS, and pain intervention will result in an additional 40-50% increase over the next 2 years.  VA National mandates, market competition, and demographic changes have put some of our radiology departments in tough circumstances for near-term staffing.  I’m worried about a “critical mass” of increasing workload beyond the expected VA standards leading to short order retirement of multiple VA rads.  Also, I’m told that NTP is not currently taking new business, so there is no internal safety net to account for personnel losses in the near-term.  To be clear, VA radiology has a lot of regional and local variability in workload and staffing, so these trends may not be universal.  

[abstone38_669]

VA will be the worst job for rads if volumes creep up and vacation and pay stay where they are. Why would you work there if volumes expectations are similar to other workplaces?

[carlosadube]

Hey Cigar … most of the VA Rads like me I would guess work for a salary and are not Fee Basis … so they and I don’t know anything about Fee Basis .. you need to chat up an HR person for that … that’s probably why you’re not getting any answers … SO … stop complaining because someone isn’t feeding you what you want.  As far as characterizing VA Rads as “lackadaisical” … you are quite wrong in that respect too.  Stop trashing what you don’t know about … It’s unprofessional and won’t get you hired by the VA
 

[suyanebenevides_151]

FlyNavy, please read my post. I said “as their job is said to be”. I have asked a couple of people with particular fee basis experience if I could PM them, they said yes, and I never received a response. I gave credit to striker and nomore, because they deserve it.
 
I know plenty and have heard from plenty. Your post is uninformed, and you didn’t even read mine. I never trashed anything; not sure why you want to be so negative and make things up about other people.

[Singhp21987]

so….
 
some say Cigar is mean-spirited and selfish and money-grubbing
 
it is said that Cigar is not satisfied with an intellectual discourse
 
it is commonly known that Cigar is not satisfied with the PM answers he has received
 
sheesh, Cigar, lighten up – and stop attributing nasty comments to vaguely-defined “others”
 
  (and Fly AirForce – Navy drives boats)

[suyanebenevides_151]

Bobbo, who says that?
 
I’m not sure where you get any of those assertions? I appreciate all of the correspondence that I’ve received, which is only from the 2 members I noted and gave credit to. I never trashed anyone. Read my posts.
 
I am a very laid back, reasonable person. I was hoping to receive a response from you a while back on a very straightforward question, but never got a response. It’s hard to be unsatisfied or satisfied when you don’t receive any answers. That’s what my point was.
 
Still, I’m willing to hear any response. I have said please and thank you, and I still maintain those sentiments.

[suyanebenevides_151]

Does anyone know if the maximum fee basis allowance is made per each facility or is it a national maximum (150 or 300)? I’ve heard both, though the latter may be a recent change and still lagging at most facilities.
 
Thanks

[Singhp21987]

I know but I’m too lackadaisical to respond, Cigar

[suyanebenevides_151]

You already did.
 
You are so smart, so cool, and so helpful. Wondering why you even bother

[Singhp21987]

I’m lackadaisical not particularly smart

But here’s your answer. Fee basis limit decided locally by admin and rad chief negotiation and, indirectly, dept budget. VA rads in the trenches usually have no knowledge of fee basis limits/payments

As I pm’ you previously my personal limit this yr is 300 k and most likely will drop back to the usual 150k unless dept loses another rad

I also I don’t know why I respond either, Cigar, to someone so dismissive of VA rads

[suyanebenevides_151]

Two things:
 
I thank you for responding and providing your answer.
 
I am not dismissive of VA rads.

[yoyo_medicine_958]

I am a PGY4 resident hoping to get a VA job in the Southeast after graduation or fellowship. I don’t have a VA attached to my residency or in town. Any tips for getting a VA job besides checking the VA Career board in a year or two? Is cold calling a VA of choice a good idea and if so is it too early now?

[suyanebenevides_151]

Not too early. Lots of good ol’ boy networks that are hard to get into, but I know that if you make an effort with a few, and keep on them (not in an annoying but interested way) they’ll consider you when something finally opens up. Politics may be tough to overcome, but trust me when I tell you that there are protocols and usajobs etc, but they will still keep an eye out if you show interest
 
Just follow up and keep getting after it. You’ll have no idea if a recruiter or chief is FOS at any given time, so you have to just use the volume approach for those areas that interest you.

[yoyo_medicine_958]

Thanks

[hugolpneves_898]

I thought there was a VA radiologist association. I have seen a VA physician organization: NAVAPD
 
Any good resources about VA benefits for physicians?

