Sunday, September 9, 2007

VA's Health Records Software Allows Blacklisting of Veterans

The Veterans Health Information Systems and Technology Architecture (VistA) is a system-wide electronic health records program employed by the United States Veterans Health Administration to enable doctors in any VA hospital or outpatient clinic to quickly create and review patient records as well as order medications and tests. Computerized medical records improve efficiency, reduce the need for repeated tests, and reduce the potential for medical errors. Used properly, they are a powerful tool for improving the quality and efficiency of patient care. But they have a dark side, as well. The same technology that enables a VA doctor in San Diego to review an MRI within minutes of its being performed in New York allows any doctor within the system to view any negative, inflammatory or libelous statements that may be included in the patient’s record, possibly prejudicing the doctor against a particular veteran, and compromising if not sabotaging that veteran’s medical care.

The VistA electronic medical records software contains a feature called a “Patient Record Flag” (PRF) that gives doctors in the VA system the ability to blacklist patients who in their opinion are disruptive or pose a potential risk to the health and safety of patients and staff, or who have exhibited drug-seeking behavior. When a doctor in the VA system accesses a patient's electronic record, there is a small button labeled "Flag" in the upper right-hand corner of the menu that appears with the patient's record, and doctors can easily read or enter remarks about "problem patients" by clicking on that button, which will be highlighted in bold red letters if there are any entries, but is otherwise greyed-out (see image below).

The PRF is by design readily accessible to anyone within the system with access to a computer terminal, including receptionists and administrative clerks, and thus compromises patient confidentiality. While ostensibly designed to protect the safety and wellbeing of patients and staff from patients with a documented history of threats or acts of violence, the Patient Record Flag has enormous potential for abuse, and can be used by a doctor to demonize or libel a patient who has filed a complaint against the doctor, or who has simply engaged in behavior the doctor personally finds suspect or annoying. Patient blacklisting is a particularly insidious form of libel, as it can and often does result in denial of medical care and puts the patient's life, health and privacy at risk.

Patient blacklisting is a fairly common but rarely discussed problem throughout the US medical system even though it is widely considered to be unethical and is often illegal as well. Doctors use these blacklists as a means of alerting other doctors to patients they feel may pose a problem, but they are also used to punish patients for no other reason than the patients in question annoyed the doctor or filed complaints against him, and are often a willful attempt at medical sabotage. Sometimes doctors will specifically request that a particular patient be denied medical care. Other times, doctors will voluntarily refrain from providing care due to the fear a particular patient might file a lawsuit against him or might be a drug seeker. Since denial of proper treatment can lead to the injury or death of a patient, blacklisting is in reality a form of medical assault and malicious libel.

But despite their widespread use, medical blacklists tend to be fairly local in scope, often existing exclusively within a particular hospital or shared across a few local hospitals, doctors and pharmacies. These blacklists are usually informal, often just a notebook maintained in the ER of "problem patients," such as "drug seekers" or "frequent flyers" (patients who come to the ER looking for drugs to treat their pain or to get high, or with a perceived excessive number of visits). It is remarkably easy to get added to a blacklist, particularly for chronic pain patients who are routinely stigmatized as "addicts" by uninformed or unethical physicians who frequently confuse legitimate requests for pain treatment with the behavior of drug addicts looking to get high. Some private pharmacy chains also maintain records of any "drug-seeking" behavior they perceive to have encountered and share this info throughout their own computer networks, as well as with doctors upon request.

But the VA has unfortunately moved this primitive practice into the 21st Century by incorporating the ability to blacklist patients right into its software, which means that any patient who is so branded is going to have a problem not just in his local VA hospital or outpatient clinic, but throughout the entire VA system. Although the VA publishes a guideline for the use of the PRF (Patient Record Flags Phase III User Guide, available here) it is possible for a doctor to write anything he wants in the PRF, and unless the patient finds out about it, which is unlikely, he will not be able to challenge it. This documentation describes the PRF thusly:

Patient record flags are used to alert VHA medical staff and employees of patients whose behavior and characteristics may pose a threat either to their safety, the safety of other patients, or compromise the delivery of quality health care. These flag assignments are displayed during the patient look-up process (pg 1, PRF user guide).

