Following up on its investigation into poor patient safety records and lax oversight at military hospitals, a new report from the New York Times reveals how the system itself is designed to discourage internal criticism and even punish those who point out problems in care.
The Times isn't the only entity taking a closer look at military hospitals--the U.S. Department of Defense issued its own report in October that found eight of the 56 domestic and overseas facilities have "significantly higher than expected" rates of patients getting sick following treatment, FierceHealthcare reported. That review was inspired in part by the scandal that rocked the Veterans Affairs (VA) Health System last year, which revealed dangerously long wait times at some facilities not only led to patient deaths but were covered up by "secret waiting lists" kept by administrators.
While the Military Health System (MHS) serves only active-duty troops and operates separately from the VA, the newest Times report indicates that many of the issues the VA has experienced with whistleblower reprisals also plague the MHS. Former clinicians interviewed by the publication indicated that they faced reprimands, transfers and even termination when they spoke up about unsafe practices or substandard patient care--due mainly to the culture of obidience that pervades the MHS. Scores of other healthcare workers, adding comments through on online portal, shared their concerns anonymously for fear of harm to their careers.
Col. Italo Bastianelli, D.O., who was the head of obstetrics and gynecology at the Keller Army Community Hospital that serves the U.S. Military Academy at West Point, told the Times he was involuntarily transferred despite an exemplary record after complaining about blatant safety and ethics violations, lax infection control measures and understaffing.
"Simply put, I was targeted because I wasn't a 'yes man' and stood in the way," he said. "The Army surgeon general wants the medical staff to speak up about patient safety and quality concerns. I spoke up and was retaliated against."
The Army inspector general's office as well as Bastianelli's former boss have disputed his claims of retaliation, as well as his complaints about budget cuts affecting patient care.
But the Times' initial report in June backs up Bastiannelli's concerns, finding that babies born at military hospitals were twice as likely to sustain an injury during delivery, while mothers were more likely to hemorrhage after childbirth, as compared to civilian hospitals nationwide.
Beyond patient safety concerns, the MHS is further under scrutiny for the high costs it incurs as well as the lack of standardization in care among the military's different branches, FierceHealthcare has reported. The MHS cost the Pentagon $51.4 billion in fiscal year 2012, making up 9.7 percent of total military spending, and that number could reach $65 billion by 2017, according to the Congressional Budget Office.
To learn more:
- read the article