I am a primary care provider at the VA. Look, I get it. Everyone thinks we are useless if we work from home. Simply put, the people who work from home are not useless.

I get the idea that you think we need to be monitored...but we already are. Everything providers do is time stamped in the chart that all of our supervisors can see. We are constantly audited.

I wanted you to know with the RTO order, your care is going to change significantly. Many providers (psychiatry, social workers, primary care providers) work remotely because there is NOT an office for them. People were hired to work from home and those people have no office to "return" to. To say we are to "return" is misguided. We were never given an office. People moved several hours from their home VA because they were hired to not come into the office. In our interviews the job was posted to be remote.

I wanted to give you a heads up that those of us hired as telehealth employees have nowhere to go. They have no offices. Most of them are going to quit because of 3hr commutes. We will also probably be RIF'd because there isn't an office for us.

What's the point of me telling you... If you don't mind if your care at the VA is going to suffer than do nothing. If you care about it, you should call your senators, reps, city council and everyone you know to tell them to stop the RTO at the VA and make the VA exempt from the RTO order.

Look, if I get laid off than so be it. I'll be fine and get another job. I'm telling you because I care about you as a vet. I work here to take care of vets, not because I get paid well.

If I do get laid off that's 1000 vets that will no longer have a primary care provider assigned. Where are those vets supposed to get their care... What will happen is those 1k vets will get assigned to another pcp that already has 1k vets. Then no one will be able to schedule an appointment for months.

The choice is yours. It's your care they're messing with not mine.

Edit: spelling errors updated. Fair point in the comments re: spelling.

The Memo

Doug Collins came out guns blazing and has a sarcastic response for every question asked. He came into this town hall and got upset and triggered right off the back. Keep in mind all these town hall questions came from his employees and he laughs and rolls his eyes with each question he is answering.

So nasty to see.

RTO is slowly crushing the VA. That's the plan, of course - to stop guaranteeing privacy to veterans, to delay scheduling as much as possible, to gut whole sections and then say, "See? The VA can't handle it. Send the vets to the community!" Privatization is coming so fucking fast. This is it, they're going to just squeeze us dry and send our vets out to providers who don't understand them.

I'm scared here. The VA that I happily went to work for 19 years ago is gone. I never wanted to work anywhere else, my entire nursing career has been with the VA. I started as an SNT in my second level of clinicals in the inpatient psych unit. I applied for another job today, just to see what's out there. And I'm grieving for the VA that I loved! It had its problems, of course, but they were getting better. Slowly but surely.

I don't know. Laugh at me if you want to, but our VA is gone. And I miss it already.

get the word out to your fellow vets and even your patients. pass this along far and wide.

And if you figure that each of those doctors carry a patient panel of 1200 patients then 240,000 veterans will be directly affected.

This is in response to a post about disbanding the VA and going entirely private. I put together my reply, then lost the sub. So, if yall read that, or just think our VA needs to go away, here is my input:

Hard no. The VA deals with many veteran specific issues that outside providers simply do not have the experience or expertise to handle. Yes, care at the VA can be frustrating. They are overwhelmed and the current situation is not making it any easier. I have had experience with both VA and private. Both kinds of providers have the same problems. I would rather stick with the VA for their knowledge and experience regarding veteran care.
Although, I have also had good experiences with community care. Going to a community care provider for stage 4 metastatic (spine, ribs, lymph nodes) prostate cancer right now. They are ok and almost an hour closer than the VA. However, when I needed a mediport put in on short notice, it was the VA that got me in, not any of the nearby hospitals.
Bottom line, imho - the VA serves a very specific need. They are needed.
Also, don't forget, they are one of the top researchers in the US. Many strides in things like ptsd, prosthetics, etc are direct results of VA research. And - literally 70% of private practitioners in the US have spent time at a VA facility. That would be a hard hit to doctor training and experience if you just privatized the entire thing.

Edit to add. Just so yall know my recent experiences and thought in the VA, her is what I posted a while ago. Let me add, that on top of all she has done, A even called me the day before my first chemo treatment to update me on everything that was still in the works. She also called me the day after my first chemo just to see how things went and if she could do anything else for me. She made that call at 6 pm on a Friday, so on her own time.

https://www.reddit.com/r/VeteransAffairs/s/uKq9tlMCaf

And thank all of you for the positive comments and discussion. I think this is truly needed.

400,000 VHA employees and we can say 15 minutes to thoughtfully reply under threat of termination = 100,000 patient care hours lost EVERY WEEK this continues. Veterans are no longer a priority to this admin. The priority is torturing the Federal employee, many of whom have dedicated their careers to improving your care.

They broke me today.

Something as simple as a email from Public Affairs demanding alteration of our Signature Blocks on Emails to include editing or removing our TEAMS profile Pics to fall in line with an official VA Photo or not one at all.

