The public's attention is rightly focused on efforts to dial back unnecessary prescribing and use of opioids. But some patients still require opioid-based drugs.
“Have we made it too difficult for our legitimate pain patients to get the opioid medication they need for comfort?” Tracy L. Brooks of the Manchester University College of Pharmacy asked in a recent letter to the editor.
We were reminded again of that question when the Veterans Health Administration revealed disciplinary actions it had taken at the VA Outpatient Clinic in Peru, Indiana. The clinic is part of the VA Northern Indiana Health Care System, which also oversees the campus in Fort Wayne.
In a letter responding to inquiries by U.S. Rep. Jackie Walorski and members of the the House Committee on Veterans Affairs, the VA said two employees of the clinic were fired and three others disciplined this spring.
As The Journal Gazette's Brian Francisco reported, an investigation by the VA Office of Medical Inspector confirmed allegations an employee had reduced several patients' pain medication without examining them.
The agency noted one of the patients whose opioid medications had been improperly reduced last year has since died of coronary artery disease; it was not known whether the mistake contributed to his death.
The investigation also found several employees had engaged in “blind scheduling” of veterans – setting up appointments without consulting the patients – and sometimes canceling those appointments on the day scheduled.
In response to the problems it identified, the VA said it would monitor opioid prescribing more closely and increase the frequency of audits of patient schedulers.
The Kokomo Tribune reported many of the veterans who attended a town hall meeting in Peru expressed support for the two employees who were fired for blind scheduling. Miami County Veterans Service Officer Jay Kendall told the Tribune the employees were dismissed as “scapegoats” for problems at the understaffed clinic.
Dr. Wayne McBride, chief of staff for VA Northern Indiana, told the newspaper the facility should be fully staffed with three physicians by the end of the year. He also said he is trying to fill the clinic manager position, which has been vacant for two years.
Reports of poor service and care at VA systems elsewhere have abounded. Walorski and other members of the Indiana congressional delegation seem to have been aggressive in seeing complaints and problems are quickly addressed in our area's facilities. Our veterans who depend on the VA for care deserve nothing less.