Perhaps recognizing the potential for abuse of the PRF, the VA also notes in its guideline that:

PRFs should never be used to punish or to discriminate against patients; nor should they be constructed merely for staff convenience. The effectiveness of PRFs depends upon limiting their use to those unusual risks that threaten the safe delivery of health care. Threats to the effective use of PRFs are their misuse and their overuse." (p 27, PRF user guide)

PRFs need to be free of redundant language, slanderous or inflammatory labels, and language that provides insufficient information or guidance for action.
(p 29, PRF user guide)

But it is difficult to see how adopting a guideline that many doctors in the system have probably never bothered to read is going to prevent abuse of this system. Though the VA requires that all PRFs be reviewed every 2 years or whenever a patient requests a review, as noted below, there is no requirement for notifying a patient that he has in fact been red-flagged and the damage is often done by the time a patient figures out he's been blacklisted, if he ever does. Two years is a long time to have to go without proper medical care because some doctor at the VA didn't like your attitude, and there is no guarantee the review process will remove frivolous or libelous PRFs.

As part of the patient health record, all PRF are under authority of the Chief of Staff at each facility and must be reviewed at least every 2 years. A reminder for upcoming review must be generated 60 days prior to the 2-year anniversary date of the PRF. NOTE: PRFs must be accorded the same confidentiality and security as any other part of the heath record. (p 28, PRF user guide)

However, it is unlikely the confidentiality of patients is being protected when the VA authorizes nearly anybody within the system with access to a computer terminal, including enrollment clerks, insurance and billing staff, and travel clerks to access the PRF.

While some strategy to alert the staff in VA hospitals of patients who have a proven history of violence may seem logical and warranted, the mechanism they have chosen amounts to little more than a blacklist where any doctor can voice hostile opinions about patients he doesn't like and effectively sabotage any patient's care.

The VistA software's built-in blacklist is of particular concern to veterans with chronic pain problems, as patients complaining of pain are the most frequent targets of blacklists in other medical contexts and some blacklists are maintained exclusively for "drug-seekers." VA's guidelines specifically allow the PRF to be used to red flag patients who exhibit "drug-seeking" behavior (pg 23) without specifically defining exactly what that behavior is. In fact there is no consensus definition as to what actually constitutes "drug-seeking behavior" and the term lacks scientific precision. For the most part, drug-seeking behavior is whatever the doctor says it is, based on nothing more than medical folklore or his own prejudices. Chronic pain patients often find themselves branded with the modern-day equivalent of the Scarlet Letter (in this case, the "A" is for "addict.") for no other reason that they exhibited behaviors that are often associated with real drug addicts, a phenomenon known as "pseudoaddiction." Dr. Frank B. Fisher, a Harvard-trained general practitioner and chronic pain advocate in California, describes pseudoaddiction thusly:

The term pseudoaddiction was coined in 1989 to describe chronic pain victims mistakenly diagnosed as suffering from opioid addiction after they were driven, by undertreated pain, to display certain drug-related behaviors. Simply stated, pseudoaddiction is a misdiagnosis that results from undertreatment of chronic pain. When this diagnosis is made, the medical system has erred. Recognition that patients are frequently harmed by misdiagnosis of addiction should prompt an aggressive search for undertreatment of pain. Unfortunately, this usually does not happen. Instead, when a patient displays certain behaviors, he is typically threatened with termination of his treatment, rather than questioned about its effectiveness. (Source)
So clearly, labeling a patient as a "drug-seeker" is not only libelous, it is unscientific as it is impossible to determine whether a person is an addict or not simply through behavioral cues. Of course, doctors certainly do not need to use the PRF feature to blacklist a patient, but can do so through more traditional means or by simply entering libelous or inflammatory comments in other areas of the patient's medical record. But the mere existence of the PRF suggests to any doctor in the VA system that blacklisting a patient is not only a permissible but a desirable thing to do, even when that blacklisting doesn't fall within the parameters of the stated guidelines, which are problematic in themselves. Thanks to the VA's creation of an officially-sanctioned, computerized blacklist, many veterans may find themselves unfairly branded for the "crime" of being wounded during their service and demanding treatment for their pain.

(The VistA software was developed at taxpayer's expense and is public domain and can be downloaded with a Freedom of Information request, but the website also has a downloadable demo available here.)


Anonymous said...

one of the only patients i've cared for at the va that i remember being flagged (in advance of my encounter) literally almost beat me up after i refused his completely ridiculous requests for opiates. flag away, i say. if somebody else's "libel" protects me from battery, all the better...

Payne Hertz said...

Of course, this begs the question how the patient protects himself from your particular form of battery, which is denial of treatment and blacklisting. Some people are not as inclined to give you a pass for gratuitous attempts to destroy their lives as others, a point you might want to consider along the road to a much needed attitude adjustment.

Anonymous said...

Dear Anonymous VA provider:
What exactly is a "completely ridiculous request for opiates?" Did you make your decision not to precribe medication before you walked into the room based on the flag in the patient's chart? Could the patient's response to your denial of treatment be based on his fear, frustration, illness and pain? Unless you have lived with chronic pain, you have no idea how powerless you can be made to feel by a medical provider who dismisses your suffering. I imagine your patient to be a crusty old line seargent wondering why a snot-nosed young doctor who is still wet behind the ears could possibly know anything about medicine, let alone properly treat him for his pain. Has compassion left the medical profession? It seems to have left the VA, and you.

