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[News] Top VA Health Official Resigns under fire
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Post: #1
Top VA Health Official Resigns under fire
Top VA health official resigns under fire

[Image: Robert_Petzel.jpg]

The second in command at the Department of Veterans Affairs resigned Friday amid the growing controversy over patient wait times and allegations of falsification of records.

VA Secretary Eric Shinseki announced he had accepted the resignation of Dr. Robert Petzel, the VA's undersecretary for health, just a day after Petzel had joined Shinseki in a contentious hearing before the Senate Veterans Affairs Committee.

Senators grilled Petzel, who has been with the VA for four decades, over the agency's perceived inaction in reducing the wait times for veterans seeking VA care.

Sen. Richard Burr, R-N.C., described a phone call that Petzel made to regional VA officials nationwide after the Phoenix VA director was placed on leave. Burr said he was told that Petzel called the removal "political, and she's done nothing wrong."

Whistle-blowers in Phoenix have alleged that as many as 40 veterans may have died while awaiting appointments for care through the Phoenix VA Health Care System. They also have claimed document fraud in reporting wait times at Phoenix facilities.

The disclosures in Phoenix created a wave of similar revelations at other VA facilities across the nation, putting Shinseki and his top administrators in the line of political fire. Senators said Thursday that they now have information on problems at VA facilities in at least 10 states — including Colorado, Georgia, Illinois, New Mexico, Texas and Wyoming.

Shinseki's announcement didn't directly address the controversy but said, "As we know from the veteran community, most veterans are satisfied with the quality of their VA health care, but we must do more to improve the timely access to that care."

"I am committed to strengthening veterans trust and confidence in their VA healthcare system," he said, echoing his testimony Thursday.

Petzel had announced in September that he planned to retire in 2014.

The White House simultaneously announced the nomination of Dr. Jeffrey A. Murawsky to fill Petzel's post. Murawsky has been the network director of the Veterans Integrated Service Network since 2009.

Murawsky is also an associate professor of medicine at Loyola University Chicago Stritch School of Medicine, according to a White House news release. Previously, he was chief medical officer for the Veterans Integrated Service Network from 2006 to 2009.

He also served as the associate manager for medicine and neurology services at Edward Hines Jr. VA Hospital in Hines, Ill., about 10 miles west of Chicago, and as the associate program director for internal medicine at the combined program with Loyola University Medical Center in nearby Maywood, Ill.

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The above post may contain copyrighted material the use of which has not always been specifically authorized by the copyright owner. The material available is intended to advance the understanding of Sleep Apnea treatment and to advance the educational level of Sleep Apnea patients with regard to their health. Sometimes included is the full text of articles and documents rather than a simple link because outside links frequently "go bad" or change over time. This constitutes a "fair use" of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material in this post is distributed without fee or payment of any kind for research and educational purposes. If you wish to use copyrighted material from this post for purposes of your own that go beyond "fair use", you must obtain permission from the copyright owner.
05-16-2014 04:14 PM
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Post: #2
RE: Top VA Health Official Resigns under fire
From a previous May 2nd story:

Second VA doctor blows whistle on patient-care failures

[Image: images?q=tbn:ANd9GcRVIwvp-iPisPfljmE-4XS...N9pf5ykrnQ]
Dr. Katherine Mitchell

Late on Sunday night, Dr. Katherine Mitchell said she received a phone call from a fellow employee at the Phoenix VA hospital who needed advice on how to handle a sensitive situation.

Her co-worker explained that patient appointment records in the Phoenix VA Health Care System were in danger of being destroyed. But he had printed paper copies to ensure that accurate wait times for patient care would not be lost if removed from computers. The purported "secret lists," along with accusations that up to 40 Arizona veterans died awaiting care, are the subject of national controversy and investigations by Congress and the VA Inspector General.

Mitchell was a confidante with experience — nearly 16 years at the veterans hospital, first as a nurse who became supervising physician in the emergency room, then as medical director over a transition program for veterans of the Iraq and Afghanistan wars.

She said her colleague explained that the documents were likely to be deleted within a day. Aware that the House Committee on Veterans' Affairs had issued orders for the VA to preserve documents at the medical center in Phoenix, the two agreed to protect evidence.

Mitchell said she went to the medical center and walked her co-worker to VA police headquarters, where they asked officers to secure the documentation. Police declined, Mitchell said, but suggested they find a safe place to conceal the materials inside the hospital.

Twelve hours later, Mitchell said, her co-worker delivered the evidence and a statement to an investigator from the Office of the Inspector General while Mitchell visited The Arizona Republic, asserting status as a government whistle-blower.

Mitchell struggled with emotions as she described the incident, her career-threatening decision and concerns about the integrity of VA administrators.

