This report from the Government Accountability Office (GAO) came out on Monday, http://www.gao.gov/products/GAO-18-63. It has gotten some considerable press already. Frankly, I am appalled. For over 20 years there have been Federal laws requiring that certain conduct of or events related to doctors and other healthcare providers be reported to the National Practitioner Data Bank (NPDB). The rationale for the NPDB was that hospitals, licensing agencies and other entities could avoid hiring or granting privileges to problematic providers. Bad actors could be prevented from just moving on and causing more harm elsewhere.
As a medical malpractice defense lawyer for over 30 I was well versed in the implications of data bank reporting, especially as most settlement payments triggered a report. It sometimes made it difficult to settle cases that should have been settled. Doctors understandably did not want such information on their records, but it was the law and it was just something we had to deal with. Apparently, the VA operates differently. The GAO sampled five medical centers. In these five institutions there were 148 providers whose conduct required review. The VA was unable to provide any documentation of even having done a review in half the cases. There was just no record. The GAO found that VA officials did not make NPDB reports for 8 of the 9 doctors who should have been reported. The report noted that officials at the selected VAMC’s “misinterpreted or were not aware” even of the VA’s own policies relating to such reporting.
While this study addressed only five facilities there is no reason not to think the problem is system wide.
Personally, I am no longer a defense lawyer and I now represent veterans and military families nationwide. The VA’s inconsistent quality is well known to me and others at my firm. Still, I am sadly surprised to see that the culture of the VA seems to be that the rules applied to everyone else do not apply to it. One has to conclude that compliance with such rules is simply not a priority for this agency. The risks for veterans and, indeed, the general public are quite real if dangerous doctors are not identified and prevented from doing further harm.