VA investigators say there's no evidence of poor care, but say morale problems on the staff could put patients at risk.
By PAUL DE LA GARZA
Published March 12, 2004
ST. PETERSBURG - A Veterans Affairs investigation of Bay Pines VA Medical Center has concluded that morale among hospital doctors is so low it is jeopardizing the quality of care.
The investigation focused on Dr. Pramod K. Mohanty, who was forced to step down as chief of staff Wednesday as part of a management shakeup at Bay Pines.
Doctors had said Mohanty's conduct, including his failure to fill critical staff positions, endangered the lives of veterans.
"While allegations about the quality of care suffering do not appear to be supported, the current morale and state of the medical staff place the quality of care at risk," said a 13-page executive summary released by the office of VA Secretary Anthony Principi.
The hospital is the target of multiple federal inquiries looking into allegations of mismanagement and a flawed $472-million pilot computer system.
The findings released Thursday night marked the first assessment of Bay Pines by VA investigators.
"Although the Review Team could not find evidence supporting the allegations that the quality of care had suffered in the last three years - in fact the quality of care with cardiac disease and with primary care access appear much improved - it was clear that the medical staff is in crisis," said the report, parts of which were blacked out for privacy.
Investigators noted that doctors were "deeply divided into groups supporting or opposing (name deleted). A number of individuals from both groups expressed fear of retaliation from the other group."
Investigators attributed the problem to "changes, fluctuations, and absence of key service chiefs."
Investigators also said they heard several complaints from doctors in the cardiology, neurology and pulmonary departments who had either been replaced or felt threatened with replacement.
"This has been perceived by a number of individuals as an unfair personnel action, though wage, grade, step, and pay have not been changed. These do not constitute adverse personnel actions," the report said.
The report said lack of communication by management, coupled with actions perceived as hostile, "has resulted in an atmosphere described as demoralizing, divisive, and personally destructive."
"Allegations about threatening or disparaging comments as well as other behaviors by (name deleted) were confirmed in interviews."
To resolve the problems at the hospital, investigators recommended bringing in an independent consultant with expertise in medical staff development.
They also suggested regular staff meetings and an end to "public display" of disparaging comments.
The investigation was ordered by Dr. Elwood J. Headley, director of the VA hospital network in Florida, southern Georgia, Puerto Rico and the U.S. Virgin Islands, in response to articles published in December in the St. Petersburg Times.
Doctors have questioned the thoroughness of the review because of its speed and because Headley, who they say ignored repeated complaints about Mohanty, selected the investigative team. Investigators were at Bay Pines for three days in late January.
In a recent interview, Headley defended the investigation. He said he was offended at suggestions by critics that he would try to manipulate the outcome of the investigation.