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News

Last 50 News Postings

 (Click on title to be directed to posting, most recent listed first)

CEO Compensation-One Reason Healthcare Costs So Much
Doctor or Money Shortage in California?
FDA Commissioner Gottlieb Resigns
Physicians Generate an Average $2.4 Million a Year Per Hospital
Drug Prices Continue to Rise
New Center for Physician Rights
CMS Decreases Clinic Visit Payments to Hospital-Employed Physicians
   and Expands Decreases in Drug Payments 340B Cuts
Big Pharma Gives Millions to Congress
Gilbert Hospital and Florence Hospital at Anthem Closed
CMS’ Star Ratings Miscalculated
VA Announces Aggressive New Approach to Produce Rapid Improvements
   in VA Medical Centers
Healthcare Payments Under the Budget Deal: Mostly Good News
   for Physicians
Hospitals Plan to Start Their Own Generic Drug Company
Flu Season and Trehalose
MedPAC Votes to Scrap MIPS
CMS Announces New Payment Model
Varenicline (Chantix®) Associated with Increased Cardiovascular Events
Tax Cuts Could Threaten Physicians
Trump Nominates Former Pharmaceutical Executive as HHS Secretary
Arizona Averages Over 25 Opioid Overdoses Per Day
Maryvale Hospital to Close
California Enacts Drug Pricing Transparency Bill
Senate Health Bill Lacks 50 Votes Needed to Proceed
Medi-Cal Blamed for Poor Care in Lawsuit
Senate Republican Leadership Releases Revised ACA Repeal and Replace Bill
Mortality Rate Will Likely Increase Under Senate Healthcare Bill
University of Arizona-Phoenix Receives Full Accreditation
Limited Choice of Obamacare Insurers in Some Parts of the Southwest
Gottlieb, the FDA and Dumbing Down Medicine
Salary Surveys Report Declines in Pulmonologist, Allergist and Nurse 
   Incomes
CDC Releases Ventilator-Associated Events Criteria
Medicare Bundled Payment Initiative Did Not Reduce COPD Readmissions
Younger Smokers Continue to Smoke as Adults: Implications for Raising the
   Smoking Age to 21
Most Drug Overdose Deaths from Nonprescription Opioids
Lawsuits Allege Price Fixing by Generic Drug Makers
Knox Named Phoenix Associate Dean of Faculty Affairs
Rating the VA Hospitals
Garcia Resigns as Arizona University VP
Combination Influenza Therapy with Clarithromycin-Naproxen-Oseltamivir
   Superior to Oseltamivir Alone
VAP Rates Unchanged
ABIM Overhauling MOC
Substitution of Assistants for Nurses Increases Mortality, Decreases Quality
CMS Releases Data on Drug Spending
Trump Proposes Initial Healthcare Agenda
Election Results of Southwest Ballot Measures Affecting Healthcare
Southwest Ballot Measures Affecting Healthcare
ACGME Proposes Dropping the 16 Hour Resident Shift Limit
Non-Small Cell Lung Cancer: RT Out, Pembrolizumab In, and Vaccine
   Hope or Hype

 

For an excel file with complete news listings click here.

A report from Heartwire described a letter written by Peter Wilmshurst to the AHA asking for full disclosure of conflicts of interest in the MIST trial. Wilmshurst was portrayed in SWJPCC on April 27, 2012 in our Profiles of Medical Courage series. We felt the report of the letter might be of interest to the readership of SWJPCC but there was no good section to pass along the Heartwire article. For this reason, a new Section entitled “News” has been started to report developments outside the usual medical journal purview or from other sources which might interest our readers. We encourage bringing news-worthy articles to our attention and would welcome submission of written reports of such articles.

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Entries in Office of Inspector General (2)

Wednesday
Aug272014

VA Office of Inspector General Releases Scathing Report of Phoenix VA

The long-awaited Office of Inspector General’s (OIG) report on the Phoenix VA Health Care System (PVAHCS) was released on August 27, 2014 (1). The report was scathing in its evaluation of VA practices and leadership. Five questions were investigated:

  1. Were there clinically significant delays in care?
  2. Did PVAHCS omit the names of veterans waiting for care from its Electronic Wait List (EWL)?
  3. Were PVAHCS personnel not following established scheduling procedures?
  4. Did the PVAHCS culture emphasize goals at the expense of patient care?
  5. Are scheduling deficiencies systemic throughout the VA?

