VA Hospitals Often Lax in Checking Doctors’ Backgrounds, Report Says

Veterans Administration hospitals are often lax in screening doctors to make sure they have no felony convictions and hold required licenses, according to a federal study that examined hiring procedures at VA hospitals in Sepulveda, San Diego and six other cities.

The General Accounting Office report found that at the eight Department of Veterans’ Affairs hospitals reviewed, fewer than half of the physicians hired between 1986 and 1988 had their licenses properly verified with state medical boards.

But the report did not specify which medical centers had problems, and it cited no inadequacies at Sepulveda, San Diego or any of the other individual institutions.

Reviews Called Satisfactory

Officials at the Sepulveda hospital said that the GAO found no problems there and that two recent reviews gave the hospital satisfactory marks.

“There was nothing of any substance,” Rocco Bellantoni, assistant to the hospital’s director, said of the GAO review. “We were very comfortable (with the findings) when they left.”

An administrative assistant at the San Diego hospital said late Wednesday that other hospital officials could not be reached for comment on the study.

The report did not provide any examples of inadequately credentialed doctors making mistakes, but it said the potential for problems exists.

For example, background checks on residents were so lax that some were found to have been convicted of selling and using drugs, burglary and sex offenses. The report did not identify the physicians involved.

“By not following procedures, VA medical centers could unknowingly hire ‘problem’ physicians and/or be allowing physicians with sanctions against their licenses to treat veterans,” the report said.

Sen. Frank H. Murkowski (R-Alaska), ranking member of the Senate’s Veterans Affairs Committee and the lawmaker who requested the report, was more alarmed.

“This report contains some extremely troubling results,” Murkowski said. “It is VA’s obligation to ensure that all VA physicians are qualified to treat veterans. The integrity of the medical care system is built on trust, and VA must improve their programs so that veterans will know that their doctors are competent.”

While the report cited no specific problems at Sepulveda, a 685-bed hospital, or San Diego, a 701-bed hospital, they were among eight randomly selected medical centers included in the study. At those eight institutions, the GAO found that:

--State licenses were not being consistently verified with authorities.

--Proper background checks were not made of resident physicians.

--The ability of staff doctors to perform specified procedures was not adequately reviewed or documented.

--The responsibilities of deficient doctors were not formally reduced.

--The names of incompetent doctors were not turned over to state licensing boards soon enough, if at all.

“The conditions cited do not mean that the medical services provided by VA are substandard or that VA physicians are incompetent,” the report said. “It does mean, however, that the VA cannot assure the public or the veterans it serves that its physicians are appropriately privileged.”

The report said the VA’s procedures are adequate, if followed. But it said the agency’s procedures could be improved, and it recommended that Congress approve more stringent standards.

The VA’s physician application form, for example, does not ask about drug or alcohol problems, even though most actions against a physician’s license are drug- or alcohol-related, the study said.

Most public and private hospitals routinely require that doctors applying for credentials turn over detailed information about education, licensing, experience, insurance and criminal convictions, hospital officials say. In many cases, hospitals require written proof, and they attempt independently to verify the information with state licensing authorities.

The study noted that the VA agreed in principle with all the recommendations except the proposed congressional legislation, which would require that doctors not only meet clinical standards but also subject them to disciplinary actions for substance abuse, unprofessional conduct, felony convictions and any conduct “that places the safety of patients at risk.”