VA Health Care:

Physician Peer Review Identifies Quality of Care Problems but Actions to Address Them Are Limited

HEHS-95-121: Published: Jul 7, 1995. Publicly Released: Jul 7, 1995.

Additional Materials:

Contact:

David P. Baine
(202) 512-7101
contact@gao.gov

 

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

Pursuant to a congressional request, GAO examined the relationship between problem identification and problem resolution in the Department of Veterans Affairs' (VA) physician peer review process, focusing on: (1) how the results of VA peer review are being used in disciplining physicians with performance problems; (2) the impediments to effective peer review; and (3) whether VA is taking action against physicians who are not performing in accordance with professional standards.

GAO found that: (1) actions taken by VA to address quality of care problems are often limited to undocumented discussions with the physicians involved; (2) there is generally no record of the extent to which quality of care problems are addressed or the actions taken to deal with the problems identified; (3) VA is developing practice guidelines and using peer review to help reduce heavy reliance on professional judgment in peer review; and (4) VA medical centers are not reporting many actions taken against physicians to the National Practitioner Data Bank because of their restrictive reporting procedures.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: VA agrees with the GAO findings and concurs with the recommendation. VA provided copies of this report to all facilities and a policy directive was issued to the service chiefs requiring adequate documentation of all follow-up actions taken by service chiefs in response to peer review findings.

    Recommendation: The Secretary of Veterans Affairs should direct the Under Secretary for Health to require service chiefs to fully document all discussions held with practitioners involved in cases that peer reviewers conclude that most experienced, competent practitioners might or would have handled differently.

    Agency Affected: Department of Veterans Affairs

  2. Status: Closed - Implemented

    Comments: VA agrees with the GAO findings and concurs with the recommendation. VA revised the criteria being used by VAMCs to report practitioners to the National Practitioner Data Bank, thereby making VA Data Bank participation more consistent in the two identified areas with reporting practices required for the private sector.

    Recommendation: The Secretary of Veterans Affairs should direct the Under Secretary of Health to revise the criteria now being used by medical centers to report VA practitioners to the National Practitioner Data Bank so that they are more consistent with the reporting practices now used in the private sector.

    Agency Affected: Department of Veterans Affairs

 

Explore the full database of GAO's Open Recommendations »

Sep 8, 2014

Sep 2, 2014

Aug 22, 2014

Aug 13, 2014

Aug 11, 2014

Jul 30, 2014

Jul 29, 2014

Jul 23, 2014

Looking for more? Browse all our products here