In each case, the OIG found that the allegations were true. Despite initial denials, the OIG report showed that former PVAHCS director Sharon Helman, associate director Lance Robinson, hospital administration director Brad Curry, chief of staff Darren Deering and other senior executives were aware of delays in care and unofficial wait lists.

Perhaps most disturbing is the OIG finding that scheduling deficiencies are systemic throughout the VA. The OIG is currently investigating 90 VA facilities. The findings prompted Rep. Jeff Miller, House Veterans’ Affairs Committee chairman to comment “We have seen no evidence that the corrupt bureaucrats who created the VA scandal will be purged from the department’s payroll anytime soon. Until that happens, VA will never be fixed,” (2).

Though whistleblowers alleged veterans died while awaiting care in Phoenix, acting Inspector General Richard Griffin did not draw any conclusions about criminal culpability and declared that he was “unable to conclusively assert that the absence of timely quality care caused the deaths of these veterans.” Phoenix whistleblowers Drs. Sam Foote and Katherine Mitchell, said the OIG standard made no sense because 45 examples described in the OIG report showed that delayed care likely resulted in premature deaths or harm to patients’ quality of life. It is the later standard that is usually applied to physicians.

The day prior to the release of the report the Deputy VA Secretary Sloan Gibson was interviewed noting that more veterans are being sent to private doctors for care reducing waiting times (3). "The fundamental point here is, we are taking bold and decisive action to fix these problems because it's unacceptable," said Gibson. It is unclear whether these reports of improved waiting times are any more reliable than the initial denials of prolonged patient waiting times from both the Phoenix VA and VA Central Office.

Richard A. Robbins, MD

Editor

Southwest Journal of Pulmonary and Critical Care

References

  1. Office of VA Inspector General. Review of alleged patient deaths, patient wait times, and scheduling practices at the Phoenix VA health care system. Available at: http://www.va.gov/oig/pubs/VAOIG-14-02603-267.pdf (accessed 8/26/14).
  2. Wagner D, Lee M. Scathing VA report stirs outcry for accountability. Arizona Republic. Available at: http://www.azcentral.com/story/news/arizona/investigations/2014/08/26/scathing-va-report-stirs-outcry-accountability/14665455/ (accessed 8/27/14).
  3. Associated Press. Watchdog report details ‘systemic’ problems at VA facilities. Available at: http://www.foxnews.com/politics/2014/08/26/no-proof-delays-in-care-caused-vets-to-die-va-says/ (accessed 8/25/14). 

Reference as: Robbins RA. VA office of inspector general releases scathing report of Phoenix VA. Southwest J Pulm Crit Care. 2014;9(2):140-1. doi: http://dx.doi.org/10.13175/swjpcc112-14 PDF

Friday
Mar292013

In Aftermath of Financial Investigation Phoenix VA Employee Demoted after Her Testimony

A previous Southwest Journal of Pulmonary and Critical Care Journal editorial commented on fiscal mismanagement at the Department of Veterans Affairs (VA) Medical Center in Phoenix (1). Now Paula Pedene, the former Phoenix VA public affairs officer, claims she was demoted for testimony she gave to the VA Inspector General’s Office (OIG) regarding that investigation (2). In 2011, the OIG investigated the Phoenix VA for excess spending on private care of patients (3). The report blamed systemic failures for controls so weak that $56 million in medical fees were paid during 2010 without adequate review. The report particularly focused on one clinician assigned by the Chief of Staff to review hundreds of requests per week and the intensive care unit physicians for transferring patients to chronic ventilator units (1,3). After the investigation, the director and one of the associate directors left the VA and the chief of staff was promoted to chief medical officer in one of the VA’s networks. The other associate director was appointed as director of another VA medical center in 2010 before the investigation.

According to the Arizona Republic, Pedene was interviewed in May 2011 by the OIG to probe the misspending along with allegations of sexual harassment and a hostile workplace (2). Pedene testified that the Phoenix VA suffered from “leadership run amok” (2). She said that agency bosses intimidated employees and that then-Director Gabriel Perez threatened her with banishment to a basement workspace, making it clear he did not want a woman — or someone with a service-connected disability — as the VA’s public-affairs officer. The OIG report makes no mention of intimidation, sexual harassment or a hostile workplace in their report (3).

