The Army’s Medical Department
A world class heath care delivery system?
By Thom Stoddert, 2/17th Cav, 1970
Now another major scandal is developing that includes the Army’s Medical Department. Special compounding pharmaceutical factories are selling drugs of questionable value to service members and TriCare beneficiaries at extraordinary costs to the Department of Defense (DOD).
In a memo and chart obtained by this paper from the Western Region Medical Command – Navy Pharmacy Consultant documents, as early as 2012, the (DOD) was following “significant growth in compound prescriptions utilization and cost.”
This memo further records that the DOD Pharmacy and Therapeutics Committee met in November 2014 to discuss implementation of a screening process. The chart shows that in May, 2014 the monthly payments made to compounding pharmacies were under $50 million, then in September and November it rose to $90 million each month, December - $150 million, January - $190 million per month.
Another document from the Defense Health Agency - Health Care Operations, Pharmacy Ops Division, dated 25 Feb. 2015, an Executive Summary was distributed worldwide within DOD pharmacies - that federal investigations from at least eight agencies are in place and a warrant was served on a pharmacy in Florida along with many others. Then on May 5th of this year, CBS News reported that the Pentagon paid out $335 million to pharmacies in March 2015 - after the initial investigations had started.
If the numbers are correctly reported, the military just paid out in six months $865 million to pharmaceutical companies with questionable ethics and questionable products. According to emails received, the Army may have been affected the most. The Army Medical Department which has had major problems, now has another one.
“A world class heath care delivery system,” is what LTG Patricia Horoho, the Surgeon General of the Army and former commander of Madigan, promised the staff of that army medical center, in September 2012. Madigan is the flag ship of Western Region Medical Command located in Tacoma, Washington. The following year former employees of that hospital, including Army retirees, filed a complaint with a local congressman concerning patient endangerment, chronic nepotism, retaliation, and waste of government money.
That complaint and subsequent investigation, along with a major national hospital accrediting agency, a Department of the Army review, and a Department of Defense review, all showed significant problems since that presentation in 2012.
Hal Bernton , Seattle Times reporter - April 20, 2013, “A high-profile Army Medical Command task force charged with improving the health care atmosphere among patients and staff was shut down late last year after an investigation found that it created a “toxic and intimidating working environment” in its own ranks. … The investigative report also noted the use of questionable ‘Wiccan practice’ in training, such as using stones and crystal bowls for ‘energy readiness.’”
Bernton further describes the program, “… investigation concluded that leaders of the national program, based at Madigan Army Medical Center…, sometimes used “bullying tactics” and created “a wolf pack mentality” when training its staff.” Other news media stories tell of failed oversight and retaliation against staff.
Patricia Kime, staff writer, Army Times quoted, “The New York Times reported that the military hospital system has a record of avoidable errors higher than many civilian systems and faces little scrutiny, oversight or consequences related to hospital mishaps.” Kime cited the New York Time’s reporters, Sharon LaFraniere’s article, June 28, 2014. That NY Times’ article also pointed out that Army hospitals held 5 of the 8 worst positions, Madigan the very worst.
In another article titled “Military Hospital Care Is Questioned; Next, Reprisals” by LaFraniere, Dec. 20, 2014, “… Most employees insisted on anonymity for fear of further harm to their careers.” The article, focused on Womack Army Medical Center, Fort Bragg, NC continues, “The Pentagon’s own review, ordered in May (2014) by Defense Secretary Chuck Hagel, … was especially concerned by suggestions of a system wide shortcoming: medical workers’ reluctance to identify problems. More than a dozen physicians and nurses interviewed for this article said their own experiences illustrated why.” Horoho is quoted in the same article, “We want people to come forward,” Horoho, stated. “We are committed to patient safety, we are committed to transparency, and there will be NO COMPROMISE.”
The remarks made by Horoho are thought provoking. In April 2013 at news conference held on North Fort, Joint Base Lewis-McChord, Hal Bernton of the Seattle-Times asked senior Army brass why were so many requests under the Freedom of Information Act (FOIA) are being ignored. That reporter has written several stories on the issues at Madigan.
Cheryl Balcon, a long time employee of Madigan, states that when she took her handicapped son to Madigan, he was placed on a blood pressure medication without the standard testing; he died less than ten days afterwards. She brought her concerns to COL. Irene Rosen and the chain of command. Balcon described in tears how no one answered her with any explanation or investigation. Rosen is now a deputy commander at the Fort Carson community hospital.
COL. Dallas Homas took over command of the Fort Lewis hospital within a short time after Horoho left for her position as the Surgeon General. He was eventually to be relieved of command by her, five months later Horoho was ordered to reinstate him. A quote from his investigation explains why he was sent to Madigan, “General Volpe shared with me his biggest concern at Madigan was the ‘baron’ … individuals that had been at Madigan for decades that were comfortable with their positions … and not working as hard as they could or should be.”
The investigation further documented that Volpe and Homas were aware that doctors were leaving work two hours early and clinics being closed on Fridays. Clinic employees have reported doctors were also moonlighting. Which may explain why COL. Homas in his investigation stated, “My guidance in a nut shell was to get Madigan back on the right track, … So I came in with an agenda of restoring accountability for providers and discipline and focus on patient care rather than personal agenda.”
Information received from patients, staff, and former employees indicate a long history of nepotism, physical assaults, waste, and retaliation against staff. These reports have not just come from Washington State, but from Colorado, Hawaii, North Carolina, and Texas. Complaints received by this writer include ignored federal HR laws - unqualified people being selected for positions in various clinical areas, and IT departments, harassment/bullying of employees, and patient documents being misplaced resulting in death.
A recent incident happened on Madigan’s ward 6-South. A nurse with a problematic history failed to initiate chest compressions/cardiac resuscitation on her patient who had ceased breathing. When queried by an ICU nurse as to why; her reply was that it is ward policy not to do chest compressions - basic CPR. The ward’s supervisors had tried to terminate the nurse several times, but were held back by the Human Resources staff.
Again - Patricia Kime, Military Times, March 25, 2015, reporting on Horoho’s response to recommended changes to military medicine by a Congressional Blue Ribbon committee, “Top military doctors: Our Health System Works, … Horoho spoke most bluntly on the need to continue a transition plan now underway, calling any comparisons between Army medicine and civilian health programs one of the ‘biggest threats’ to the system. .. Our hospitals are our health readiness platforms,” Horoho is quoted. ‘This crucial link to readiness sets us apart from the civilian health system. … Any radical departure from our combat-tested system would degrade readiness in an environment where our next deployment could be tomorrow.