From a veteran who is also a compassionate RN with chronic pain

Anonymous said...

Hi all,, am wondering if i have been Blacklisted. have been fighting the VA for 7years now after they, the VA dr's, broke off two pieces of wire inside me and left them. have filed a 1151 claim but to no avail even using a lawyer hasnt helped. I need to find a doctor in Arizona who will help me fight these people. Also went to the VA in Phx, to get help for my pain, the dr there gave me a small amount and that was it, when i moved out of the metro Phx area and had my records tranferred to the Prescott VA, the docotor there would not help at all, said that since i get all my meds from my outside doctor i would have to go to him,k, thats BS, they are there to help ALL of us, i finally drove all the way back to Phx to see my private dr and he did give me a script for pain meds, i hate living with this pain but have no choice, my private dr has mentioned that i might have to have my kidney removed because of the FU of the VA dr's. I have no faith in the VA anymore. Have a Happy New Year you fkng VA doctors

Ian MacLeod said...

I strongly suggest you look into the Pain Relief Network. There you'll find some stories of people whose lives are being casually destroyed by people like you, along with how pain should be treated and why. You'll find my own story there, as well as those of other veterans. You'll also have a chance to explain your POV.

Ian MacLeod

Ian MacLeod said...

I had to add more than that last comment: I have been a chronic pain patient for the past 23 years, during which time I could have been working and contributing instead of having to beg for the medications and procedures that kept me alive, if just barely at times. Because of lack of Tx, I have lost my home, job, a wife and child (who has since moved here to be with me), ended up on the street, and I have treated as an addict, no definitive tests done, then had 6 back operations. For a time I was treated right and actually put a life together again.

Now, sole caretaker of a wife in end-stage COPD, I have been blackmailed into signing a draconian pain contract that is designed to be unavoidably violated,(my PCP and I already had one that had worked well for years), been forced to see a "Pain Management Specialist" whose "specialty" seems to be removing any medications that help - he removed 2/3+ of my oral meds with no exam, no consult, just took away the meds and threw me into withdrawals, and left me in almost too much pain to move, much less care for a dying wife. How would YOU feel if you were forced to be the instrument of your dying wife's early death by neglect when the regimen you had been on - a legal, medically justified and effective regimen - was pulled out from under you, destroying your ability to function?

Aside from the fact that we're human, you VA doctors seem to forget how we were trained, and how we stayed alive. It may have been recent, or as in my case (I'm 51) it may have been long ago, but no one forgets training and experience like that, and no one is friendly to someone who just casually calls him or her a liar and just as casually, literally destroys one's life. And make no mistake - that's what the result is!

I am a moderator, contributor and administrator, as well as an advocate at PRN. You will find some strong emotions there, but no attacks. There are links to educational materials all through the site, including a vet's forum with our stories, and materials on current treatment standards, VA directives (which the VA itself is violating) - there's a LOT of information there, and there are also doctors and other healthcare professionals, as well as extremely well-informed lay-people.

Please - for your own sake as well as that of your patients, check it out!


Ian MacLeod

momcat617 said...

I'm going to print this off and keep it. I think my husband has been blacklisted at the VA.

He's been diagnosed with ankylosing spondylitis, which is a progressive degenerative disease of the spinal vertebra. He had an appointment at the pain clinic last week because his pain meds are not working any more.

He had a failed nerve block last year at the VA, and has had trouble with his legs working properly ever since. The doctor who did the block sent him for an MRI, which didn't show any cause for the problems.

Now this same doctor has scheduled him to have a psych eval for somatization syndrome, which is basically saying it's all in his head. He is in therapy for PTSD, so they're using that as an excuse.

We are furious, and worried that they will do it the eval from his records if he cancels it. He has already been diagnosed with a condition that causes chronic pain, and we think he's been blacklisted as a "problem patient."

My question is, how do you fight this?

Payne Hertz said...

"I'm going to print this off and keep it. I think my husband has been blacklisted at the VA.

He's been diagnosed with ankylosing spondylitis, which is a progressive degenerative disease of the spinal vertebra. He had an appointment at the pain clinic last week because his pain meds are not working any more.

He had a failed nerve block last year at the VA, and has had trouble with his legs working properly ever since. The doctor who did the block sent him for an MRI, which didn't show any cause for the problems.

Now this same doctor has scheduled him to have a psych eval for somatization syndrome, which is basically saying it's all in his head. He is in therapy for PTSD, so they're using that as an excuse.

