Second VA doctor blows whistle on patient-care failures

By Dennis Wagner
The Republic
Originally published May 2, 2014

Here is an excerpt:

Both physicians, as well as other VA employees who asked not to be named for fear of retribution, said the Phoenix VA leadership disdains internal criticism and retaliates against those who speak out. In interviews and a written statement, Mitchell told The Republic she can no longer remain silent.

"I am violating the VA 'gag' order for ethical reasons," she wrote. "I am cognizant of the consequences. As a VA employee I have seen what happens to employees who speak up for patient safety and welfare within the system. The devastation of professional careers is usually the end result, and likely is the only transparent process that actually exists within the Phoenix VA Medical Center today."

The entire story is here.

People with mental health problems still waiting over a year for talking treatments, UK

Medical News Today
Originally published November 28, 2013

More than one in ten (12%) people with mental health problems are stuck on waiting lists for over a year before receiving talking treatments and over half (54%) wait over three months, reveals a new report launched by the We Need to Talk coalition of which the mental health charity Mind is part of (1).

The survey (2) of over 1,600 people who have tried to access talking therapies such as counselling and Cognitive Behaviour Therapy on the NHS in England over the last two years also shows how some people are paying for private therapy to get the help they desperately need. One in ten (11%) said that they had faced costs for private treatment because the therapy they needed was not available on the NHS.

The choice of treatment on offer was also found to be limited even though CBT, the most commonly prescribed talking treatment, doesn't work for everyone. The coalition found that three in five people (58%) weren't offered a choice in the type of therapy they received.

Since 2007, the Government's increased investment in the Improving Access to Psychological Therapies (IAPT) programme has helped millions of people to access psychological therapies on the NHS who otherwise wouldn't have had this support. However, delays in accessing support and a lack of choice is having a devastating effect on people's lives and recovery.

The entire article is here.

Kaiser Permanente cited for EHR mental health violations

By Jennifer Bresnick
EHR Intelligence
Originally published on March 20, 2013

Kaiser Permanente, the largest healthcare provider in California, has been cited by the California Department of Managed Healthcare (DMHC) for keeping two sets of patient records: an official EHR that it showed to state inspectors, and a parallel paper record that hid violations of the state’s “timely access” law that mandates shorter wait times for mental healthcare than Kaiser was able to provide.  The inaccuracies involved in the HMO’s dual record keeping system meant that mental health patients may have waited weeks longer than the law stipulates for appointments, resulting in illegal denials of access to care for schizophrenia, autism, depression and suicidal ideation, among other serious conditions.

The problem stems from Kaiser’s double appointment keeping procedures.  While there is an electronic version – the version that gets reported to government officials – Kaiser also used paper lists in some facilities, rendering its electronic appointment wait time calculators useless.

The entire story is here.

Thanks to Ed Zuckerman for this story.