20 Reasons Doctors Like Working for Veterans Health Administration

20 Reasons Doctors Like Working for Veterans Health Administration June 2016

Reason #1- Let Us Worry About the Bottom Line Freedom to practice medicine and focus on the patient without the distractions of running a business VA doctors do not have the ‘overhead’ of running an individual or group medical practice No need to build patient base to create revenue 30 minutes standard visit length in VA, compared with an average of 20 minutes outside VA VETERANS HEALTH ADMINISTRATION 2

Reason #2 – Why not join the #1 Health Care System in the country 340,000 employees VA-Wide 9 million enrolled Veterans Nobel Prize winners High performance on Quality Indicators Licensure valid in all 50 states Over 1,200 locations Career opportunities to fit every lifestyle VETERANS HEALTH ADMINISTRATION 3

Reason #3-Groundbreaking Research Opportunities Doctors get to participate in research Salary support for awardees to pursue research and training Clinical innovations projects Part of broader academic and clinical communities of practice Dynamic collaborations with its universities, federal agencies, nonprofits, and private industry Impacting health of Veterans and the Nation VETERANS HEALTH ADMINISTRATION 4

Reason #4-Teaching Residents, Medical Students through Academic Affiliations VETERANS HEALTH ADMINISTRATION Over 120,000 trainees in over 40 health professions disciplines – 41,000 physician residents – 23,000 medical students – 27,000 nurse trainees – 27,000 other associated health disciplines VA is affiliated with over 1,800 unique educational institutions across over 7,000 training programs VA is affiliated with over 90% of allopathic medical schools and over 85% of osteopathic medical schools Over 70% of VA physicians have faculty appointments and spend some portion of their time in education and research activities 5

Reason #5-Great Work/Life Balance 49 Days of annual paid time off – 26 days paid vacation – 13 days paid sick leave – 10 paid federal holidays Predictable work schedules and a focus on quality vs. volume Many outpatient doctors work a M-F schedule with little to no on-call VETERANS HEALTH ADMINISTRATION 6

Reason #6-Robust Benefits Package Federal Employees Retirement System (FERS), or Civil Service Retirement System (CSRS), or CSRS-Offset; Thrift Savings Plan (TSP) Health insurance options are excellent, and this is one of the few places in the country that has a pension for doctors as well as a good 401K. Federal Employees Health Benefits (FEHB) Program Flexible Spending Accounts (FSA) Federal Employees Dental and Vision Insurance Program (FEDVIP) Federal Long Term Care Insurance (FLTCI) Program Federal Employees’ Group Life Insurance (FEGLI) Program VETERANS HEALTH ADMINISTRATION Federal Leave Program 26 days of paid annual leave starting the first year and the ability to accumulate up to 86 days 13 days of sick leave each year with no limit on accumulation 10 paid Federal holidays Military Leave, up to 15 days a year for active reservists and National Guard members Predictable scheduling Reduced paperwork Elimination of billing hassles Malpractice insurance Education Debt Reduction Program 7

Reason #7-Comprehensive Professional Development Doctors are supported and empowered by VA training and coaching in patient-centered communication skills that promote patient engagement, health behavior change and self-management Nation’s leading provider of continuing medical education (CME) credits/hours VHA doctors can earn CME credits at no cost through VHA’s accredited Accreditation Council for Continuing Medical Education (ACCME) activities VETERANS HEALTH ADMINISTRATION Access to a nationally recognized CME program accredited with commendation for a six year term by the ACCME Continuing education delivered via face-to-face, virtual, and blended options Cutting-edge simulation and education gaming modalities Annual CME reimbursement of 1,000 and possible paid absence to attend for qualifying physicians Education Debt Reduction Program (EDRP) offering up to 120,000 over 5 years for qualifying physicians 8

Reason #8-Best Mission in the Federal Government With the words, “To care for him who shall have borne the battle and for his widow, and his orphan,” President Lincoln affirmed the government’s obligation to care for those injured during the war and to provide for the families of those who perished on the battlefield. VETERANS HEALTH ADMINISTRATION 9

Reason #9-A team to support you in caring for your patients Team-based model of care: VHA’s model of Patient-centered medical home “Patient Aligned Care Teams (PACT) Interdisciplinary team-based care Care coordination Population health management Mental health integration in clinical practice and clinical pharmacists embedded in primary care VETERANS HEALTH ADMINISTRATION 10

Reason #10– Best Patients in the World Opportunity to give back to America’s greatest heroes Opportunity to care for patients from military discharge through their lifespan 21.7 Million living Veterans in the USA from World War II, Korean War, Vietnam, Gulf Wars, Post 911 and peace time eras 8.97 Million Veterans enrolled in VHA Health Care 6.2 Million Veterans treated in VHA in 2015 – “As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them.” —John F. Kennedy VETERANS HEALTH ADMINISTRATION Veterans – Defenders of Freedom https://www.youtube.com/watch?v X2QnyMiYyOc 11

Reason #11- Provide Holistic and Comprehensive Care “Our ‘whole health’ model of care is a key component of the VA’s proposed future delivery system. This model incorporates physical care with psychosocial care focused on the veteran’s personal health and life goals, aiming to provide personalized, proactive, patient-driven care through multidisciplinary teams of health professionals.” David J. Shulkin, M.D. N Engl J Med 2016; 374:1003-1005 Whole health model with personalized, proactive, and patientdriven care Complementary and Integrative Health Strong partnerships and motivated teams to create comprehensive health care for patients VETERANS HEALTH ADMINISTRATION Diverse group of patients interested in learning more about holistic approaches to care The VA benefits package covers all the critically important services that are so often unavailable or require a big paperwork battle to obtain outside VA 12