We are furious, and worried that they will do it the eval from his records if he cancels it. He has already been diagnosed with a condition that causes chronic pain, and we think he's been blacklisted as a "problem patient."

My question is, how do you fight this?"

I wish I knew the answer, Momcat. I know that any refusal to fully comply with the demands of the pain management doctor to get a psych eval or anything else he orders may be interpreted as non-compliance, and may result in your husband being denied treatment. So unfortunately you do have to play the game, even though having a psych eval on his records can in and of itself be used to deny treatment based on the alleged "somatization." It sounds like the doctor is just trying to cover his rear by trying to document that any pain your husband has suffered since he did the procedure is the result of somatization, and not medical error or simply a failed procedure on his part. If you find you are being stonewalled in getting proper care and are being treated as a "difficult patient," then it can sometimes be in your interest to become just that by writing your senator and demanding an explanation of what they are doing and why. Very often, doctors will recognize the path of least resistance is just to cut the bologna and do what needs to be done rather than deal with the hassle of a senator's office scrutinizing their practices, though of course this is no guarantee. I wish you the best of luck, No one should have to endure this kind of treatment but unfortunately, that is the way things are in this country your husband and I gave of our time to serve.

Anonymous said...

My husband believes he has been blacklisted by the VA also. He didn't even know about this software until he looked it up online. He has had problems with his primary care provider, she gives him a hard time. He was evaluated as having Gulf war syndrom a few years ago and was always sick. Recently, he had a operation paid by the va for Arterial fibulation, afterwards he developed a pulmary emobolism and was in the Va hosp. for a week or so. While he was there he took note of how the patients were being mistreated and ignored, he tried to take pictures with his cell phone and they called security. anyway, I think this action has put him on thier blacklist -- he has had shortness of breath and a fever for 3 weeks, he went to the emergencyroom at the VA-- sat there for 4 hours, someone finally came out and told him all his tests were negative (blood tests, x-ray) and if he still has a fever to go and see his family doctor. So, yes I truly believe his record is flagged. He vovs never to return to the VA for care.

Anonymous said...

I am being blacklisted now in my local medical community due telling a doctor that I was going to report her practice to the medical board because of complete incompetence. Her assistant did not even know how to take my blood pressure. Word is spreading and both my CT and US results have been fraudulently reported stating that the lymph nodes in my neck are not diseased. I know I have cancer and I looked at the scans myself and it is obvious. Also, my Ca-125 level is increasing dramatically and my neck is swelling as well. I believe in justice but mostly I believe in Karma. Trust in God or whatever higher force and stay on the right path. Ask God for direction and protection and find the voice inside where he speaks to you.

In 2002 I worked for a mortgage company that fumigated for mold for a month while we were in the building. They lied to us and told us that it was safe. When we continued our complaints, we were told that we did not have to work there. My immune system has always been compromised and I was very sick. My health continued to decline and I finally had to go out on disability. I believe that the chemical used was Ethylene Oxide, which is one of the main chemical components of Mustard Gas. I now have symptoms related to Gulf War Syndrome.

In regards to the 'flag' system: I am saddened by the 'use them up and spit them out' attitude about our heroes. Many of you have been forced to kill and witness atrocities that no one should ever have to experience. Life on earth is about freedom over our own minds and bodies. Do not allow anger to take over your hearts. Try your absolute best to limit your dependence on this corrupt part of the health care system by forgiving yourself and loving yourself and your loved ones.

People everywhere are finding their voices and will prevail against cruelty and malicious evil.

Love and light

Anonymous said...

Contact the Office of Civil Rights and inquire about the HIPAA law regarding privacy of medical records and who should have access to them. They also have a website. It is in everyones best interest to read through your rights so that you do not have to depend on others to inform you. Good luck to all.


Anonymous said...

A psychologist once told me that I was 'fucked up' after I confided in her that I was going to report a very popular hospital to the local health department for the filthy conditions. When I asked her what security measures are taken to insure privacy of my records, she replied 'honey, there is no such thing as privacy in the medical industry'. What a 'psycho-logist'!!

Is 'fucked up' an actual medical diagnostic term??? She's on MY list.

Anonymous said...

If I'm in chronic &/or intense physical pain and I go see the doctor seeking treatment, how is this not, given the efficacy of pain-killers in treating pain, a "drug-seeking behavior"? It's a relief-of-symptoms-seeking behavior, a "treatment-seeking behavior", if you will, which in many cases calls for the dispensing of drugs. You know, stimulants are the first-line treatment for AD[H]D for a reason, and the fact that they can for some also be "fun" and "worth-seeking" should not delegitemize the efforts of those afflicted patients who also "seek" to enlist their aid in the struggle to manage symptoms and function effectively. The behavior of actively seeking drugs is not in itself a negative thing, though with connotation laden terms like "drug-seeking" it is often greeted as such in the medical community. And this is quite unfortunate.

