VA secretary announces Manchester reforms, but doctors remain skeptical

  • Secretary of Veterans Affairs David Shulkin listens to members of New Hampshire’s congressional delegation during a visit to the Veterans Administration Medical Center in, Manchester on Friday Shulkin earlier met privately with doctors at the center, who have alleged substandard care at New Hampshire’s only hospital for veterans. AP

  • U.S. Sen. Jeanne Shaheen, D-N.H., right, and U.S. Sen. Maggie Hassan, D-N.H., center, listen to Secretary of Veterans Affairs David J. Shulkin, left, during a visit to the Veterans Administration Medical Center in, Manchester, N.H., Friday, Aug. 4, 2017. Shulkin earlier met privately with doctors at the center, who have alleged substandard care at New Hampshire's only hospital for veterans. (AP Photo/Charles Krupa) Charles Krupa

Monitor staff
Published: 8/4/2017 11:39:17 PM

VA Secretary David Shulkin announced Friday that he’s launching a national search for a new director, chief of staff and nurse executive at the Manchester VA Medical Center, and is prepared to spend $12 million on new projects to improve its offerings.

The nursing position was held by Carol Williams, whose removal was disclosed for the first time at a press conference. Williams, who was also a member of the senior leadership team, was one of two employees that the whistleblowers specifically said should be fired.

Eleven doctors and medical staff at the state’s only veterans hospital, several of whom quit in the past year, reported to federal agencies last year that veterans were receiving substandard care. The state’s highest-ranking politicians gathered around Shulkin on Friday in the wake of a Boston Globe report detailing their allegations.

The whistleblowers also had targeted another official for firing, who in a stark contrast to Williams’s fate has received more responsibilities. Michael Mayo-Smith, the regional director for the New England VA system, has been tapped to lead a task force that will explore how the hospital can in the future serve all veterans’ needs within New Hampshire.

Shulkin said that doesn’t necessarily mean that Manchester will have a “full-service hospital,” but that it would engage in partnerships that can effectively achieve the same level of service.

“That is what I think New Hampshire veterans deserve, and I’m charging our network director to create a task force specifically to tell us how to get there,” said Shulkin, who traveled to New Hampshire to meet with veterans, staff, politicians and the whistleblowers.

He also pledged that $12.4 million would be spent on new projects to bolster services at the Manchester VA. Of that, $7 million will go toward improving facilities that were ruined recently when a pipe burst, and $5.4 million will be used to establish a center for coordinated care. Shulkin said there’s another $18 million in ongoing improvements.

“That will help make sure when veterans go out into the community that they’re not lost in the community, and not taking as long as it’s been taking through the Choice Program for them to get the care that they need,” he said.

After the press conference, five doctors among the group of whistleblowers told reporters that they had a mixed reaction to the day’s events. Dr. Ed Kois, the director of the spinal cord program, said their meeting began on awkward footing, but he was “cautiously optimistic” by the end of the nearly hourlong private session.

Shulkin said that he wouldn’t meet with the whistleblowers unless their attorney, Andrea Amodeo-Vickery, left the room. Department of Veterans Affairs Press Secretary Curt Cashour confirmed this account in an email, noting that Shulkin “didn’t bring a lawyer to the meeting, so he asked the whistleblowers’ lawyer to absent herself as well.”

Amodeo-Vickery said the whistleblowers told her that one of Shulkin’s first questions after she left was “whether they were going to sue and ask for money and compensation under the whistleblower law.”

“They said no,” she said. “This was never our intention. Our intention is to help the veterans, to help patient care, and do what is best. We have no financial interest in the matter. I think Dr. Shulkin misunderstood my role there.”

Dr. Ed Chibaro, the former chief of surgery who stepped down in April, recalled another question that struck him as odd. He and one other doctor said Shulkin asked them why they still wanted to work at the VA if the conditions were so bad.

“To have someone ask you what you’re still doing here is a very perplexing question,” Chibaro said. “We’re here for the veterans. I think it’s pretty obvious.”

Kois added: “I think he was honestly surprised it wasn’t about some kind of settlement. We don’t want better parking spaces for ourselves. … We want better care for the patients.”

Shulkin said he toured the hospital, met with its management, its staff, the whistleblowers and held a town-hall meeting with veterans and staff. None of those events were open to the press.

Afterward, he held a press conference that the whistleblowers said they weren’t allowed to attend.

“Kristin Pressly wouldn’t let us in the room and had the police there to keep us out of the room,” Kois said, referring to the hospital’s public affairs officer.

The whistleblowers also expressed concern that Mayo-Smith – who oversees the New England region – was chosen to steer the future of the hospital, saying that he didn’t take significant action when he was informed that veterans with severe spinal cord injuries weren’t being treated properly.

Kois said an outside doctor wrote a letter to him “saying that he hadn’t seen these problems, except when he practiced pro bono in the jungles of Nigeria.”

“That was a very powerful letter, and I sent that out to Dr. Mayo-Smith. … We heard back that Dr. Mayo-Smith was not happy with the letter,” but didn’t undertake any meaningful inquiry, Kois said.

Dr. Stewart Levenson, the former medical director, said he spent years trying to get Mayo-Smith’s help on problems at the hospital.

“We feel he’s part of the problem here. I was meeting with him and contacting him on a regular basis, and nother ever came of it,” Levenson said. “He felt that local problems should be handled locally.”

Shulkin, for his part, said that he felt with “the right leadership team in place,” Manchester would be able to address the concerns brought up by the whistleblowers and cut through the bureaucracy that they said is holding the hospital back.

He said of the prior director, chief of staff and nurse executive: “We have not found that there has been anything wrong that they have done. These are good, dedicated professionals who came here to help veterans, but there are times in an organization – and this is my call – that you do need new leadership teams.”

He partially rejected the whistleblowers’ claim that the symptoms in Manchester were indicative of a broken system.

“Many of the issues that I looked at were Manchester-specific,” he said, noting however that other issues weren’t unusual or surprising in his experience running private hospitals. “What I was surprised about was why it was taking so long to resolve these, and why the clinicians weren’t being listened to.”

Shulkin added: “None of these are unsolveable problems.”

(Nick Reid can be reached at 369-3325, or on Twitter at @NickBReid.)

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