Doctor: Austin VA delayed tests
Potentially life-threatening delays driven by bonus system, lack of resources, retired doctor says.
A push tomeet national performance measures masked potentially deadly delays in cancer and other screenings for veterans seeking care at the Department of Veterans Affairs’ Austin Outpatient Clinic, a recently retired VA doctor revealed exclusively to the American-Statesman on Wednesday.
Dr. Joseph L. Spann, who retired in January after 17 years at the Austin clinic, said that the chief of radiology at the VA’s Olin Teague Veterans’ Medical Center in Temple regularly asked physicians to change their requested date for ultrasounds, MRIs and CT scans to hide the existence of long backlogs for tests that are required before life-saving treatment can begin.
VA officials didn’t respond to a request for comment.
The revelation is the latest in a string of claims of wait time data manipulation that has rocked VA facilities in Texas and across the nation. Embattled VA Secretary Eric Shinseki, who has resisted calls from several Texas lawmakers and the American Legion to resign, is scheduled to testify about the growing scandal at a U.S. Senate committee hearing Thursday morning.
Spann said the Austin screening delays were potentially life-threatening.
“I cannot categorically say that I ever saw a patient die from such manipulated scheduling, but I did see several cancer patients have their possible surgery or chemotherapy treatments delayed awaiting the required radiology tests,” Spann wrote in a letter to the VA’s Office of Inspector General, which is investigating data manipulation claims in San Antonio.
Spann said Austin doctors frequently complained to supervisors and administrators about the delays in radiological procedures, “but nothing was ever done about it.”
A recently retired VA doctor in Phoenix has alleged that more than 40 patients there died while awaiting VA appointments that were concealed by a secret waiting list.
According to U.S. Sen. John Cornyn, at least one Austin veteran has died while awaiting chemotherapy for laryngeal cancer. A surgeon who contracted for the VA told Cornyn, R-Texas, that, two months after advising the VA to start chemotherapy, he followed up on the case, only to learn the VA never provid- ed the treatment, according to information provided by Cornyn’s office. The veteran died several days later.
“We still don’t know exactly how many veterans have died or otherwise suffered because of the VA’s assorted failures and abuses, but we do know that it’s disgraceful and unacceptable for even one veteran to needlessly die or suffer because of bureaucratic malfeasance,” Cornyn said Wednesday on the Senate floor.
Spann said the requests to manipulate appointment dates would increase depending on the backlog of radiological tests. “The primary care doctors at the Austin VA clinic would try to be ‘team players’ in the optimistic hope that we were creating open slots in the radiology schedule for our patients,” he wrote. “Even so, many times patients would have to wait weeks before their URGENT radiology procedure could be done.”
Spann said the VA’s data manipulation hid shortages of physicians and patient caseloads that far exceeded the VA’s goal of 1,200 patients per primary care doctor. He said the Austin clinic is in need of two or three additional primary care doctors.
“By continuing to overload the primary care providers the Temple supervisors and administrators could produce numbers that would show tremendous productivity,” Spann wrote. “Also, by not requesting additional primary care providers, the supervisors could demonstrate financial frugality, something the regional and national VA leaders reward.”
Spann said the focus on performance targets over care took a toll on his fellow physicians. “I have a lot of friends over there who are working their tails off,” Spann said in an interview. “I retired early because I couldn’t stand the deceit. ... The incentive system, the bonuses, doing more with less got out of hand.”
He said the delays were ameliorated somewhat when the new Austin clinic opened last year with additional testing equipment, but lags persist.
The doctor also backed up allegations made last week to the American-Statesman by VA scheduling clerk Brian Turner, who said he and other clerks in Waco, Austin and San Antonio were told to manipulate appointment data to mask long wait times.
Central Texas VA officials have admitted improper scheduling practices, but they told the American-Statesman last week that it was a “training issue” that top executives weren’t aware of until recently. Officials say a series of training sessions has been held for scheduling clerks in hopes of ending the practice.
But Spann said he had no doubt the orders came from above, writing: “The Central Texas VA Healthcare System has fostered a culture of deceit and manipulation in data in order to achieve performance measures that promote only the careers and pay of its administrators and supervisors.”