Anonymous said...

At our most recent appointment, we noticed the flagg highlighted in red on my husband's PCP computer. We asked whatit was and to look at it because it is part of his record she showed us.

It appears that the flag was a CATI flag (National) stating that he didn't like his provider so he allegedly spat on him. Well I can tell you now, my husband doesn't spit and this never even happened. Interesting that the flag was added just days after a VA employee was told to right a written apology to my husband for the VA employees behavior towards my husband during an appointment. How can these weasels get away with this crap? and what can WE do about it?

Anonymous said...

I've been through so much at the VA and I have written numerous letter to my representative congressmen with no results. When I tell a doctor at the VA I'm going to write a letter to my congressman, she just shrugged.

I was injured in an accident in 1993 while on my way to work. The accident was not my fault. Immediately I started having pain in my shoulder. I went to the doctor and told him that I was hurting and he did X-rays and told me that there was nothing wrong with my shoulder. I saw an orthopedist who said there was nothing wrong with my shoulder. I had to stop working and go on disability. I no longer had insurance so I started going to the VA for help. I was told that there was nothing wrong with my shoulder and that I just wanted narcotic medication. I have taken so my Tylenol over the years that I now have liver disease. In 2008 with Medicare Advantage I was able to see another doctor outside the VA system. The doctor told me that I had a broken arm, a torn rotator cuff, and some arthritis. He did surgery and I was out of pain, no pain meds needed, but it only lasted for 1 year. In Nov. 2009 the pain returned and is worse than ever. I have long believed that doctors deliberately misdiagnose persons injuries to prevent insurance companies from having to pay a claim. Well, after my surgery I had signs printed saying this and placed them around the city. I HAVE BEEN BLACKLISTED! Doctors in the US have told me that there is nothing wrong with my shoulder. I went to Venezuela and the same tests were performed there, that had been performed in the US and I was told that there were two torn ligaments in my shoulder and a separated bone. I was told that I needed surgery, however the insurance company wouldn't pay for surgery outside of the US.
Not only have I been blacklisted in the US but I'm finding that it's the case in France as well.
Please refer to sites on "blacklisting by doctors", it's quite prevalent. As of yet I have found any information on how to get treatment when you have been blacklisted. If you have any information please post it here as I will be checking this site frequently.

Payne Hertz said...

Anon, I am sorry about the ordeal you have been through, and wish there was a simple answer to patients being blacklisted. The only thing I can suggest is to keep on going to doctors until you can find one who is ethical and honorable and doesn't play these games. Of course, I am sure you realize that it is dangerous to bring medical records from doctors who have previously been problematic, so perhaps the best thing you can do is tell any prospective doctor you want to start from scratch with a fresh perspective. Easier said than done.

As for your suspicion that doctors deliberately misdiagnose patients so insurance companies can avoid paying claims, that has absolutely been confirmed. See this article on fraud by the "independent medical examiners" hired by workers comp insurance companies.

According to one doc in this article:

“If you did a truly pure report,” he said later in an interview, “you’d be out on your ears and the insurers wouldn’t pay for it. You have to give them what they want, or you’re in Florida. That’s the game, baby.”

These IME exams are supposed to take as much as 45 minutes, but typically take less than two based on which the doctor generates 6 pages worth of bogus narrative.

NY State has even gone so far as to pass an IME fraud bill to confront this kind of abuse, but I would imagine it is mostly window dressing and this kind of thing still goes on in NY as elsewhere.

electronic medical records said...

Very informative! Thanks for sharing. I just wonder if there is any update with this post.


Anonymous said...

