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| Congress and the military have examined how Maj. Nidal Hasan was trained, evaluated and promoted as a military physician. |
STORY
HIGHLIGHTS
- Congress called for the General Accountability Office report after the Fort Hood shootings
- The report urges the Defense Department to speed efforts to revise the review process
- The military says its centralized system will be delayed without adequate funding
Washington
(CNN) -- A federal watchdog took a bite out of military hospitals this month,
warning it is impossible to tell if some doctors are licensed, properly trained
and evaluated in their specialties.
"Army
oversight and physician credentialing and privileging requirements were not
sufficient to assure that MTFs (Medical Treatment Facilities) fully complied
with existing requirements or completely documented information needed to
support credentialing and privileging decisions," said the new General
Accountability Office report.
"Specifically,
Army Medical Command's oversight of individual MTFs' reviews of physicians'
applications for privileges was insufficient to identify the instances of
noncompliance and incomplete documentation," the report added.
In some
cases the military had failed to check properly on the legitimacy of doctors'
licenses to practice medicine, the report alleged.
"Some
credentials files we reviewed lacked complete documentation to show that MTFs
had primary source verified all of the physician's state medical licenses,
including seven instances involving a physician's only active medical license,"
the report says.
Primary
source verification of credentials means they are verified with a specific
credential's source.
Congress
called for the report in the aftermath of the Fort Hood, Texas, shooting in
November 2009, for which an Army psychiatrist is charged with 13 murders.
Congress
and the military have examined how Maj. Nidal Hasan was trained, evaluated and
promoted as a military physician. Nine military officials, including doctors,
were disciplined for their actions or failures in the Hasan case. He faces a
court-martial, with a possible death penalty, in March.
The GAO
report cast a wider net and urged the Defense Department to speed up its
efforts to revise and standardize reviews of doctors' credentials. And it
singles out the Army for problems at its facilities.
"Based
on our review of 150 credentials files at the five Army MTFs we selected for
our review, we found that none of the five Army MTFs fully complied with
certain Army physician credentialing and privileging requirements," the
GAO report said. "Specifically, we found that the selected MTFs did not
fully comply with the Army's requirement to primary source verify all state
medical licenses at the time of privileging and at renewal."
In a
response included in the report, Assistant Secretary of Defense for Health
Affairs Dr. Jonathan Woodson wrote the department is progressing with
standardization and centralization of credential files and improving how
doctors can apply for and renew privileges to practice at military hospitals.
But the military warned that its centralized system would be delayed
"without adequate funding."
The report
cited over-reliance of so-called peer reviews, especially in cases where
coworkers might have only a limited familiarity with a doctor.
"In
one file we reviewed, both peer recommendations were from individuals who
indicated they had limited knowledge of the physician's clinical
competence," the report says. "The department chief later told us
that this physician was terminated within the first three months due to issues
with the physician's competence and professionalism."
In another
instance, a doctor had problems with errors in prescriptions, above what the
hospital allowed. However, this was not reflected in the doctor's file. And the
physician's department chief "was not aware of the negative prescription
days but was 'not at all surprised' because there were current concerns about
this physician," the report said.
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