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Hon. Ginny Brown-Waite, Ranking Republican Member, and a Representative in Congress from the State of Florida

Mr. Chairman, thank you for yielding.

Mr. Chairman, when news reports came out last year showing a spike in surgical deaths at the Marion, Illinois VA Medical Center, we on this committee were concerned.  We wanted to know whether this was an isolated incident or more widespread than reported.

On September 14, 2007, Ranking Member Buyer and I wrote a letter asking for an investigation by the Office of the Inspector General into the spike in surgical deaths.  I ask unanimous consent that a copy of this letter be submitted for the official hearing record. 

I hope to hear from the IG this morning about the results of this investigation.  On November 6, 2007, our Senate counterparts held a hearing on this issue as well.  During this hearing, GAO testified that in their 2006 review of VA’s credentialing requirements, it made four recommendations that VA medical facility officials must:

  1. Verify that all state medical licenses held by physicians are valid;
  2. Query Federation of State Medical Boards (FSMB) database to determine whether physicians had disciplinary action taken against any of their licenses, including expired licenses;
  3. Verify information provided by physicians on their involvement in medical malpractice claims at a VA or non-VA facility; and
  4. Query the National Practitioner Data Bank to determine whether a physician was reported to this data bank because of involvement in VA or non-VA paid medical malpractice claims, display of professional incompetence, or engaged in professional misconduct. 

I am interested to hear if the VA was following all of the recommendations.  If they were, I would like to know how a physician who lost his license in the state of Massachusetts, but was still licensed in the state of Illinois, was allowed to practice at the VA facility in Marion, IL. 

It is imperative that we explore the circumstances of this situation to prevent similar cases in the future.  To do this, several questions need answering.  

How current are the national databases available to maintain licensing standards, and how is information on licensing actions disseminated to other states?  

The current NPDB system does not inform the agency of actions taken against a license, although I understand that they are developing a prototype to provide Proactive Disclosure Services.  Has VA enrolled in this prototype?

Committee Members have been told repeatedly that the VA has one of the best healthcare systems in the nation.  The VA healthcare system is one that many other hospitals and health care systems are trying to emulate. 

However, when the VA maintains credentialing for a practitioner whose license has been revoked in another state, we must question the quality of care being provided to our nation’s veterans.  

Also, it is apparent that the scope of privileging and the commensurate appropriateness of staffing support has not been afforded the professional due diligence of responsible senior management.  VA’s premier health care delivery system is marred by some senior managers asleep at the wheel.

When veterans come to VA hospitals and outpatient clinics, they should not have to worry about whether or not their physician has a valid license to practice medicine. 

Veterans should not have to worry about whether the state of Massachusetts has revoked the license of a doctor practicing in Illinois for quality of care issues. 

Our veterans trust that the VA does its part to ensure practitioners in VA medical facilities are the best trained and most qualified individuals to care for them.  For the VA to do anything less is unacceptable.

Thank you for calling this hearing, Mr. Chairman.  I look forward to the witness testimony.