I have been blacklisted and cannot receive the healthcare I need in my country.?
I have been blacklisted by the medical community in my country the U.S. because I attempted to expose corruption in the system. I am in horrible pain and have been for months. Doctors will tell me that there is either nothing wrong or that they don't know how to treat me. Example: Most recently, I have a toothache, and one dentist referred me to another to have a root canal on an infected tooth that had already had a root canal. When I returned to the VA Hospital and saw another dentist he said that he couldn't tell what was causing me the pain. I have a shoulder injury and have seen several doctors in the states that tell me that nothing is wrong with my shoulder, I went to Venezuela and was told that I had two torn ligaments and a separated bone in my shoulder. The doctor there wanted to perform surgery but my insurance wouldn't pay for surgery outside the country and the public hospitals there weren't up to performing the surgery that I need. I am diabetic and the doctor that was treating me was aware but I didn't find out until 6 years later when another doctor within the system told me. The same year I found out that I was diabetic I found out that I had kidney disease. I have been having UTI's since Feb, I found out that it is because I need a hysterectomy. My stomach has been killing me, I am often rolling in the bed crying because of the pain, the doctor I saw that was going to do surgery told me I would have to wait atleast 2 months. I traveled to another state to get the surgery and the doctors I saw there told me that I did not need a hysterectomy and that in fact it would be dangerous for me to do so. I canceled the scheduled surgery because one of the doctors was from a prestigious university hospital and told me that it would be dangerous for me to have the surgery. I ended up in the emergency room and an ultrasound was performed and while the tech was performing the test she was pressing on something in my pelvis and after the exam the pain was gone. I do need a hysterectomy. I saw a doctor today, the one that initially told me that I needed a hysterectomy, and he scheduled me for an ultrasound, but the test can't be done until 18th Aug. I am making arrangements to have test result from Emergency Dept faxed to doctor here so that maybe I can get the operation sooner. I am unable to use the bathroom without taking a medication to (sorry) liquify the stool. I still have horrible pain and am considering a liquid diet to see if that will help.
Question: I want to know which is the best country for me to seek asylum? I feel as though I am being tortured to death in my country the U.S.A.

2 days ago
- 2 days left to answer.

Action Bar:
0 stars - mark this as Interesting!


Answers (2)

Rick Rick
You are getting service from the VA! -- Nice try Troll!
2 days ago
Report Abuse

Choose as Best Answer

Anonymous said...

I am disgusted by how prevalent apathy, disrespect, disregard, and outright emotional and verbal abuse is leveled at veterans seeking care.

I have seen check-in clerks treat veterans doing nothing more than trying to make an appointment or check in for their appointments be spoken to like they are chattel. Your average VA hospital has, at most, 3 PA's for THOUSANDS of vets and are usually very burnt out people whose role is a job that gives them no real power. The personnel suffer no real repurcussions. I've even seen clerks REFUSE to allow veterans to either know the name of or speak to their supervisors!!

I believe the IG needs to be ALOT more involved in the process of cleaning up the administrative and sub-par medical personnel in hospitals and mental health clinics. There really should be a sense on the part of VA personnel of "Uh oh..." when or if an agent with the IG comes in.

I also believe that veterans should abandon, as much as possible, their own belief that they should 'suck it up' and passively accept this sort of treatment; abandon the whole concept of 'chain of command' where complaints to VA personnel are concerned, and send their complaints directly to the President's office. Period, end of story. I sincerely believe if the President were TOTALLY AWARE of exceptionally poor, abusive, and dangerous treatment that most veterans experience at some point, ( things can be great at first, and quickly deteriorate so it's not the negative reviews that I am specious about, but the positive ones - sad, but a reality ), he would swing the hammer from above ( as he should as Commander in Chief ) and make reverbating, widesweeping, and serious changes within the VA as well as the VBA and then set up national teams of EXTERNAL audits of VA's and do this by INCLUDING veterans themselves by both an anonymous and client facing system of resolution for veteran complaints.

Here's hopoing the top representatives in groups such as the DAV and AmLeg really ARE taking issues vertically with immense steam and here's hoping more and more veterans form organizations that 'watchdog' the VA. It is high time that the culture inside the VA of 'get a job and coast' be ended for good and that employee reviews and such are taken with a great deal of understanding that two poor performance reviews, to include veteran complaints, is sufficient for permanent dismissal with no chance of being re-hired in the VA system in ANY position.

Taylor said...

I have been intentionally battered by a number of MDs in a series of assaults over a few years. I have been trying to blow the whistle on corruption by the medical indemnity insurers, such as Doctors' Choice, Kaiser Permanente and outside of the US the most prevalent one seems to be the Medical Protection Society. All are insidious and making out like bandits in terms of profits.

AMA lobbying & policy, tort reform, waves of health and civil liability legislation to limit patients’ rights, and collusion between all law firms, especially the plaintiff's law firm, ensure you have no legal recourse to either a fair courtroom and least of all, compensation for your injuries. This is proving very profitable for the insurance sector and the medico-legal industry. Medical malpractice liability insurers, including doctors' mutuals, are medical defence organisations (MDOs) and are the puppeteers coordinating all the fake medical reports, fake x-rays, fake IME reports, electronic medical records and patient blacklist databases. They are the ones behind the frontline of terror and abuse we experience as criminally battered or iatrogenic patients. The American Medical Association is the lobby power, but don't forget none of our dire situations are possible without collusion by law firms, government and police, and the financial sector, insurers and actuaries.

It is this kind of information the MDOs don't want in the public domain and have, with the help of corporate friends and government, been wiping blog posts, shutting down websites, using spambots to stop comments, buying up independent news sites and book publishers into the corporate domain, sending viruses to anyone if they can your IP number from websites they are targeting or bribing. Medical indemnity insurers are worse than health insurers but much more secretive. Both collude with their big law firms to abuse the information on your medical records in their defence strategies with law firms.

