Hampton, VAWhile it smacks of VA hospital malpractice, a VA hospital in Virginia has been largely cleared by federal investigators of wrongdoing. Specifically, according to the October 12th issue of the Virginian-Pilot, allegations had surfaced that doctors had been coerced into overprescribing powerful narcotics to veterans.
However, it appears that questions remain.
According to the Virginian-Pilot, the investigation was prompted following the firing this past March of a doctor who was let go just prior to the end of her two-year probationary period at the Hampton VA Medical Center, allegedly for "poor interpersonal communication skills," according to the text of a written report by the inspector general's office of the US Department of Veteran's Affairs.
However, Dr. Pamela Gray alleges that her termination stemmed from her complaints about pressure to write prescriptions for narcotics she deemed as unnecessary.
The investigator's report cleared the hospital of any wrongdoing based—it seems—on the fact that the majority of doctors interviewed indicated they were not unduly pressured to prescribe narcotics to patients who did not need them (a suggestion of veterans medical malpractice).
However, a minority of doctors took an opposing view. Specifically, four of the 15 doctors interviewed admitted to investigators that they were pressured to write prescriptions that were not necessary.
"After extensive interviews with all stakeholders," the investigators wrote, "it is clear that among some...providers there is a perception of pressure to write narcotic prescriptions and a fear of retaliation if they fail to do so."
It should be noted that most complaints in general come from VA patients with chronic conditions who request pain medications that are refused.
It was not clear in the investigator's report just who was responsible for the alleged coercion. Patients with chronic pain conditions will often ask for pain meds a doctor feels is not necessary. However, it was not clear if the hospital was pressuring the doctors to prescribe the narcotics, or if that pressure was coming from the patients themselves.
It was revealed that one doctor and several staff members at the facility had been threatened by patients.
Dr. Gray also alleged that the hospital had improperly altered patient records to cover up the improper prescribing of narcotics. However, investigators did not find that to be the case, nor did they find any evidence of narcotics diverted from the hospital for resale—which would be illegal.
Still, the investigators found that of 16 doctors who left the center's employ from December 2008 through March of this year, three had "documented concerns with prescribing narcotics for patients with chronic pain issues."
VA hospital malpractice is always a serious allegation which, when litigated as necessary, will involve VA medical malpractice lawyers skilled and knowledgeable in the discipline of malpractice law. Any urging or coercion of a doctor to prescribe a narcotic to a VA patient beyond the realms of good medical practice could be interpreted as veteran medical malpractice.
In a statement released October 12th, Deanne Seekins, director of the facility, said, "After a thorough investigation, the [investigators have] concluded that there was no evidence that physicians were threatened by administrators to write inappropriate narcotic prescriptions.
"It is important to understand that as a licensed, independent practitioner, each physician makes the clinical decision of prescribing any medication, as the report states. The Hampton administrative staff has no authority over clinical decisions made by physicians."
Gray, however, continues to believe that "providers are coerced to write prescriptions for narcotics that they know to be improper or excessive. If you don't go along with it, you have two options: Quit or be fired." In either scenario, VA hospital malpractice is always a possibility.
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