Joseph T. Burns, MD
Fargo VA Health System, North Dakota
Generally, the patients here are more appreciative of what we do than those from civilian settings in which I have worked. The scope of what is seen is often more narrow, but is often deeper or more complex. We don’t see pediatric patients or deliver babies, but patients here require “brain power” to work through their complaints. You will get a cerebral workout with each shift. Time spent with patients can be greater. On the whole, the opportunity to talk with patients is greater than in civilian settings. History is the most important component of making a diagnosis; it’s easier to do that here. Many civilian nurses in our community have come to the VA because this represents “real” nursing practice as well, meaning they have time to spend with patients. The benefits are great, but the pay is less, and the total work intensity is generally less than civilian facilities.

Thomas Schneider, DO
Muskogee VA Medical Center, Oklahoma
We get to work 24/7 for Veterans, who served our great nation. The better we serve these great people, the more people might step up and serve our nation in the future. I am a proud American physician, serving people willing to provide freedom and safety.

Neil Patel, MD
West Los Angeles VA Medical Center, California
“One of the chief reasons why I love working at the VA is that I can practice medicine without incorporating medico-legal concerns and patient financial circumstances into my medical decision-making. In other words, I can practice the art and science of medicine in its purest form, for the sole benefit of the patient, without worrying about my pocketbook, both in terms of reimbursement and medical malpractice. The fact that it’s an integrated health care model, where I can see what other providers have done and can freely refer to specialists, isn’t too shabby either!”

Andrew Auerbach, MD, FACEP
Dallas VA Medical Center, Texas
I think the best reason is the opportunity to improve the quality of emergency care in the VA system. A more material reason is paid time off; I never had that when I was in the private world.

Henry Pitzele, MD
Jesse Brown VA Medical Center, Chicago, Illinois
Relative shielding from litigation restores the physician-patient relationship and allows us to actually care for our patient instead of concentrating on protecting ourselves. Longevity and predictability of career: In the current climate of change in insurance, payment, and oversight of medical decision-making, the VA offers a system that is unlikely to change in the near future. We will not see our department contract sold out from under us. We won’t see our pay decreased, and we won’t be downsized. Opportunities and funding for career development: the VA abounds with chances for professional development, both within emergency medicine (directorship, VA and national leadership, research, and teaching) and outside EM (local hospital leadership, non-EM development opportunities in integrative medicine, women’s health, informatics, emergency medical services, policy, etc.) Hands-down, VA patients are the best patient population of any American medical system. I was thanked by patients and families more in my first week of work at the VA than in the preceding four years of urban, community EM.

Peter Hasby, MD
Ft. Meade VA Medical Center, South Dakota
Eligibility for VA services includes patient financial need. In other words, our patients are not only US military veterans, but most often low income. Many commonly use the VA not because they have no other option, but because they are proud of their veteran status and happy with our service to them. So, we see grateful patients, giving us the privilege to serve a low-income population without having to personally face the financial challenges that may impact a civilian hospital.

Alan Sorkey, MS, MD, FACEP
Overton Brooks VA Medical Center, Shreveport, Louisiana
I have never been told thank you so often as by patients at the VA. Emergency medicine is relatively new at the VA, and it is very rewarding to makes changes that improve emergency services for the veterans and improve the care provided. The VA was the perfect transition from 20-plus years of full-bore private sector emergency medicine. The potential for career advancement is very good. As a former independent contractor, I wish I had known about the opportunity to work as little as one-fourth time at the VA and be eligible for full benefits—this is the ideal situation for many in emergency physicians. Anyone with prior military service can “purchase” that time towards Federal retirement.

Curt Dill, MD
VA NY Harbor Healthcare System, New York
We are modern trailblazers for emergency medicine. Veterans are entitled to the highest quality of care from an emergency department. Emergency medicine professional organizations now dominate the training of acute care physicians. As such, EM can meet its own standard by providing emergency care to all in need, including veterans who receive their care in VA hospitals. Students and EM residents rarely have an opportunity to
see post-traumatic stress disorder, victims of military sexual trauma, and other conditions that disproportionately affect veterans. Understanding these entities is necessary and valuable for the sophisticated development of the modern emergency physician.