PROFESSIONAL ISSUES

VA audit: Part-time doctors often absent

The VA inspector general says work-hour rules are being abused. Doctors say the report distorts reality.

By Myrle Croasdale, AMNews staff. June 23, 2003.

In a damning report on the Dept. of Veteran Affairs Health Administration and the physicians who work for it part time, VA Inspector General Richard Griffin detailed during a recent hearing before the House Veteran's Affairs Committee a health care system fraught with abuse.

Early this May, Griffin told the committee that the VHA was more likely to set part-time physician hours to meet the financial needs of affiliate universities so they could meet physician pay objectives rather than by the number of hours needed by the VHA to meet patient workloads.

For example, in Griffin's report, one surgeon was found to have worked three hours over a given period of time, while being paid for 250 hours. Another performed five surgeries and saw 13 patients for a total of 23 hours, but got paid for 127.5 hours.

The inspector general's findings paint a picture of physicians taking advantage of the VHA with the tacit approval of VHA medical center managers. But VHA managers, physicians and even the inspector general's investigators say the picture the report paints is incomplete.

To begin with, said Tom Hogan, director of the VHA management support office, the VHA's timekeeping rules were so out of line with the way doctors actually schedule their work, everyone assumed that there was no need to follow them.

"It was more a systemic failure than a matter of duplicity on our part," Hogan said.

Hogan concedes that lack of regard for the rules was carried too far. Physicians with part-time VHA appointments of 20 hours a week must spend five hours at the hospital.

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