"I had no doubts they were capable of destroying evidence, or altering evidence," she said. "So there I am, a 47-year-old doctor with two degrees, trying to figure out where to hide stuff.

"I spent my whole professional life wanting to be a VA nurse, and then a VA physician. ...(But) the insanity in the system right now needs to stop, and whatever I can do to accomplish that, I will."

The Republic this week sought comment from Phoenix VA Health Care System Director Sharon Helman about Mitchell's assertions, and an interview with the director, scheduled Thursday, was canceled at the last minute when Helman was placed on administrative leave by Secretary of Veterans Affairs Eric Shinseki.

Fight for improved care


Mitchell said she fought for improved veterans care within the system, warning that Emergency Department patients were in jeopardy and, more recently, that suicides had escalated amid a shortage of mental-health staffers.She said she was transferred, suspended and reprimanded.

[Image: 1399028666001-PNI-helman.jpg]
Sharon Helman, medical center director,
reacts to allegations during an interview
at the Phoenix VA Medical Center in Phoenix.


Many of her allegations coincide with complaints lodged by Sam Foote, a VA primary-care physician who retired in December. In letters to the House Committee on Veterans' Affairs and the inspector general, as well as in interviews with The Republic, Foote first made the accusation about patient deaths and fraudulent records.

Both physicians, as well as other VA employees who asked not to be named for fear of retribution, said the Phoenix VA leadership disdains internal criticism and retaliates against those who speak out. In interviews and a written statement, Mitchell told The Republic she can no longer remain silent.

"I am violating the VA 'gag' order for ethical reasons," she wrote. "I am cognizant of the consequences. As a VA employee I have seen what happens to employees who speak up for patient safety and welfare within the system. The devastation of professional careers is usually the end result, and likely is the only transparent process that actually exists within the Phoenix VA Medical Center today."

In recent interviews, Helman said employees are encouraged to express concerns, especially about medical care. She and chief of staff Darren Deering said their leadership team has dramatically improved service to veterans, is unaware of any patient deaths linked to delayed care and did not manipulate or falsify wait-time data.

But Mitchell and other VA employees have expressed fears of evidence-shredding before and after inquiries were launched by congressional committees and the Office of Inspector General.

Those concerns were echoed Thursday by Rep. Jeff Miller, R-Fla., who first disclosed the Phoenix VA allegations as chairman of the House Committee on Veterans' Affairs. In a letter to Shinseki, Miller warned against the destruction of evidence and threatened to issue a subpoena.

Helman was placed on leave hours after that letter was sent, and one day after Dr. Robert Petzel, undersecretary for health in the Department of Veterans Affairs, told the Senate Committee on Veterans' Affairs that a VA team sent to Phoenix found no evidence of secret patient lists or related patient fatalities.

Early warnings

Hospital administrators and critics in Phoenix agree that, beginning several years ago, a surge of veterans and an exodus of medical staffers resulted in huge delays in care. Waits for first-time appointments with primary-care doctors exceeded one year, and referrals to specialists often took months.

Because of the logjam, vets began flooding the hospital emergency room, which already was shorthanded. Mitchell, then director of the Emergency Department, said patients waited hours while nurses with inadequate triage training tried to determine which ones needed immediate attention for life-threatening problems.

Mitchell said she wrote memos to hospital administrators, including Deering, describing "near misses," to raise a red flag. The Republic has obtained substantiating emails.

Mitchell said her warnings were dismissed at first, and patients were further endangered as some nurses, resentful of perceived criticism, became uncooperative. Then, in early 2012, Helman took over leadership at the hospital and paid a visit to the Emergency Department, which was overwhelmed with patients.

"When she asked me how things were going, I pulled her into the back and answered her honestly and without the usual political correctness," Mitchell said. "Without adequate staffing, ancillary services and sufficient triage training, I told her the ER was so dangerous that it should be shut down immediately. ... The only thing worse than losing my career was failing to prevent another vet from dying. I hoped a new leader would understand the critical nature of the situation and divert needed resources. I was wrong."

Mitchell alleges that, within days, she was told by senior administrators that the only problem in the Emergency Department stemmed from her deficient communication skills. After other ER doctors met with administrators to express similar concerns, Mitchell said, hospital managers began making improvements.

But they also transferred Mitchell out of the ER to a position as medical director of transition services for vets who served in Iraq and Afghanistan.

In that role, Mitchell said, she became concerned that suicides among Phoenix veterans had spiked in recent years amid a shortage of mental-health staffers. Once again, she said, vets appeared to be suffering from delayed care and triage failures. She sounded another alert without immediate results.

Mitchell said she decided in September to file a confidential complaint with the Office of Inspector General, channeled through Arizona Sen. John McCain's office because she believed that would be more effective. She said the Phoenix VA was so dysfunctional that she included a multitude of other safety and patient-care issues in hopes of bringing "the greatest change possible."