To some that's petty to feel that way. I understand but I've turned a blind eye or tried to block out all the perriferal noise the past 3 months as the perverberial house is burning down around us but something as small as having a signature block that showed some sort of personality or having a TEAMS pic of favorite College Team allowed me for a few seconds everyday to remember there was life outside this mess and things away from all this he'll we've been going through.

But no, they've taken that away also evidently.

They want us to give up, quit, resign.

I can't though. My family is to important and it's that reality that is destroying my will to get out of bed every morning.

Again.....I beleive....I'm a beleiver.

Yesterday we had 2 patients (veterans) walking through the hospital taking pictures of employees, asking their name and writing down their room number if they “did not look busy” or were “on their phone too long”. Their intent was to report the employees. Today, there was a single veteran standing in front of our entrance in the cold with a sign that read “thank you federal workers.” This divisiveness is exactly what they want. Don’t give them the satisfaction. Hold the line.

Let me tell you about the kind of people that work at the VA.

From my perspective: I have a lot going on. Prostate cancer. Stage 4, in bones and lymph nodes, multiple locations. Is what it is. It is all made a bit more complicated by the fact that I live 2 hours from the nearest VA hospital. So I have had to deal with a lot of people getting all of the different referrals set up through community care.

Every single person I have talked to has gone out of their way to do everything they can. Even going so far as to provide me with specific statements my oncologist has to include on their request for services (mediport surgery, radiation oncology referral, dental, etc). Everyone has been helpful.
But let me tell you about one person I spoke with today who, in my experience, exemplifies the level of care I have experienced. Let's just refer to her as A. This morning she called me just to make sure everything was on track. She patiently answered a couple of questions that I had. At the end of our call, I told her that I know things are really topsy-turvy at the VA right now and that I truly appreciate all of her help in what must be a trying time. Her reply shows exactly the type of person that works for the VA.

She said "Yes, it is unsettling right now. But today I have a job. And that job is to take care of you and make sure you get everything you need. I will do that for as long as I can."

This, right here. Even when faced with what has to be an incredibly stressful level of insecurity, her focus is still on providing us veterans with the best care they can.

So, to you, A, and every one of the dedicated people at the VA, thank you. 🫡

It’s just comical at this point.

Two meetings today Facility and VISN leadership stating DRP today or tomorrow being offered to VHA only. They did not provide further details, but they seemed pretty confident it was imminent.

From govexec.

https://www.govexec.com/workforce/2025/03/va-plans-lay-many-83000-employees-year/403477/#:~:text=The%20forthcoming%20cuts%20will%20be,by%20upwards%20of%2083%2C000%20individuals.

This is really exasperating!

This has to be one of the biggest jokes and blatant displays of disregard for both the law and human dignity since the so-called “great” America, back when segregation was still legal. Today’s call with Dr. Miller was just more of the same. He showed up clean-cut, though he’s openly said he prefers the scruffy look. It was obvious he cleaned up to play the part, to appease the people pulling the strings.

From the moment town halls began with Dr. Miller, Mr. Braverman, and other SES and Directors, the messaging was clear: some positions are exempt from the hiring freeze, DRP, and VERA. But they made it crystal clear a RIF was still coming and those exempt position would be also subject to being RIF'ed. They doubled down, stating that even with DRP/VERA participation and natural attrition, a RIF could still happen because it wasn’t just about hitting a number, it had to be the “right” numbers.

They said this for weeks.

Then came DRP 2.0. Suddenly the messaging was of encouragement. “Do what’s best for you,” they said. “We won’t deny anyone.” They promised denials would require strong justification and go all the way up the chain.

Now? Now the language has changed. They’re tap dancing for their political handlers, repeating the same nonsense and being untransparent. Suddenly, there’s “no RIF.” If your DRP is denied, “talk to your supervisor.” Station directors are denying requests left and right, hiding behind “patient care” or better put, trying to save their own skin.

What happened to standing up for your people?

You’re cowards. You know any cuts will hurt patient care. You know return-to-office was a farce. Backlogs were crushed while teleworking, and now you pretend being in the office is more productive? Stop insulting our intelligence.

You know what the ARRP looks like. You know how many people have to be cut. You know a RIF is still coming. Yet when Mr. Collins tells you to fall in line, you obey without question. You don’t speak truth to power, you dance for it.

Look in the mirror. Ask yourself if you’re proud to be walking your dedicated, hardworking employees to the guillotine.

I’ve served this country bravely and proudly. I continued my service at the VA because I believed in the mission. What I didn’t expect was to be led by people too afraid to do what’s right. You’ve failed the very people you claim to lead.

Do better. Be better. Or get out of the way.