Medical boards (who don't protect the public), government health authorities (who use the same corrupt and dirty tactics to avoid paying Workers' Compensation), law firms, website/ media editors and journalists, etc all pass your information on to their country's medical indemnity insurer for various kinds of 'incentives' (kickbacks).

With great sites like this, let's target them and expose them for decades of sinister activities against the public. Don't be fooled by their propaganda, astroturfing and frequent Google-bombing to hide the truth about them.

James Inderson said...

Nice post with great details. Like it. Thanks.

emergency alert software

Butler Chean said...

It's actually a cool and helpful piece of info. I'm happy that you shared this helpful information with us. Please keep us up to date like this. Thanks for sharing.

Need help in billing? Please visit:
Medisoft Software

Anonymous said...

Hahaha! Pathetic Butler Chean and James Inderson!! The advertising for the two types of medical software posted above by doctors/ medical indemnity insurance companies and/ or their law firms are exactly what hospital corporations, doctors and dentists use to report 'adverse events' information to medical indemnity insurers about patients.

It starts the process of monitoring and tracking of injured patients and this type of software ia at the heart of blacklisting and secret surveillance of patients that the public don't know about or understand.

The medical malpractice indemnity insurers and their lawyers then instruct doctors and dentists in what action to take on injured patients-taunt them/ refuse them treatment/ batter and assault them further/ fleece them for costs of no treatment or further bad treatment/ swap in fake radiographs and x-rays with their photoshopped evidence they want to show that shows the injury is caused by the patient as much as possible/ orgainse an ‘expert witness’ who is a hired gun for the insurers and make sure the duplicitous plaintiff lawyer gets a cut of the IME report fees and maybe some retainer fees as an exercise in how to easily fleece the patient for some easy money/ etc etc.

It's all part of the American Medical Association's policy of providing 'secure online reporting' of 'adverse events' so the insurers can 'risk manage' and 'limit the risk' and ensure no prima facie evidence is given out or restorative treatment to the patient, and so, NO COMPENSATION.

It's abuse of privacy at its worst and institutional corruption at its clearest. This is what medical malpractice tort reform means and you should stop the Republicans from furthering the interests of the insurance lobby. The AMA is just a front for the insurance industry, an industry which is not subject to fraud and collusion laws.
Tort reform is tort 'deform'.

Anonymous said...

I have experienced blacklisting
to an extreme for several years
due to a car accident case which
was not my fault and was settled in my favor
in a small way due to tort.
Since then I have repeatedly
received no treatment and poor
treatment by doctors. This past
year two serious health
conditions were not made known
to me and I found out by accident.
Do patients have any recourse
against blacklisting which is
another name for white collar
murder of innocent patients.
Because "failure to diagnose"
serious conditions can have
devastating results for the
unknowing, innocent patient.
Thank you.

Anonymous said...

Blacklisting is a reality. I'm blacklisted. However, I've concluded that trying to deal with incompetent doctors at the VA isn't going to help my pain. I suggest you all move to a state where weed is legal as it will provide some relief. Especially if you drink a couple beers and then smoke a bowl of good Indica. Other than that, I'm taking my SSDI payments and heading out of the country. There are places where your disability are more than sufficient to allow you massages three days a week and you can lay around on the beach everyday. I will not comment on the availability of other substances in third world countries. You'll have to figure than one out on your own but I'll say you can get major pain relief. I'm outta here!

Giftbearer said...

This not only happens in the VA system but in civilian healthcare corporations as well. A major healthcare corporation tried to destroy my ability to get diagnostic testing and treatment after I asked why my treatment was moving so slowly and my condition got worse ending up in my being hospitalized for 11 days. I ended up again at the ER (this time the one where my doctors practiced in the connected clinics) and was abused and bullied by an on-call neurologist, beaten with his hammer, suggested I had s mental problem, and then his resident slammed her butt down on my foot to see if I was faking. Soon after, I found he and a mid-level hospitalist had written libelous statements in my electronic medical record, some of them innuendo and some outright directly accusatory, written in a very contemptuous tone.

I filed a formal grievance and found that their department which was supposed to investigate such matters called "Patient Relations" was a complete sham and only there to give the appearance of fairness in order to meet their federal funding requirements. The woman assigned asked me on our second conversation "why" a "doctor would do that", clearly showing her bias.

