THE COUNTRY has a porous system for protecting patients from unfit doctors. That much is clear from the case of a Massachusetts surgeon under scrutiny for botched operations here, who went on to be investigated for possible malpractice in Illinois. The fact that the surgeon, Dr. Jose Veizaga- Mendez, found work at a Veterans Affairs hospital has also raised questions about how carefully the VA is screening applicants as it staffs hard-to-fill positions in rural hospitals.
Illinois's two senators, Democrats Richard Durbin and Barack Obama, have called for a hearing on the case by the Veterans Affairs Committee tomorrow. The senators should scrutinize the hiring practices of the VA as well as the national databanks on disciplined doctors maintained by the US Department of Health and Human Services.
Veizaga-Mendez landed his job at the VA hospital in Marion, Ill., in January 2006, while under investigation by the Massachusetts Board of Registration in Medicine. This January, the board charged him with eight instances of substandard care at a hospital in Attleboro. But because the case was just in the investigative stage with information still kept confidential, VA officials in Illinois learned nothing from the Massachusetts board about Veizaga-Mendez's problems. Now the VA, alerted by a surgical quality surveillance system it maintains, is investigating his role in the deaths of up to 10 patients since he started working there, including a 50-year-old Air Force veteran who died in August after what was expected to be routine gallbladder surgery.
The most direct solution to the loophole that Veizaga-Mendez took advantage of would be to have state regulatory boards report to the databanks as the boards begin an investigation. The potential downside to such early publicizing of an investigation is that it could keep a doctor's colleagues or superiors from bringing concerns to the state boards. The senators should spur the operators of the databanks and the state regulatory boards to come up with a reporting mechanism that gets information to the databanks in a timely way without discouraging the reporting of possible misconduct by physicians.
While information from the Massachusetts board was not in the databanks when the VA hospital hired Veizaga-Mendez, officials there did know about other red flags in his record. The VA has reassigned four administrators at the Marion hospital while it conducts its own investigation. The Senate should explore whether growing wartime demand for VA facilities has caused officials to lower their standards in hiring, especially at small, rural hospitals like the 55-bed one in Marion. No patients - and especially not patients who have served their nation - should face the risk of being treated by physicians who have fled disciplinary action in another state.