[pbradley]

[size=”4″]I exist, and here i[size=”4″]t is . . [size=”4″].[/size][/size][/size]
[size=”4″][size=”4″][size=”4″]
[/size][/size][/size]

[size=”4″][b][size=”4″]BENEFITS[/size][/b]
[/size]
[size=”4″]Working for the Department of Veterans Affairs offers a comprehensive benefits package that includes, in part, paid vacation, sick leave, holidays, life insurance, health benefits, thrift savings plan, and participation in the Federal Employees Retirement System.[/size]
 
[size=”4″] [color=”#0000ff”][link=http://www.vacareers.va.gov/why-choose-va/benefits/index.asp]http://www.vacareers.va.gov/why-choose-va/benefits/index.asp[/link][/color][/size]
[size=”4″][color=”#0000ff”]
[/color][/size]
[size=”4″]26 Days of paid annual leave (vacation) per year[/size]
[size=”4″]10 Days of paid Federal Holidays per year[/size]
[size=”4″]13 Days of paid Sick Leave per year with no limit on accumulation[/size]
[font=”calibri, sans-serif”][size=”4″][color=”#1f497d”][b]Education Debt Reduction Program [/b](EDRP):  may be auth[size=”4″]orized for [/size]difficult to rec[size=”4″]ruit[size=”4″], difficult to filled positions.  Check with the local EDRP coo[size=”4″]rdinator for the position at a particular VA that interest[size=”4″]s you.[/size][/size][/size][/size]
[/color][/size][/font]

[suyanebenevides_151]

Question(s),
 
1. What is the difference between a “part-time” VA doc and a fee basis one? Does the part timer get some form of the major benefit scheme?
 
2. Do you all have to code studies as per their importance or acuity? That is, do you have to have an additional part of the dictation (not in the dictated field) which delineates some “status” of the study to notify people? Do you still spend hours trying to track others down to notify them that there’s an important finding?
 
Just wondering. I’m also wondering what the best studies would be for a fee basis person given that time is money, and low RVU per year full timers do in fact have the time to do all this coding and quantifying and informing — and they hardly work after hours or weekends.
 
Thanks

[Unknown Member]

Part time is 20 hours a week, set salary and you come in for those 20 hours – you read what you can. 
 
Fee basis is you get paid a set amount per study read, you eat what you kill.  The downside to this is if there just aren’t that many studies to be read, then you won’t make much obviously.
 
If you are fee basis for a VA, you likely will be reading most of the studies that were done afterhours or you are reading studies on the list no one else chose to read for the day.  If its weekends, you could be doing this for years.  If its during the week, they could just be using you for very short term until they can hire a full time or part time radiologist. 
 
Full time positions are extremely secure/permanent, part time usually less secure and just temporary, fee basis even more temporary/less secure. 
 
All studies get coded and usually this notifies the physician of the finding, but sometimes this still somehow gets lost to follow up.  All life threatening findings obviously get communicated to the physician phone to phone, major findings like newly diagnosed or suspected malignancy should also be communicated but some va physicians are lazy and don’t do it, only using the internal coding system.  Internal coding system automatically goes to the referring physician, I don’t know how this can get screwed up but I have seen several cases lost to follow up…Was this the referring physicians fault (most likely) or computer notification’s fault?  The referring physician can get the alert but accidentally delete it and not even know, they get many alerts everyday from areas outside of radiology as well such as lab. 
 
Most places I believe have ancillary staff to help you get in touch with the physicians, which can be hard sometimes because these are VA physicians – 1 hour lunches and several leave home early every day. 
 
If you are fee basis, it is unlikely you are going to be able to just pick out what studies you want to read. You will be reading whatever is on the list unless you work out something like you only read MRI, or just CTs, or just plain films. 

[suyanebenevides_151]

Thanks for the comprehensive reply.

[pbradley]

In answer to Cigar, below is the official definition of part-time federal employment with prorated benefits.  You could find out more info by going to the Office of Personnel Management (www.opm.gov) website below:
 
[link=https://www.opm.gov/policy-data-oversight/hiring-authorities/part-time-and-job-sharing/#url=Part-Time-Employment]https://www.opm.gov/policy-data-oversight/hiring-authorities/part-time-and-job-sharing/#url=Part-Time-Employment[/link]
 
[b]”Part-time Employment Defined[/b]
A part-time permanent employee has a career or career-conditional appointment (or a permanent appointment in the excepted service), works between 16 and 32 hours each week (or between 32 and 64 hours a pay period) on a prearranged schedule, and is eligible for fringe benefits. Part-time permanent employees are eligible, on a prorated basis, for the same benefits as full-time employees: leave, retirement, and health and life insurance coverage.”
 
Basically, our part-time VA radiologist works a part-time but regular schedule & is considered a regular, permanent member of our radiology staff.
 