As I feared I lost almost every doctor in their clinics that I had had a positive working relationship with, all but 2 of the ones I saw most frequently turned against me (including my primary care physician of 13 years. It was quite upsetting to go to his office and find him laughing, sneering, and rolling his eyes at me because of the opinion of a doctor neither of us knew nor had any relationship with, and then another doctor told me based on the gossip he was reading in the electronic record that I should see a psychiatrist, adopting the same sneering and disrespectful demeanor the GP had exhibited just a week earlier.

You can read more about what happened to me at where I've provided some links to news sources that show a pattern of corruption the corporation shows and copies of some of the threatening letters I received from key people in positions of power within the corporation. Rather than doing the right thing and removing the libelous material and providing me the care I needed to move on with my medical diagnosis and treatment they covered it up and made me the focus rather than the bad apples who acted unprofessionally in their employ.

I do not know whether the corporation that tageted me has an official tagging system, but the coded language was very clear and it achieved the purpose they intended (to deny me access to timely diagnosis and treatment for my medical condition(s).

This sort of predatory behavior should be against the law and those who blacklist a patient, prosecuted to the fullest extent of the law. I'm currently trying to get existing laws strengthened so that this trend will not continue to have a pay-off to medical personnel.

Giftbearer said...

I ask everyone who reads this to please sign this petition and if you have a personal experience with blacklisting or other abuses at the hands of medical professionals please add your stories. These accounts and signatures will be counted by Dept. of Health and Human Services and sent to Secretary Sylvia Burwell for the purposes of letting them know what a widespread problem this is so that HHS will put this on their list of priorities.

We need for them to close all loopholes that such medical settings currently use to circumvent accountability such as their incestuous practice of stating "we find this material to be true and correct" which is all an entity is required to state in order to floor any and all administrative procedures currently at a patients' disposal. How on earth can a corrupt medical corporation be reasonably trusted to police itself. Of course it is going to double down and cover the butts of all those under its umbrella.

In my situation although I could prove with documentation that the corporation retaliated agsainst me for filing a complaint (a violation of every civil rights law in the land), my Office of Civil Rights complaint was closed in less than 30 days with the "true and correct" loophole outlined but no other explanation given. That is as far as one can go administrstively. I have been advised to take legal measures to restore my good name, but this is such uncharted territory legally that most attorneys are daunted by the thought of filing suit because it spans several areas of law and is sort of a hybrid of Civil rights law, Defamation, Personal Injury, and Malpractice. Attorneys are faced with a David and Goliath scenario in which there are few if any precedents. This is not the way I would have preferred to handle it but the corporation refused to correct their malfeasance at every level, and quite frankly left me for dead.

Moving out of the country or even the state is not an option for me, as I am a homeowner and pretty much bedbound. Most likely I will die here.

I was never any danger to anyone, so warning doctors I might see in the future was designed to do nothing but kill me by default because, simply put; I was assertive enough to ask for what I needed medically, because I called bullshit on the healthcare rationing that goes on under the surface of a profit-driven system.

4edental said...

Thanks for the fantastic clarity of your writing. I most certainly will directly grab your rises feed to remain up-to-date with any updates about Patient Record Management System.

Anonymous said...

If the veteran has a PRF Patient Record Flag, Are the VA police allowed to be in the room with the doctor during treatment ? And two can the Veteran go to release of information to see what has been written by other doctors in the Veterans PRF file ?

Lazoi Thelifecare said...

One of the unique services provided by us is the online software for Doctors. Under this service we offer to manage the profiles of the doctors who tend to opt for this service. If you opt for the Practice management software, we will assist you in various ways for enhancing your practice as a doctor. We understand the fact that it is difficult to keep track of all the aspects of a flourishing practice. We offer to manage your profile and various administrative work required for the successful functioning of your practice.

vanaja N said...

For best health care network and online Software for doctors
Healthcare providers in India,
Best Doctors Electronic medical office
Best Practice management software for Hospitals
Medical Software for Doctors in India
Best Online appointment software for doctors
EMO Provider in India

Anonymous said...

For best health care network and software
Doctors Electronic Medical Office,
Health care services in india,
Patient’s e-consultation
Best Health care network in india

vanaja N said...

For best health care network and hospital software
Online Appointment booking system,
Patient medical record app,
Online Pharmacy Order services

vanaja N said...

Nice comment for best hospital and doctors Software click on below link
Best Doctors Electronic medical office,
Best Practice management software for Hospitals,
Certified EMO Software Providers-i Physicianhub
Healthcare providers in India,
Best Online appointment software for doctors

vanaja N said...

Good Information For best health care network and software
Doctors Electronic Medical Office,
Health care services in india,
Patient’s e-consultation
Best Health care network in india

vanaja N said...

Nice Information for best health care services click on below link
Online Appointment booking system,
Patient medical record app,
Online Pharmacy Order services
Mobile friendly health care apps