The San Diego Veterans Administration hospital received a clean bill of health in two recent inspections, according to San Diego VA Director Thomas A. Trujillo, who has not yet seen a federal report suggesting that VA hospitals have done a sloppy job checking whether doctors have felony convictions or hold required licenses.
Trujillo said he was "very comfortable" with the results of reviews by the Joint Commission on the Accreditation of Health Care Organizations, a professional organization that inspected the local VA hospital in June, and the VA's Medical Inspector General's Office, which conducted a similar investigation in July. "Both stated that we have an excellent program," Trujillo said.
The General Accounting Office, which examined hiring procedures at VA hospitals in San Diego, Sepulveda (a Los Angeles neighborhood) and six other cities, said Wednesday that fewer than half of the physicians hired by those eight hospitals from 1986 to 1988 had had their licenses properly verified with state medical boards.
"I'm put in the peculiar situation of trying to answer questions, to give adequate responses, but I don't have the figures" from the GAO report, Trujillo said.
Officials at the Sepulveda hospital said Wednesday that the GAO found no problems there and that two recent reviews gave the hospital satisfactory marks.
GAO Report Not Specific
The GAO report did not specify which medical centers had problems, and it cited no inadequacies in San Diego or at any of the other individual institutions.
Trujillo, who transferred to the San Diego facility in July, 1988, from the state of Washington, has not yet seen results of the study that was conducted a month before his arrival. However, doctors who met with the GAO team after their review "do not have any information" about violations uncovered during the review, Trujillo said.
Trujillo said the local VA regularly asks applicants if they have been convicted of crimes and if they hold a bona fide license. Applications at the local hospital then are forwarded to Washington, where background checks are completed by federal agencies, Trujillo said.
Doctors' files are checked regularly to ensure that medical licenses remain current, Trujillo said.
Doctor's License Lapsed
One doctor was suspended from practicing at the facility because his license had lapsed and had not been renewed. That physician was soon reinstated, however, after his license was renewed.
On four other occasions between 1986 and 1988, the VA did not physically have new licenses for doctors in hand because of paper-work problems at state agencies that issue licenses. Those agencies had instead forwarded letters that were "equivalent" to the licenses, Trujillo said.
Technically, that practice might "not have been in compliance," Trujillo said. "But that's the only thing we can come up with right now . . . and that was because state licensing boards were running behind on their workload."
The GAO report did not give examples of licensing problems, but it said that the potential for problems exists.
"The conditions cited do not mean that the medical services provided by VA are substandard or that VA physicians are incompetent," the report said. "It does mean, however, that VA cannot assure the public or the veterans it serves that its physicians are appropriately privileged."