Our fee-basis radiologists work for us on an as-needed/as-available basis for a particular fee per type of study read.  That is, we contact our fee-basis radiologists when we know we’ll be short of staff to see if they’re available to work for us on certain days.  Most of our fee-basis radiologists have another job (often full-time) elsewhere, so they’re under no obligation to work for us if they’re not available, but they could come in to work for us after hours or during the weekends to earn extra income if they wish.  A fee-basis radiologist with another part-time job elsewhere could come in to work for us during the day, depending on when (s)he is available.  Fee-basis radiologists are not considered permanent employees, so they are not eligible for pro-rated benefits.  Being a fee-basis radiologist is a good way to earn extra income but should not be your primary source of income.  It’s also a good way to find out whether you might want to work for that particular VA on a permanent basis should a position opens up later.
 
Every VA hospital is different, so I would like to caution everyone from making generalizations in this public forum that may be misconstrued as facts for all VA hospitals.  For example, while we’re not obligated to work after 5 pm in our radiology department, we do “voluntarily” stay later at work when there’s an urgent case or to get as much of the work done as possible when we’re short of staff. I also see other clinical colleagues staying late as needed as well.  The point of all this is that we’re first & foremost doctors, VA doctors or not.  By the same token, while time is indeed money for the fee-basis radiologist, you would be a more desired fee-basis radiologist if you provide the needed services without counting every penny.  At our VA hospital, there’s a weekly radiology schedule with daily assignments for the regular radiologists as well as possibly the fee-basis radiologists, if needed/available, so everyone is protected from  cherry picking.
 
At our VA hospital, a fee-basis radiologist gets paid 4 times as much for reading an MRI as for reading an X-Ray. However, if you’re not an MSK or neuroradiologist, it may be faster for you to read 4 X-Rays than say, 1 finger MRI or 1 C-spine MRI.  Again, it’s better to focus on what service is needed & what service you could provide to contribute to patient care than on the exact monetary compensation.  All studies do need to be coded before they could go through, but this is no big deal at our hospital.  We have PowerScribe 360, and there’s a quick pull-down menu for coding prior to signing off on a report.  It takes only 1-2 seconds to code each study.  Obviously, critical results still need to be called to the clinician & documented.
 

[mferg47_176]

I exist

[suyanebenevides_151]

Thanks, Eo

[pbradley]

[b]ATTN:  sleepyrad[/b]
You sent me a PM message regarding VA RVUs, which I just replied via PM, but your inbox is full.  Clean out your inbox, and you’ll receive my reply. I got the following automatic message from your account:
            “Inbox is full. Private Message will be delivered automatically once the recipient cleans up his inbox.”

[Unknown Member]

I exist. I have been a full time VA Radiologist for 31 years. I enjoy the job and have no plans to retire.

[Unknown Member]

I am currently an active duty (Army) radiologist, but will be leaving the military next summer and I’m looking for civilian work.  I would be interested in pursuing opportunities at the VA, particularly in Texas if possible.  What is the best way to contact the Radiology departments at VA institutions and inquire about any possible openings?  If it’s better to talk about something like this off of the forum, but someone thinks they can help, please let me know and I can send a PM.  Thanks.

[Unknown Member]

I would suggest calling and speaking to the Chief of Radiology Service at the VA Hospital you have an interest in. The Service Chief is a working Radiologist. They know what positions are open or will be coming open in the near future. It is in their interest to get the position filled now. Dealing with an administration person, such as Human Resource Chief in my opinion would be less helpful. They are less concerned about when or if a position is filled. Good luck.

[txavit]

Avoid El Paso TX VA. RAD Chief is a dkhead. Short man syndrome
 

Quote from TheHammer1

I am currently an active duty (Army) radiologist, but will be leaving the military next summer and I’m looking for civilian work.  I would be interested in pursuing opportunities at the VA, particularly in Texas if possible.  What is the best way to contact the Radiology departments at VA institutions and inquire about any possible openings?  If it’s better to talk about something like this off of the forum, but someone thinks they can help, please let me know and I can send a PM.  Thanks.

[suyanebenevides_151]

That’s funny, I checked usajobs yesterday for the first time in months and 2 positions at San Antonio were listed, but I recall El Paso advertising for a while …
 
What’s crazy is that the VA is like what residency became in the 2000s. FMGs or American low level docs that got a handshake ortho spot in the 70s, for example, all of a sudden thought they were hot (crap) and were the “deciders” of things for others that were WAY more accomplished than they ever were.
 
Annoying.

[suyanebenevides_151]

Can someone PM me what a normal 3-4 hour (after hours) shift would render (payment) on average, for a fee basis rad at the VA?
 
Thanks.

[carlosadube]

 Cigar are you working hard to make friends in the VA? … From your post it would seem that you are calling VA Rads “low level”  Was that your intent? 

