The national Veterans Administration (V.A.) hospital system has been under administrative scrutiny for many years. There have been accusations that the V.A. system serves as a safe house for dangerous doctors with dubious credentials that get transferred from hospital to hospital without discipline. It has been further alleged that the V.A. hides reportable mishaps from state licensing boards and national registries such as the National Practitioner Data Bank (NPDB).
While these matters certainly need to be addressed, political shifts have encouraged what can only be described as a "purge." Unfortunately, this haphazard and highly publicized "housecleaning" can only diminish the quality of health care for our veterans, increasing waiting times and making it much less likely a patient will receive prompt and effective healthcare services.
As a VA-licensed practitioner, you need to know you can fight for your right to practice in the wake of this politically-motivated wave.
If a V.A. licensed physician or dentist receives a "letter of intent to remove" a practitioner from service, the V.A. has step-by-step due process safeguards in place to protect practitioners.
These safeguards are published in the employee handbook and involve, at a minimum, three different levels of internal reviews available to a V.A. physician to determine if the removal action was proper and may result in either reversal or approval of the discipline. Be careful though as the V.A. has strict timelines and deadlines associated with each process.
A V.A. practitioner may also request a Disciplinary Appeal Board (D.A.B.) review of the case. The D.A.B. is where licensed professionals of the same approximate grade are brought in from other facilities to review the intended disciplinary action. Again, this process requires strict adherence to time frames explained in the employee handbook.
One of the biggest advantages any practitioner has in this process is a settlement. At any point in this process, it is always possible to attempt to enter into a settlement agreement with the administration. Settlement agreements are highly encouraged and can save you a great deal of time and stress. However, if you are considering a settlement there are some potential drawbacks and pitfalls that you must keep in mind. They must be well discussed, contain simple-plan language, and carefully reviewed, especially if the settlement might be deemed to be a "reportable" event by the V.A.
While the V.A. employee handbook provides some safeguards for practitioners, many of those procedures are not followed by many of the facilities, and there have been discrepancies in the V.A. handbook as well. This means that you will need to carefully look over the handbook and constantly monitor what the V.A. administration is doing and saying with your case.
The most important piece of advice I can provide in the V.A. disciplinary process is get everything in writing. It is the responsibility of the employee to make sure that any suggestions, promises or recommendations that occur during the process are documented in writing. These writings must be in sources that will be recognized by the parties in the event they are not carried out or are somehow "forgotten" in the process.
If the case comes down to inappropriate handling of the case, then there is always a place of last resort - the Federal Courts. These cases could be the subject of a further appeal to the courts. The courts are available to the extent necessary if the employee has been the subject of improper or even illegal action or mismanagement. The courts are the last resort; however, it may be necessary if there has been an egregious violation of the practitioner's rights.
Throughout these procedures through the VA, the main goal must be to minimize the negative future long-term impact that professional sanction actions have on the careers of licensed professionals. These impacts are usually not understood or appreciated by the unlicensed officials who often make these important employment decisions and have, on more than one occasion, brought a medical career to its end.