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Roseburg VA Death Panel Rejects Sick Veterans To Rig Performance Ratings


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I am shocked at what another SKP here sent me to post. If you think the VA is getting its collective excrement together and all in one bag it looks like The Roseburg Oregon VA didn't get the memo.

Here is an excerpt sent to the NY Times by the Physician group the VA there contracted for Emergency room staffing. The whole blog is after the excerpt on the bottom with a lot more shocking facts about what and why they are doing it. The letter excerpted is only about a third of the link.



" Whistleblower Letter From Roseburg VA To NY Times

The following is the letter from 5 Roseburg VA doctors to NY Times about the schemes at the facility. It is included in its entirety in italics below:

Mr. Dave Philipps,

U.S. House Representative Peter DeFazio contacted our group of emergency medicine physicians, Emerald Valley Emergency Physicians, and requested we speak with you about concerns regarding patient care at the RVAMC. Therefore, at his request, we write you this summary of matters that are of longstanding concern to our group of emergency medicine physicians. We are all partners and owners of a physician group that has a contract to supply physician coverage to the emergency department at the Roseburg VA Medical Center. The five partners are all Board Certified in Emergency Medicine and continue to additionally work in a busy tertiary care medical center that is a certified stroke, cardiac and trauma center. We also have 12 additional Emergency Medicine Board Certified physicians with vast clinical experience working with us to supply physician services. Five of us have worked at the RVAMC for 7 years.
Over the course of time, worsening over the past 2-3 years, we have seen a very concerning trend of patient care being seriously compromised by the decision making of senior administrative personnel at the RVAMC.

The limitations imposed on us and our ability to care for patients is very concerning. As experienced emergency medicine physicians, we understand the complexity of patient needs and have devoted our professional lives to providing the best possible care to our patients. The current processes are being forced onto us by administrative non-practicing physicians, nonphysician positions including nurses and non-clinically trained positions which includes the medical center Director. There has never been any effort to work with us to use our knowledge of emergency medicine patient care to improve care of the veterans. They make patient care decisions without speaking to the patient, without seeing the patient in the ED and without speaking with the physician caring for the patient.

The processes are unethical, unsafe and driven by a constant discussion about needing to comply with their misguided efforts to make the “SAIL” report better. Many times, we have been told that the Director demands these artificial processes be used so that certain metrics are met in order to try to increase the “star” rating of the facility. This has gone to such an extreme that there has been an “Exclusion List” created by all these leadership positions that is used to direct how we care for patients in the department. The exclusion list is not one created by nor agreed to by the Board-certified physicians working in the facility.
We have tried every manner possible within the VA system to address these concerns. We have personally met with these people in leadership roles to discuss our concerns. We have made it clear that we hope to be included in any processes that might discuss clinical care within the medical center so we could offer our experience to assist the VA. We are available at all times to meet with and discuss any clinical concerns. We have participated in formal investigative processes conducted by the VA.

We have attempted to develop processes to collaborate with leadership. Despite our efforts, we are not involved with nor consulted about clinical decision making. Often when we voice concern that a process is dangerous and not good for patient care, we are met with the response that “this is what the Director wants”. For many months the Chief of Staff, the Chief of Surgery, the medical center Director, the previous Chief of Medicine and a previously employed physician who is part of the “Bed Control Team” who all direct how we should be caring for patients in the ED have been unwilling to discuss these items with us. Of importance is that the RVAMC is a small facility and our group of emergency medicine physicians is by far the largest physician component there. Yet, we are completely excluded from all patient care discussions and our concerns are continually ignored.

Nowhere in a non-VA facility have we ever heard of this type of admission/care process being discussed, suggested as a standard of care, nor forced upon physicians. Physicians within our group hold many high level medical staff positions in a large tertiary care private hospital system and trained at highly respected training programs around the country giving us years of experience and context for our comments. We cannot express strongly enough how detrimental this process has been for patient care and how unacceptable it would be anywhere else. It is in our opinion a gross misuse of positions of power in a complex government hierarchy to allow those people to misrepresent the quality of care being provided to the veterans.

Reasons for this process being so adamantly defended by these few in power seem to be desire for promotion, financial compensation and protecting their current salaries and positions.

It has become evident that a driving force behind restrictive processes and compromised care in the RVAMC is an effort to meet a variety of metric measurements, one of which is the SAIL report. The manner in which these metrics are discussed and change is approached differs from any experience we have previously had in non-VA medical centers.

Although the metrics are purportedly to be used as a measurement of quality, unfortunately the all-consuming drive to make spreadsheets look better by senior leaders such as the Director Mr. Paxton , the Chief of Staff Dr. Ratnabali Ranjan, the Chief of Surgery Dr. Dinesh Ranjan, other physicians Dr. William Stellar and Dr. Bilal Chaudhry as well as RN staff Mr. Cowan and non-clinical staff Mr. Beiring has created a nepotistic cartel of power that completely prohibits sound clinical decision making by the emergency department staff and hospitalist physicians.

 Veterans are suffering. Unethical practices are being promoted. We have no recourse within the VA system to try to address these safety issues because every senior position above us refuses to consider perspectives other than their own. It has become clear that the senior positions starting at the Director level do not value the knowledge and experience of the committed, educated, experienced staff physicians and nurses.  

Our group has never before spoken with anyone outside of the VA system about our concerns because we had tried to maintain faith that given time, the process for improvement within the organization would correct these dangerous patient care problems. It has become evident that there is no functioning process within the VA system to improve care for these veterans and subsequently the health and safety of the veterans is compromised.

At this point we maintain some hope that speaking out publicly might be the last hope for veterans to get the quality and compassionate care they deserve. We feel we are placing our contract at risk by speaking to you at the request of Mr. DeFazio but at this point it is simply not possible for us to find any other means to address the malfeasance of the senior administrative positions in the RVAMC.

We would have liked to work collegially with the staff and administrators to correct the many issues of concern but there is unfortunately a very antagonistic, unprofessional, unethical and deceitful relationship fostered at the RVAMC.

We hope that by speaking with the New York Times some of these issues might finally be addressed to allow our group of dedicated physicians to provide the quality care that the United States Veterans deserve and were promised for their service to our country.

Thank you for your professional consideration of the information we present to you. To demonstrate how seriously we consider these issues, we are willing to allow these statements to be used by you “on the record” if necessary as well as any other comments in any possible follow up discussion with you that we explicitly discuss in that context.  

Dr. Christoffer Poulsen, President, Emerald Valley Emergency Physicians
Dr. Charlotte Ransom, Secretary/Treasurer, Emerald Valley Emergency Physicians
Dr. Bradley Anderson, Partner, Emerald Valley Emergency Physicians
Dr. Michael Day, Partner, Emerald Valley Emergency Physicians
Dr. Ann Cooley, Partner, Emerald Valley Emergency Physicians

See: Original Letter To NY Times

Source: https://www.nytimes.com/2018/01/01/us/a ... s-say.html "

The whole source article with much more is here:


Edited by RV_
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