Outside panel reviewing psychiatrist’s practices

Opioids are focus of examination

A panel of outside experts has already begun its review of the opioid prescribing practices of a physician at the Clement J. Zablocki Veterans Affairs Medical Center.

The panel could deliver its recommendations as soon as the end of next month, said Jon Lehrmann, associate chief of staff for mental health at the Zablocki VA.

“My sense is, this person has saved lives,” Lehrmann said in an interview this week.

On Tuesday, the VA inspector general released a report that reviewed the Zablocki VA’s opioid prescribing practices. The investigation took place from January 2015 through March 2016, with updated information provided last fall.

Investigators said they “substantiated that a provider prescribed opioid medications for some patients in a manner that varied from clinical guidelines and other providers at the facility.”

The psychiatrist has not been named publicly and is still on staff. His work has already been reviewed internally, Lehrmann said, and he was confident in the provider’s work.

Lehrmann said the psychiatrist treats “a very complex” group of patients.

“The IG found that at times this provider is treating outside the guidelines,” Lehrmann said. “But when you’re dealing with challenging, complex patients, at times you prescribe outside the guidelines.”

The inspector general report also found that “facility managers did not track patients prescribed Suboxone as part of their monitoring of opioid prescribing.” Suboxone is used to treat patients addicted to opioids.

Lehrmann said he welcomed the report.

“I see this as a helpful assessment that gives us guidance to continue to improve the quality of the care that we provide at the VA,” he said.

He said it was important to review the prescribing of opiates across the country.

“With the current opiate epidemic nationally, we need to reassess how we’re treating pain and addressing addiction, not just in the VA system but across all health care in our country,” said Lehrmann, chairman of the Department of Psychiatry and Behavioral Science at the Medical College of Wisconsin.

He said the report reinforced practices that were already underway at Zablocki VA, including use of the state prescription monitoring system to cut down on “doctor shopping” by patients seeking medications from more than one health care provider.

He said the facility is also using “inter-professional care teams addressing addiction.”

Asked what patients and their family members should take away from the report, Lehrmann said: “We’re taking it serious. We’re working hard on this issue every day.”