Ravager135

No downvotes from me. Family medicine doctor here who has worked outpatient, inpatient, and in the ED/urgent care setting. You hit the nail on the head.

"Prepare for ramming speed!"

Probably my favorite Worf moment of all time. A close second was when Worf kills Duras right as Riker enters the room.

This seems like a simple question, but it has a complex answer. Depending on the medical specialty, there are numerous shortages across this country simply because certain professions are in extreme demand and no one wants to pay enough to draw talent.

I am not a neurologist, but I am a family medicine doctor. I get emails and phone calls every day with job offers (15+). Most of these offers are in rural hospitals though certainly I see them in urban locations as well. There is a reason that despite being boarded in family medicine, I am the medical director of two urgent cares and run my own cash-based (non insurance participating) practice; the money just isn't enough in traditional family medicine.

I know it seems ridiculous for many to look at turning down a six figure salary as nothing but greed, but I am not sure many outside the medical community understand what is being asked of physicians. I have been offered 400k a year to go work in North Dakota. I have no desire to spend an additional 4 hours a day doing paperwork after seeing patients for 8 hours who have multiple chronic comorbidities in a 15 minute visit. I have no desire to be the only person who can deliver babies in a 100 mile radius because there is no OB/GYN in the area (and assume all the liability associated with it). I have no desire to be told by a healthcare executive that my bonuses and salary are dependent on my patient's liking me rather than how much I actually improve their health.

Going back to the neurologist, it's the same story with different roadblocks. No one in medicine wants to be on call every other night. No one in medicine wants to make 300k a year when they are 500k in debt. No one in medicine wants to give up having a family life. That's the reality for many neurologists, even in popular places to live.

In the end, it all comes down to money and autonomy. What field are medical students going into: orthopedics and anesthesia. Both are high paying and generate enough revenue for hospitals that you can basically tell the hospital to "fuck off" if they try and make you do something you don't like. Unfortunately professions like psychiatry, infectious disease, pediatrics, and family medicine are considered "less impressive" and command smaller salaries. The result, however, is exactly what you are seeing: lack of access to mental health, poor antibiotic stewardship resulting in drug resistance, and a decline in life expectancy. If you pay these people enough, they will dig a latrine behind the hospital.

EDIT: I know plenty of doctors who would work anywhere you told them for a few years if they got paid what some of these hospital VPs make knowing they could pay off their loans and finally enjoy their lives after giving up their 20s.

Founder...

There is complete ineptitude at the state and national level when it comes to administering the GI Bill. I was a medical officer in the Navy who was separating at the conclusion of my service obligation to head into a civilian residency program. While it is not the typical usage of the post 9/11 GI Bill, it has certainly been done thousands of times in the past. I was essentially using the bill to supplement my income during a training program. In order to do, I needed to process my package, but additionally a VA representative had to meet with a secretary at my program to "certify" her to submit my enrollment confirmations so I could be paid. The VA rep at my base had no idea what he was doing, the education specialist at the national level managed to screw up my documents on multiple occasions, and it's nearly impossible to contact anyone at the state level.

It took a letter to local congressmen to get anything done, at which point I had my benefits approved within the week and the certification completed. That was probably more frustrating than anything because there was a solution that only took a week after I had spent half a year trying to arrange the benefits myself.

My question is, while I am sure there clearly are IT issues at the VA, how much have you discovered the presence of poor training on the part of the staff? Unless you are a cookie cutter application for a large university that already has a certified enrollment officer, the VA seems to have no idea what to do.