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Overloaded: Tucson VA doctor resigns claiming patients are at risk

Posted at 11:46 PM, Dec 12, 2016
and last updated 2016-12-13 12:13:39-05
Another doctor is leaving the Tucson VA feeling overworked and overloaded. It's a serious issue, he says, that puts veteran care at risk and he speaks out for the first time.
The VA's second in command was in Tucson on Monday to examine the severe wait time issues. Deputy Secretary Sloan Gibson met with VA leadership, staff, and veterans groups to discuss access to care. His visit follows KGUN9's nearly year-long investigation that exposed serious wait times for veterans because of years of deceptive practices  -- whistleblower claims that two federal probes confirmed.
For Dr. William Rees, caring for veterans is a calling. It's in his blood, he says. But the Primary Care Physician is just weeks away from leaving the Tucson VA. He's already submitted his resignation a few weeks back. "I have had several emails asking for help personally saying I'm overwhelmed. I've sent emails and my resignation letter," he said.
And Dr. Rees is not alone. He says many of his colleagues and nurse practitioners are drowning and continuously struggle to come up for air. "In the sense, that they can't keep up with the patients we have because of the complexities and medical problems because most of them are pretty sick," he said.
Dr. Rees has a packed panel of 1200 patients with highly complex problems that take more time to diagnose and treat. But he says he spends too much of his time examining electronic "view alerts" that are pegged to patients health records. "I get 300 a day -- 200 to 300 a day -- they could take me 8 hours. You could do nothing but that and not see patients and they're overwhelming and it's dangerous because it could be long nodule. It could be a cancer from an X-Ray report or CT scan or MRI and I can tell you that some of the physicians I know get so overwhelmed they don't do them. They just get so far behind that they put them off -- they go on."
Cavazos: So patient health is at risk? 
Dr. Rees: I think there's no doubt in my mind that with the amount of view alerts that we're subjected to and that we're asked to do. I would definitely say that is true.
Overworked and overloaded, Dr. Rees attributes the high workload to the high turnover rate of primary care physicians at the Tucson VA. And when doctors leave, their patients can show up on his panel unexpectedly. Those unassigned new patients to add to his responsibilities. He calls them ghost patients. "There's all of these ghost patients that will suddenly show up and you get labs on the patients and you're like who are they. I've never seen them. People drop off your panel and you're assigned another hundred. It's just chaos."
And he says some of his regular appointments are pushed back. "They'll say we don't have anything available for 60 or 90 days. I hear that everyday all day long. I had a guy come in last week say that he waited 9 months to see me," he said.
Cavazos: And you have no control over that. 
Dr. Rees: I have no control over that.
Dr. Rees says he's gone to management about this concerns. 
Dr. Rees: "Yeah, I've definitely made them aware to management. 
Cavazos: And their response? 
Dr. Rees: I've never gotten a response. 
Cavazos: Not a response at all? No explanation? 
Dr. Rees. No.
Feeling frustrated and defeated, he's leaving the VA and going back to civilian practice because he hasn't seen any improvements. "My reason for coming forward is certainly not to get anyone in trouble. I think this is a problem that has not changed in 3 years and change has to be made and people have to know patient health is at risk," he said.
I addressed Dr. Rees frustrations and concerns with VA Deputy Secretary Sloane Gibson, who was in Tucson to examine the access issues.
"I can't talk to the specifics there, but I'd love for the doctor to call me and send me an email. I think every veteran in America knows what my email is Send me a note. I've love to find out specifically what his issues are. Part of what we need to do is we need to learn from you guys." 
Dr. Rees says he spoke to the OIG this past summer during their investigation and told them everything about the working conditions and scheduling issues.  
While Gibson touted the progress made at the Tucson VA, he acknowledged more work needs to be done, including more oversight in patient scheduling and implementing an enhanced scheduling tool by mid-2017.
"I'm absolutely convinced we have inconsistent scheduling practices. The number two mistake I have made in 2 years and 10 months I have been at the VA, I did not require VHA to do mandatory standardized face to face training for every scheduling assistant in the enterprise. I didn't require it 2 years ago. I am requiring it now. And the first place it will be completed will be in Phoenix. It's been a chronic problem for years."
Gibson says he instructed the OAR (Office of Accountability Review) to investigate some aspects of the OIG findings and hold employees accountable when misconduct and negligence are discovered. 
When asked what he means by holding people accountable, he said if there's substantial evidence of deceptive practices "we will remove. Period."
Gibson praised the leadership for improvements in some areas, such as mental health, but he says his first goal is to find a permanent Medical Center Director and Chief of Staff. Gibson says he plans to periodically check in on the Tucson VA.