published Thursday, June 12th, 2014

Chattanooga VA clinic to get closer scrutiny

The Chattanooga VA Clinic at 6098 Debra Road near Eastgate Town Center.
The Chattanooga VA Clinic at 6098 Debra Road near Eastgate Town Center.
Photo by Dan Henry.

ABOUT THE CHATTANOOGA VA

Who: The Chattanooga community-based outpatient clinic serves veterans of 21 counties in Tennessee, North Georgia and Northwest Alabama.

What: The clinic provides primary care, mental health, pharmacy, dental, audiology and imaging services.

The system: The clinic is a part of the Tennessee Valley Healthcare System, which serves 89,000 veterans and is comprised of the Nashville and Alvin C. York Medical Center in Murfreesboro and 13 community-based outpatient clinics in Middle and Southeast Tennessee, North Georgia and Southern Kentucky.

Source: Department of Veterans Affairs

Veterans officials in Tennessee say they are enacting new policies to try to shorten the list of veterans waiting for care after four medical facilities — including Chattanooga’s outpatient VA clinic — were flagged for further scrutiny in the U.S. Department of Veteran’s Affairs’ most recent audit.

The audit found that in the Tennessee Valley Healthcare System, which includes the Chattanooga clinic, new patients had an average waiting time of 71 days to see a specialist, and 58 days to see a primary care doctor — the sixth-longest wait among all U.S. facilities, according to an AP analysis.

Those wait times are averages taken from the system’s two medical centers in Nashville and Murfreesboro and the 13 outpatient clinics within the Tennessee Valley system. Specific wait times were not available for the Chattanooga clinic, which serves veterans in a 21-county radius in the tri-state region.

By contrast, established patients in the region faced dramatically lower wait times for care — averaging two to three days, a “phenomenal” record, said Jessica Schiefer, spokeswoman for the Tennessee Valley system.

The audit does not state exactly what caused officials to flag the Chattanooga clinic for further scrutiny.

“Our medical director has asked, but we’re not sure yet,” said Schiefer.

It is also uncertain when follow-up examinations of the clinic may take place, she said.

A clinic in McMinnville was also cited for further review, along with two in Nashville and Memphis. In Georgia, VA medical centers in Atlanta, Augusta and Dublin were flagged.

The clinics were examined as part of the nationwide audit the VA ordered two weeks ago amid a growing scandal that has revealed widespread problems at VA medical facilities, where veterans are on months-long waiting lists to receive care or have fallen through the cracks altogether.

In the U.S., 112 of the 731 VA hospital facilities in the country were flagged for additional review.

The system is long overdue for an overhaul and the waiting times, especially, need attention, a number of local veterans have stressed.

Sale Creek veteran Pete Hansel, who visits the Chattanooga clinic, says he has been told he will have to wait six months to see a specialist about a combat-related foot injury that stemmed from his time in Vietnam. He said another VA doctor has told him that it could take six months for him to get glasses.

“The VA has been pretty good to me over the years, but this is flat-out ridiculous,” said Hansel, 72, who has called U.S. Sen. Bob Corker’s office to complain.

Other veterans, however, praise the care they’ve received at the Chattanooga clinic.

Roger Ufford, a 66-year-old Vietnam veteran who has only started using the Chattanooga clinic since 2010 and more regularly this year, said the clinic has been “a blessing.”

For years, the Hamilton County man had been on private insurance through work. Even after retirement, he only opted to try a few services through the VA — until his house burned down in January. He suffered smoke inhalation and went to the VA to see what kind of help they might be able to provide.

“They found out my story and took me right in,” said Ufford. “I’ve received better care there than I ever got on private insurance or at any other hospital.”

As a part of the effort to shorten wait times, local VA offices are contacting everyone on their electronic wait list, twice by phone and once by letter, to and see if they can be scheduled sooner, said Schiefer.

If they do not wish to wait for care with the system, they will give veterans the choice to seek a community health-care provider. Offices might extend hours to meet patient demand, said Schiefer.

On a larger scale, the VA has suspended executive performance awards and implemented a new site inspection process as a part of ongoing reforms.

HISTORY OF PROBLEMS

This is not the first time the Chattanooga clinic has been under scrutiny.

After a Chattanooga Times investigative series in 1998, the VA Office of Inspector General investigation substantiated serious delays and shortcomings in Southeast Tennessee veterans’ care.

And a more recent report highlights the case of one veteran who through a series of failings at the clinic did not learn of his own cancer until it was too late.

In summer 2011, the OIG cited the Chattanooga clinic for failings in the treatment of a patient who later died of cancer.

According to the complaint filed to the OIG, the unnamed veteran had long been a patient at the Chattanooga clinic.

After complaining about back pain in the fall of 2008, the clinic arranged an MRI, which showed that the man had a tumor on his lower spine.

But the veteran’s primary care doctor, who is unnamed in the report, never analyzed the results of the MRI before faxing them to an orthopedic surgeon, who also never informed the veteran of the test results.

About one year later, the man went to a non-VA emergency room because he could not walk. A scan at the hospital found the tumor — which had by that time doubled in size — and determined that it was cancerous.

The man died by the end of the year.

The OIG concluded that the facility’s missteps had delayed the man’s diagnosis and ordered the facility to strengthen its policies providing test results and conduct further peer review of the case.

It remains unclear what changes were implemented because of the case, or whether any of the doctors involved were disciplined.

Contact staff writer Kate Harrison at kharrison@timesfreepress.com or 423-757-6673.

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