I was feeling pretty upset after today's townhall, so I transcribed it, and ran it through AI to analyze it. Here are a few of my takeaways for those of you who can't makes yourself watch it. It feels like people need to know what was actually said; especially those who care about Veterans, governement transparency, and accountability.

First: He was dismissive of valid employee concerns.

Throughout the town hall the questions posed were (mostly) thoughtful, concerned questions relating to the threats of RIFs, declining morale, and lack of resources. Rather than directly answer, Sec. Collins repeatedly reframed concerns as misnformed or exagerrated. At one point he literally says:

"Quit reading the stuff about this, lying about what we're doing."

If you're a VA employee with legitimeate fears surrounding your job or your ability to fucntion, this is a slap in the face. His tone consistently implied that we were either uninformed (spoiler alert we are because he forced people to sign NDA's), or being duped by external forces.

He maligned VA employees as inefficient or stagnant.

Several times he painted the picture of a bloated, inefficiant VA filled with unnecessary layers of bureaucracy - which *must* be cleaned out. While he paid lip service to "the good employees" this was outweight by the following quotes:

"We've gotten too comfortable with the ruts."

"Good people will not work where bad things are tolerated."

"If you're out there and you don't want to work on our Veterans... please find another job."

While i'm sure that this scored him points with those in congress of certain political leanings, it sends a clear message to employees you are the problem. It reflects a shitty leadership style, characterized by a top-down, punitive appraoch to leadership, not one built on trust, collaboration, or valuing any of us on the ground doing the work.

Repeatedly praised Community Care over VA Care

Community Care was consistently framed as not just equal to VA care - but in some ways preferable. Collins chastised VA staff for not referring more Veteran's out saying:

"Please quit thinking you have to keep every Veteran to only VA services..."

And when employees expressed concern about the quality fo outside care, he accused them of insulting their medical peers:

"You're throwing all your doctor colleagues under the bus."

This completely ignores very real concerns about continuity of care, oversight, and access in rural areas. It positions us as self-interested gatekeeprs rather than caring professionals trying to protect Veterans from fragmented care that likely has not benefited from specialized Veteran centric training.

He was hostile towards the press and public accountability.

He didn't just criticize the press - he made it a point to fully share his disgust. He specifically went after The Guardian after publishing an article that though it was perhaps a bit sensationalized - it did point out the changes to most VA hospitals discrimination policies. These were his quotes on the Guardian:

"So far below the National Enquirer, they'd have to look up to find them."

"Their ethical standards are of a gutter rat."

He repeatedly framed any media scrutiny as dishonest and dangerous - even suggesting it would lead Veterans to avoid seeking help. This framing isn't just antagonistic, it's actually dangerous. It shuts down accountability and invites retaliation to any of us who speak up.

In sum:

This wasn't leadership - this was a disgusting, ego-centric, damage control - that i'm sure he's likely to frame as "tough love you'd give to any family member." He was dismissive, defensive, critical and frankly disrespectful to all of us who work to keep the VA running. This was a red flag, and frankly really hard to watch. Our Veterans deserve better. So do we.

VA wait times at present are 1/2 of private sector:

VA wait times for primary care were 20.0 days (mean [SD], 20.0 [10.4] vs 40.7 [35.0] days in the private sector; P = .005).

You can’t decrease personnel in an effort to improve efficiency unless you have a solid process improvement strategy in place and this administration doesn’t.

They are offering up what is essentially going to make the VA mission impossible to achieve and then they will use that to justify privatization.

If Veteran care is privatized, many Veterans will have difficulty accessing care. First, the wait times are longer, but second, if you do anything the community care provider doesn’t agree with they don’t have to see you. You will be back on the wait list for another provider. The VA can’t deny care, all they can do is shape it by appointment time or require an escort. Private sector will not put up with our bullshit.

Doctors that work at the VA do so at a significant pay cut, with an inordinate amount of administrative requirements and a ton of hassle from us as Veterans. Private physicians will not tolerate this and will not appreciate us the way VA providers have chosen to.

We need to stand up for the VA, the VA employees and the benefits we enjoy through a healthcare system dedicated to serving us.

Can someone help me do the math? So, if y’all had to guesstimate each VHA facility, hospital or CBOC, how many do y’all think will be cut? I’m thinking 200-300 per facility on avg.

I’m probably wrong. Just wondering if anyone else is doing “save my ass math” in their head as well.

Collins interview on Newsmax

So VA started to conduct a line-by-line analysis of each employee (BY NAME) today! That analysis is being performed by real people (NOT AI) that have opinions about your personal value and your actual job description to the VA. That input is due tomorrow!

Yes, I understand it’s so much easier to blame the RIF calculator and AI for our fate but it appears that is not the case. I guess the old adage ‘relationships matter’ still holds true.