Second complaint says Young VA canceled 1,000-plus consultation referrals

An aerial view of the C.W. Bill Young VA Medical Center. [SCOTT KEELER   |   Times (2013)]

An aerial view of the C.W. Bill Young VA Medical Center. [SCOTT KEELER | Times (2013)]

TAMPA — The second whistle-blower complaint in a month about the C.W. Bill Young VA Medical Center's gastroenterology clinic also accuses the facility of canceling more than 1,000 consultation referrals to the clinic last year without checking to see whether patients had a legitimate or urgent need to be seen by a doctor.

The anonymous complaint, faxed to the VA's Office of Inspector General on July 2, says gastrointestinal physicians at the Seminole hospital did not have a chance to review the cases before the cancellations and apparently had no input in the decision.

While a separate complaint last month said cancellations in the clinic were done "to make the numbers look good," the second complaint does not offer a motivation beyond saying, "The consults got looked at only as numbers to make the system look cleaner."

A hospital spokesman denied that the Young VA canceled large numbers of GI consultation referrals and said the inspector general, an arm of the VA that investigates alleged wrongdoing, has not notified the hospital of any such complaint.

"We are not aware, nor is there data to support the contention that a large number of gastroenterology consults were ever administratively closed or canceled," spokesman Jason Dangel said.

The Inspector General's office does not confirm such complaints unless and until it issues a report. But the Tampa Bay Times viewed a copy of the complaint and confirmed that it was sent to the Inspector General.

The VA Inspector General has reported this year the widespread use of so-called "gaming strategies" at agency facilities around the nation whose goal is to falsely improve performance standards that can then be used with other measures to determine executive bonuses.

Whistle-blowers have complained that the VA retaliates against them when they are discovered. The VA Inspector General allows complaints to be filed anonymously.

The complaint about the Young VA says, "The situation is bad because (the VA) administration takes it out on people who bring up problems."

Dr. Dominique A. Thuriere, the Young VA's chief of staff, became angered after learning about the cancellations of the GI clinic referrals, the complaint notes. The hospital said neither Thuriere nor other officials were available for interviews.

"She was pretty upset about it and called a meeting," the complaint states. "She was afraid for patient safety and cancers that could have been missed without knowing what was on the consults."

The complaint says a high-level medical administrator at the hospital made the decision to cancel the consultations and said that some other hospital leaders knew of the decision.

"We were told that once the mistake was discovered then all the consults got looked at and some patients were rescheduled," says the complaint, though it does not say how much time passed before this was done.

The complaint also states that the hospital's Health Administration Service, which handles scheduling matters, had not been doing a good job of scheduling patients. But the complaint says hospital leaders were not allowing HAS "to hire any clerk staff to do the work."

The department, the complaint says, "might have been down 40-50 positions if not more. It's a wonder that anything at all got scheduled with no people to do the work."

The document says, "We will take any help we can get here."

Dangel, the Young VA spokesman, said that during the last two years the highest number of GI consultation referrals pending more than 90 days was 34. In that time frame, he said, the average number of consultations pending more than 90 days was 16.

It was unclear why the hospital is providing those figures since neither complaint specifically refers to the cancelation of consultations or appointments older than 90 days. And the Times has not asked about consultations pending more than 90 days.

"We continuously monitor and review open consults to ensure care is rendered to our patients and that all open consults accurately reflect true work load," Dangel said. "As part of our standard consult review process, we work to ensure all veterans receive timely and clinically appropriate care and also ensure all open or unresolved consults are addressed."

In some cases, the Young VA said, an old consultation referral may still be active even though the patient's needs have already been addressed. In those cases, a consultation will be closed, Dangel said.

Dangel noted that the Young VA hospital and the agency "actively promote a culture of accountability, responsibility and transparency. An important part of this culture is active health care system policies that support open reporting without fear of retribution or retaliation."

He said all employees are encouraged to report their concerns through "various established mechanisms."

Contact William R. Levesque at levesque@tampabay.com or (813) 226-3432. Follow @WilliamRLevesqu.

Second complaint says Young VA canceled 1,000-plus consultation referrals 07/12/14 [Last modified: Saturday, July 12, 2014 9:28pm]

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