[txavit]

Overall … i found there are good rads working in the VA systems. Many who are previous military and feel for their “brothers and sisters” and want to give their best. The problem is that they are some rotten apples and few who are dks and unfortunately in position as RAD chiefs.
 
 
 

Quote from FlyNavy

 Cigar are you working hard to make friends in the VA? … From your post it would seem that you are calling VA Rads “low level”  Was that your intent? 

[txavit]

Don’t have to say much about ELP. Recall the incident few months ago? You can google the incident. If you do a root cause analysis, one of the causes was rad department. 
 

Quote from Cigar

That’s funny, I checked usajobs yesterday for the first time in months and 2 positions at San Antonio were listed, but I recall El Paso advertising for a while …

What’s crazy is that the VA is like what residency became in the 2000s. FMGs or American low level docs that got a handshake ortho spot in the 70s, for example, all of a sudden thought they were hot (crap) and were the “deciders” of things for others that were WAY more accomplished than they ever were.

Annoying.

[carlosadube]

AuntROENT … are you talking about the past shooting incident?  That was caused by Radiology?  How so?
 

[txavit]

Can’t say much in an open forum. Just imagine how much frustration it must take for a person to do that much harm!

[suyanebenevides_151]

I’ll take some responsibility for coming off as sub-par on media like a forum, trust me, some of these posts of mine are being read into and appear more cutting they I intend, I get that …
 
BUT, let’s be honest, there are a [b]lot [/b]of old rads hanging on, retiring and getting re-hired too, and a good number of CHIEFS who are not even board certified …
 
Yes, these things are changing, but before we get all defensive let’s be fair and real.

[txavit]

Why bother! Many of Rad Chiefs don’t even work. Just sit in their offices and figure out more ways to slow the giant VA system. New protocol to scan patient with this AICD or that AICD device. They even manipulate the wRVU calculator on vista to make it look like their reading far more than the working rads on the front line.
 
Did you hear about the Detroit VA Rad chief recently terminated for scanning family members? I guess he didn’t know that the scanner was reserved for VETS.

[suyanebenevides_151]

And people have acted like I “hate” the VA or VA rads on this board, got back and check … it’s weird.
 
When you tell the truth, it hurts, and as a general rule, the stuff brought up by AuntROENT is [i][b]really common[/b][/i] at the VA, for how egregious it is.

[carlosadube]

Well I certainly hope you can see why some of us feel annoyed at least a little bit … OP wanted a string going so VA docs would have a resource list to network amongst ourselves .. no evil intentions with that … and you have hijacked the thread looking for fee basis info, indirect (or direct) jabs at VA Rads and general ranting about how the VA Rads Chiefs are incompetent … so you may not “hate” the VA or VA rads as you say but personally … I’d like to see your comments somewhere else and not on this thread
 

[suyanebenevides_151]

Why so sensitive? I didn’t hijack anything.
 
I’ll respect your wishes, however, and put any comments elsewhere.

[carlosadube]

Yes I am sensitive about the subject.  I love my VA and I feel we give great care to Veterans and there are so many people at this institution that work their A$$es off every day to see that our Vets are taken care of.  We have a quality product here that constantly gets lost in the noise of “wait time” scandals and political football games.  It seems everyone has something bad to say about the VA even though many have probably never set foot inside a VA hospital nor been taken care of at one.  So yes I am a little sensitive.  I freely admit it.

[suyanebenevides_151]

I agree with you that there are some really great VAs. I’ve always said that. But sadly, most have major issues. I was just trying to point that out. I am happy you give great service to the guys that deserve it, the Vets.

[Unknown Member]

Quote from Cigar

I agree with you that there are some really great VAs. I’ve always said that. But sadly, most have major issues. I was just trying to point that out. I am happy you give great service to the guys that deserve it, the Vets.

Is that service really great?
 
Do the Vets really deserve it?

[katiemckee84_223]

I’ll respond just to troll the likes of kpack
 
“Yes.”

[carlosadube]

yes and yes

[mbergin44]

Are there VA sites that are required to do WHEN(weekend, holiday, evening, night) coverage. Is this coming for the VA system, rumors to that effect?

[cbzagaceta]

I hope not!

[katiemckee84_223]

Quote from landrew341

Are there VA sites that are required to do WHEN(weekend, holiday, evening, night) coverage. Is this coming for the VA system, rumors to that effect?

 
I sorta heard this too

[Unknown Member]

i exist

[txavit]

Rad Chiefs fudge the wRVU calculator claiming their work schedule is 10% time weighted for clinical work and 90% on administration duties. So when the chief reads 75 DEXA’s, their wRVU skyrocket to 250%. PACS administrators show this in bar graph to the Director or VISN Chief.
 
So, who looks good … the lazy Rad Chief at 250% or you. 

[suyanebenevides_151]

Yes, sounds like the gov’t to me.