An article in today’s Cleveland (Ohio) Plain Dealer charges that a Salisbury VA doctor did not meet his part-time schedule at the Hefner VA Medical Center and got paid for time he was not there, including time he was supposed to consult with other doctors and residents.
Co-workers, the article says, complained for three years before the doctor was ordered to reimburse the VA.
The charges against the Salisbury doctor, who was not named, are listed in an article in the Cleveland paper charging that full-time doctors paid up to $140,000 a year at Veterans Affairs hospitals sometimes are working in private practices while they should be on VA duty.
Nancy Martino, spokesman for the Hefner VA Medical Center, disputed the Plain Dealer’s claim that the local doctor, an oncologist, was ordered to reimburse the VA.
The report, she said, is inaccurate.
“No improper behavior was found,” she said,“He was not ordered to reimburse the VA.”
The doctor, an oncologist, whose name she cannot give because of privacy laws, retired at least six months ago, she said, “because the investigation had been such a long and ongoing thing, and he had not done anything wrong. He just got tired of it.”
Martino said the inspector general’s office, which investigates improper behavior, looked into the issue.
The Plain Dealer series and a subsequent Associated Press story pointed out that at a time when the Department of Veterans Affairs has asked for more money, a full-time VA doctor is not expected to be at the veterans hospital 40 hours. Instead, a full-time surgeon, for example, is expected to operate on patients about 15 hours a week.
The rest of the time can be used for teaching, doing research or other activities unconnected with VA work, the Plain Dealer said in the second part of the series.
Some VA doctors have abused flexible hours, the AP reported, citing the Salisbury doctor as well as Boston neurologists who were spotted by FBI agents golfing or seeing private patients while being paid to be at the VA.
In Cleveland, the chief of surgery was operating on private patients when scheduled to be at the veterans hospital, according to the newspaper, which said the VA investigation is unresolved.
None of the doctors was identified.
While some staff doctors abused flexible schedules, doctors in training, including surgeons, sometimes practice at VA hospitals while “supervised” by phone by staff doctors at work elsewhere.
VA officials responding to questions from the Plain Dealer defended their three-tier supervision system: staff doctors directly working with doctor/residents in training, watching residents side-by-side, or consulting with residents by telephone.
“A resident physician is legally and legitimately authorized to provide health care services under the appropriate supervision of faculty members,” said Gloria Holland, special assistant to the VA’s chief academic affiliations officer.
Dr. Kenneth Kizer, former undersecretary for health at the VA, called the practice of supervising residents by phone “a sore point” during his five years as head of the VA health care system.
Kizer said he also had been concerned about salaried physicians not working their time and leaving residents unattended.
A VA committee in 1999 drafted a proposal that would have made telephone supervision “relatively rare and involve the participation of only the most senior residents.”
The reason was to “make sure that ... veterans were getting as carefully supervised care as the patients across the street at the university hospital,” said Dr. David Stephens, at the time the VA’s chief academic affiliations officer.
Residents get training at 130 of the 172 veterans hospitals. They often rate their VA experience as more valuable than stints at other teaching hospitals because of the autonomy they have.
Martino said hospital officials here knew the Plain Dealer was doing a story on the VA, but doesn’t remember the newspaper targeting any local doctors.
A total of 52 doctors, including three surgeons, work at the local VA Medical Center. The others are in internal medicine with some sub-specialties. They are all required to work 40 hours a week.
The medical center has extensive regulations about moonlighting, Martino said. The professional staff has the right to moonlight, provided it is not done on VA time.
She’s personally not aware of any doctors who moonlight.
“I don’t see how they’d have the time because they’re on duty every day,” she said.
The average salary range at this medical center, she added, is $120,000 a year.
Martino says she knew a woman “was working on this article, and I expected it to be negative.”
She said she would invite the Post to “write a subsequent story that will cite the positive stories written about the VA recently.” She believes there have been about three or four national stories, most having to do with quality care.
She says she can only guess about what prompted the Plain Dealer to do such a series, but that guess would be that “the VA is fair game. They can always sell newspapers when they write about the VA.”
The AP story, she added, “sounds like something you’d read in the supermarket tabloids.”
And, she added, “nobody gave us a heads-up that this was coming out about Salisbury. At least they didn’t tell me about it.”
Today's News