Nut Kickin'

In retrospect, I imagine this post will come across as first world bellyaching, but this is one of my preferred venting venues, so there.

I’ve been working for VES for over a month now, and as time passes I question how sustainable it will be. They show all the marks of a bureaucracy like the VA, but without most of the incentives. Working as fee basis for the VA, we had a very fair payment structure, a decent clinic and network infrastructure, and a mostly autonomous working environment including how we got paid. VES has built up an administrative behemoth for reasons not fully understood, and every exam is often beset by multiple follow up questions that can add as much time as it took to complete the exam in the first place. This might be tenable if the pay structure was adequate, but it’s averaging around half that of fee basis at best. The frustrating thing about the incessant follow ups (QA addendums) is that they’re mostly irrelevant questions that VBA has never cared about in my personal course of completing nearly 15,000 exams. Regardless, VES will insist that these are due to “VA policies” and “VA preferences”, when I’m pretty sure this is entirely made up or at least based on some subjective request from VBA that isn’t based in any sort of regulation or guidance.

An example from just yesterday - I had a case that involved a Veteran with a long history of knee surgeries that ultimately culminated in a knee replacement last year. When I entered in the diagnoses, I still included the past history, some of which he was already specifically connected for. I get a QA addendum because they wanted me to only put the knee replacement as his diagnosis, and remove all the other diagnoses. This isn’t how we document in medicine. A knee replacement doesn’t wipe the slate clean and eliminate the previous history. Not to mention that some of his issues were extra-articular and weren’t involved in the knee replacement. What this admin person didn’t understand is that “knee replacement” doesn’t mean you get a brand new knee and start over. It’s an artificial knee that will wear out and in some cases, the surgical outcome is no better and maybe even worse than before.

This is the typical run-around I get on probably at least half of my exams. Another point of frustration is that they hold us to a 48 hour window to complete exams, but I still have unprocessed work from two months ago, and they have failed to process several exams in time for our payday, so they get held over until the next pay period. Do as we say, not as we do.

Contiguous with this I have been having my recurring OS overhaul, triggered by random untraceable events. This seems to happen with me and OSX every year or two, where the only way I can get things functioning is to wipe the slate clean and start anew. Another major point of frustration is that Backblaze, who I’ve been using for several years, sent me a recovery drive for my OS disk, but the copy speeds are so slow, it’s going to take 3-4 weeks to copy around 1.5 terabytes. I’m at the point of just scrapping the restore process and falling back on time machine.

I’m also recently made a major switch in my studio setup, by swapping places between the video and craft rooms. The big drafting/craft desk moved into the closet and the bed from the craft room is now in what amounts to a basic guest room with TV. Ultimately, this will be a superior setup, but there are a lot of growing pains in the process. I’m trying to back into video recording with a plan to jump headfirst into a YouTube channel with the hope I can build enough quality content that I would earn a subscriber base leading to some passive income, even if a modest amount. We don’t need a great deal of additional money to keep us comfortable, and one major lesson of COVID is that I don’t want to depend on any corporate or bureaucratic structure for my livelihood.

All these events sort of running concurrently has felt like a kick in the nuts, figuratively speaking. I’m spending more time keeping things from burning down and it distracts me from working on my disciplines. I have renewed my efforts to study and improve my video editing and post processing, but right now I’m just trying to get things running normally, so it’s a bit frustrating. …and the microwave died. And a few other things that aren’t coming to mind right at the moment. Wahh Wahh.

Still, we have a home, the utilities are paid, we have food to eat, the dogs, Aeyoung and I are relatively healthy and not really wanting for anything critical. Like I said, first world problems…