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Highlights

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.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs 1. 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.
Closed - Implemented
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.
Department of Veterans Affairs 2. 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.
Closed - Implemented
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.

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