Pedene, the Veterans Day Parade coordinator since 1997, was accused of having her husband take photographs of the Veterans Day Parade. Pedene, who is blind, then allowed her husband to upload the photos onto the VA website using her password (2). Pedene’s legal advisers and VA records indicate the dispute stems from a larger controversy involving years of mismanagement, squandered funds, discrimination, sexual harassment and retaliation at the Phoenix VA. Pedene was notified of her transfer in a Dec. 10 letter from Associate Director Lance Robinson. He wrote that she was the subject of a “very serious” allegation, and he issued a gag order prohibiting public disclosures.  

Former Maricopa County Attorney Rick Romley, who chairs the parade-sponsoring Veterans Commemorative Committee of Phoenix, said he authorized Pedene to hire her husband as a photographer and cannot understand VA administrators’ response to a seemingly minor transgression  (2). “Quite frankly, this is peanuts in the security world,” said Romley, who in 2006 served as special security adviser to the secretary of Veterans Affairs in Washington (2).

Pedene had been called as a witness in the case. The investigation was initiated after complaints by employee Sheila Cain, who in 2010 was assistant chief of the Phoenix VA’s Health Administration Services. Cain had sought to repair problems with the Phoenix VA’s budget and fee-payment systems. According to VA reports, her efforts led to infighting over blame and responsibility. Cain filed a series of grievances alleging that she was subjected to false accusations, denied due process, stripped of authority and isolated in a basement workspace for six months. Cain endured sexual remarks, threats, improper touching, public humiliation and other abuse more than 30 times. In one instance, she alleged that Dr. Christopher Bacorn, then Phoenix VA Associate Director, hit her rear end with a spatula in front of a fellow employee (2).

Documents obtained independently by the Arizona Republic show Cain also was victimized by unlawful access to her medical records (2). An investigation of that patient-confidentiality breach resulted in the discipline of at least nine employees of the health system, some of whom left the VA. Cain remains with the VA but not under the supervision of Phoenix administrators. In the meantime, Pedene became a target of similar treatment under new bosses. Her reassignment to the hospital library, initially set at 30 days, is in its third month.

Employee-relations consultant, Roger French, who at one time represented Pedene and has represented about 40 VA employees in grievances, said he has seen a pattern of abuse, discrimination and retaliation in the Phoenix VA (2). He said Pedene was criticized for her blindness, and administrators dismantled a public-relations program once considered among the nation’s best. Recently, he added, Pedene’s name was redacted from the VA’s online employee directory, and her awards were removed from a display case at the Phoenix VA. “She stood up and told the truth,” French said. “It cost (administrators) their jobs, and they threatened to destroy adversaries and families.”

French has asked Department of Veterans Affairs Secretary Eric Shinseki to launch a new inquiry. French’s Feb. 12 letter accuses the present Phoenix VA administration of nepotism, retaliation and improper downgrading of evaluations. “I have never seen the hostility, cavalier violations of regulations and laws (or) lack of dignity and respect for employees,” French wrote to Shinseki. Shinseki did not respond, French said.

Unfortunately, if Shinseki does act, it will likely be through another investigation by the OIG which inadequately investigated the previous allegations of mismanagement (1). Instead of focusing on the administrators responsible for budget control, the OIG attempted to place the blame on clinicians acting in the best interests of the patients (1). Furthermore, if the Arizona Republic report is correct, the OIG ignored accusations of sexual harassment and a hostile workplace made at the time of their original investigation. If French’s accusations regarding the present Phoenix VA administration are true, a whitewashing with resignation of some and promotion of other present Phoenix VA administrators is likely to result, as it did in the original investigation (1).

Richard A. Robbins, MD*

References

  1. Robbins RA. Mismanagement at the VA: where's the problem? Southwest J Pulm Crit Care 2011;3:151-3.
  2. Wagner D. VA official in Arizona demoted after her testimony. Arizona Republic. Available at http://www.azcentral.com/news/arizona/articles/20130314va-official-arizona-pedene-demoted-after-testimony.html accessed 3/29/13.
  3. http://www.va.gov/oig/pubs/VAOIG-11-02280-23.pdf (accessed 3/29/13).

 

*Dr. Robbins was the Chief of Pulmonary and Critical Care at the Phoenix VA from 2003-11.

Reference as: Robbins RA. In aftermath of financial investigation Phoenix VA employee demoted after her testimony. Southwest J Pulm Crit Care. 2013;6(3):151-3. PDF