Reason #12-Government Malpractice Insurance VA physicians are covered under the Federal Tort Claims Act - 28 U.S.C. § 1346 and 28 U.S.C. § 2671 Medical personnel have statutory immunity from “individual” malpractice liability while acting within scope of employment – VA physician cannot be sued in civil court for the malpractice (tort) claim Government malpractice: providers don't feel as threatened by the malpractice climate while working for the government because they are told that if a patient sues a VA doctor, they are not really suing the doctor but instead are suing the federal government. Thus, less junk lawsuits. VETERANS HEALTH ADMINISTRATION Separate medical malpractice insurance is not required to be maintained Legal remedy is against the Government; not against the individual federal employee Medical malpractice claims are processed by VA legal staff in the Office of General Counsel – VA physician does not have to retain private legal counsel – Requests for depositions by claimants counsel must be approved and coordinated by VA legal staff 13

Reason #13-Competitive Salaries Public Law 108-445 permits VA to construct a pay system allowing for enhanced recruitment and retention. VHA physician and dentist pay, under Title 38, has three elements – Base pay component is set by statute – Market pay is intended to reflect the recruitment and retention needs for the specialty or assignment of a particular physician or dentist at a facility. – Performance pay to recognize the degree to which an individual achieves defined goals and performance objectives - earn up to an additional 7.5% of salary not to exceed 15,000 annually Approved VA salaries guaranteed and not affected by patient base, RVUs Indefinite employment tenure No significant restriction on moonlighting No coventry clause and no non-compete VETERANS HEALTH ADMINISTRATION 14

Reason #14-Access to the Latest Technology State-of-art tools - speech recognition capabilities, mobile devices and a variety of renowned knowledge-based resources. Virtual technologies (telemedicine, connected health, etc.) VA providers and community health care providers can query and retrieve Veterans’ health information with each other’s organizations for treatment VA Direct - lets VA users send and receive encrypted health information with nonVA partners World leader in telehealth, last year more than 677,000 Veterans accessed VA care through telehealth VETERANS HEALTH ADMINISTRATION 15

Reason #15-Electronic Medical Record – 25 years of Experience VETERANS HEALTH ADMINISTRATION 25 years of experience with electronic health record Access to patient’s health record from VA, Department of Defense and a rapidly growing number of community providers VA’s online HealtheLiving Assessment provides proactive, actionable health information to Veterans about the impact of their current lifestyle choices The online Veterans Health Library has 24/7 comprehensive, consistent, patientfocused health information to Veterans and their families Clinicians are able to graph lab results and vital signs over time 16

Reason #16- Innovative Clinical Care It is an exciting time to be in VHA as we develop a new model of health care focused around Whole Health VHA supports clinical innovations through resources, grants, and research VHA recognizes strong innovative and best practices related to Whole Health and clinical care VHA is actively looking into methods for increasing complementary and integrative health services delivery VHA has created a new curriculum around Whole Health that has been launched nationally to train and educate the workforce VETERANS HEALTH ADMINISTRATION 17

Reason #17 – Leadership Development Healthcare Leadership Talent Institute (HLTI) whose key goal is to establish an integrated system to identify, develop and manage VHA talent to meet the need for high performing transformational healthcare leaders aligned with the VHA mission and strategic direction. The leadership development offered by VHA to its leaders has been designed and is delivered to maximize the application of the learning to the VHA clinical environment with specific emphasis on the development of health care related leadership competencies. In addition to physicians having a variety of clinical, research, and teaching opportunities, there are also opportunities for clinical leadership roles such as service chiefs, Chief of Staff (COS), Chief Medical Officer (CMO), Chief Executive Officer, etc. VHA is developing a two-year Physician Retention and Leadership Development Training Program to ensure that physicians who join VHA have the necessary training, relationships, and experiences to successfully integrate into VHA, and to succeed as clinical leaders. VETERANS HEALTH ADMINISTRATION 18

Reason #18– Flexible Work Schedules VETERANS HEALTH ADMINISTRATION Potential for full-time or part-time opportunities, and in some cases block schedules and condensed work weeks. PRN option (VA term is fee basis). Telework – You might even be eligible to work from home on a regular or ad hoc basis – Working remotely gives you all the flexibility you need, helping you balance work and family responsibilities Vary your arrival and departure times – Working longer but fewer days during your pay period 19

Reason #19 – Endless Opportunities to Live & Work Anywhere in the U.S. 1,227 Sites of care throughout the U.S.** 168 Medical Centers 1,047 Outpatient Clinics 135 Community Living Centers 113 Domiciliary Rehabilitation Treatment Programs 60 Mobile Sites of Care 300 Readjustment Counseling (Vet) Centers 80 Mobile Vet Centers **NOTE: The number of sites of care is NOT a total of the categories listed below, as several of the sites are also listed in multiple categories (e.g., there are 135 CLCs within the 168 medical centers) Source: VSSC QES 1st Qtr FY16 VETERANS HEALTH ADMINISTRATION 20

Reason #20 – Being Part of an Elite Healthcare Community VA’s reputation for quality healthcare and its role in academics and medical research ensures VA physicians are a part of an elite healthcare community VA groundbreaking work in cardiovascular disease, diabetes, genomics, prevention, geriatrics, integrated health sets the pace for medicine in U.S. Collaboration with Military Health System and Services, to include direct care and research Providers retiring or separating from the Military Health System have ability to continue to serve our Nation’s heroes The groundbreaking achievements of VA investigators—more than 60 percent of whom also provide direct patient care—have resulted in three Nobel prizes, seven Lasker awards, and numerous other national and international honors VETERANS HEALTH ADMINISTRATION 21