Records show Mitchell's list of concerns went to Tom McCanna, McCain's staffer for veterans affairs. An aide to the senator said that more than 2,000 complaints about the VA have been received in the past 18 months but declined to discuss individual constituent complaints or to allow The Republic to interview McCanna.

Mitchell said she learned that only part of her correspondence was forwarded to the VA. Records show her list of concerns wasnot submitted to the inspector general, who investigates systemic problems and wrongdoing, but to the Office of Congressional and Legislative Affairs — a political liaison department in Washington.

A Feb. 27 letter to McCain's office from Michael Huff, congressional-relations officer for the VA, contains responses to Mitchell's complaint. It describes suicide-prevention processes, but does not address assertions that suicides increased amid growing delays in care. With regard to medical care, Huff's letter confirms a new Electronic Wait List was implemented, an inspector general probe was under way and new procedures and staff training were initiated. It does not address whether wait-time data had been falsified.

The VA Office of Congressional and Legislative Affairs did not respond to Republic inquiries.

Complaints filed

Mitchell said that within days after she made the complaint via McCain's office, she was placed on administrative leave pending an investigation for unspecified wrongdoing. She said her confidentiality had been breached, and in January, Mitchell received written counseling that alleged she "may have" violated patient privacy in filing her complaint.

Mitchell said VA leaders refused to explain what she'd done wrong or provide documentation.

"I was devastated to learn I would not be given access to the investigative file because it was shredded 'for my own protection,' " she wrote recently in an open letter describing her experiences. "I was told that HR (human resources) determined it did not need to inform me of which specific policy I had violated because a written counseling did not rise to the level of a disciplinary action employees were allowed to challenge."

Jean Schaefer, a Phoenix VA spokeswoman, said agency officials are unable to comment on investigations or disciplinary actions regarding Mitchell because she declined to sign a privacy waiver.

Mitchell said she sent a second complaint, with extensive backup materials, to the senior liaison for the Senate Committee on Veterans' Affairs. She said she was advised those documents would be shared with the Office of Inspector General, but that to date she has been unable to verify that her accusations are part of the ongoing investigation.

A spokeswoman for the inspector general said the office does not comment on specific complainants or their allegations.

Mitchell said she decided to go public as a last resort, risking a career she loves.

"It's not like I'm going to get any fame or fortune out of this," she said.

In her letter, she wrote: "The pending investigation has the potential to help address and resolve the issues which have held a stranglehold on our facility, ourveterans and our employees for decades. ... Although I welcomed news of an official Senate Committee inquiry last week, I have no faith at this point that the VA Medical Center is capable of providing an accurate accounting of its deficiencies, or that an investigative team will accurately document what it finds."

Fair Use from:
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The above post may contain copyrighted material the use of which has not always been specifically authorized by the copyright owner. The material available is intended to advance the understanding of Sleep Apnea treatment and to advance the educational level of Sleep Apnea patients with regard to their health. Sometimes included is the full text of articles and documents rather than a simple link because outside links frequently "go bad" or change over time. This constitutes a "fair use" of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material in this post is distributed without fee or payment of any kind for research and educational purposes. If you wish to use copyrighted material from this post for purposes of your own that go beyond "fair use", you must obtain permission from the copyright owner.
05-16-2014 04:24 PM
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Post: #3
RE: Top VA Health Official Resigns under fire
I find all this VA stuff heartbreaking.

I have had such good care from my VA system. Far better than I was getting on the private economy before I signed up to the VA system. Most recent experiences: A short time ago I went in for an eye exam to get new glasses. Not from the VA, but a regular eye clinic. The eye doc thought he saw something in my eye indicative of a possible stroke or heart attack. He reported what he saw to my primary doc. Three days later I'm getting blood tests, a carotid artery ultrasound, and a heart ultrasound. Everything came back fine as I thought it would, but I was impressed by the speed and thoroughness of my VA team.

When my primary thought I should have a sleep test, which was something my private docs previously decided I didn't need, I was booked into the sleep lab in a fairly decent period of time. Following the first not-so-great sleep test I met with the sleep docs and they prescribed my S9 autoset that day.

I understand that in some parts of the country there are major problems. Anytime you schedule a couple of wars and don't really make any plans for what to do with the guys that don't get killed, there will be backlogs, sometimes major backlogs. Congress in their wisdom will crucify the VA department for all this trouble, but will not do one damx thing to make things better. Well, that's not true. They might name a post office in honor of some vet.

What possible good will it do to force one or two people to resign from the VA? All our guys and gals in the system are still waiting. Just as the rest of the country waits for congress to do anything beyond discussing their next road trip.
05-16-2014 05:49 PM
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