Veterans Administration hospitals across the country have until September 20 to explain to VA officials in Washington why 87 doctors with licenses that have been revoked, suspended or restricted are still working for the hospitals.
The names of 87 full-time and part-time consulting, attending and resident physicians working for the agency surfaced in a screen- ing of 46,000 VA doctors conducted by the American Medical Association.
There may be other VA doctors with licensing problems who were not detected by this screening. The physicians' names were checked against a national list of doctors with licenses that have been revoked, suspended or restricted. However, state medical boards have not been diligent about re- porting their cases to the national clearinghouse at the Federation of State Medical Boards, according to federation records. In addition, several studies have shown that many incompetent or unethical doctors are able to escape the disciplinary process.
An auditing team within the VA's inspector general's office has referred the 87 cases to a newly formed credentials committee, according to Donna St. John, a VA spokeswoman. The committee is attempting to correct a longstanding problem of doctors working for the agency even though they have had their licenses revoked, suspended or restricted by state or other federal agencies.
"The committee is sending out information to individual medical centers, asking facilities to review their information and interview the doctors," said St. John.
"We are expecting more cases to come up" after a screening of 38,000 more doctors who work occasionally for the VA, St. John said. Those doctors are paid for office services given to veterans.
An initial screening of 17,000 full- and part-time doctors who worked for the VA in 1983-84 raised serious questions about 49 doctors, according to the AMA, which matched the doctors' names against disciplinary actions collected by the National Federation of State Medical Boards.
A total of 84,000 doctors are to be screened, St. John said. The VA, which operates the nation's largest health-care system, originally said 94,000 doctors' names would be checked, but later corrected earlier estimates.
The screening is part of an effort by the VA to improve the quality of its doctors and its disciplinary system. The agency is considering a new policy of reporting its disci- plinary actions to outside medi- cal-discipline networks, such as those maintained by the Federation of State Medical Boards and the AMA.
The VA's central office also has asked its hospitals nationwide to review the licenses of doctors affiliated with each facility, St. John said. Those reports are due to be sent to Washington by the end of this month.
The reports, along with those involving the 87 doctors, will be given to the credentials committee, which will recommend action on each case to Robert E. Lindsey, the agency's director of operations. Lindsey will pass the recommendations on to Dr. John Ditzler, chief medical director, for a decision on the fate of doctors with suspect credentials, St. John said.
The 87 cases include doctors whose licenses have been limited by state medical boards because they have drug addiction problems and were found to have been prescribing drugs for themselves, St. John said.
It is not known whether the VA will notify patients who were treated by doctors later discovered to have been impaired.