Initial Review Finds High Prescription Dosages, Unsafe Practices At Tomah VA

The Department of Veterans Affairs released an initial review of practices at a VA medical center in Tomah on Tuesday.

An investigative report by the Center for Investigative Reporting in January shed light on prescription practices and an alleged culture of fear at the Tomah VA that led to the launch of multiple investigations into the facility.

The VA clinical review released on Tuesday found that 11.5 percent of Tomah’s patients are prescribed opioids, which is less than the VA’s national average of about 14.5 percent. But among those veterans, the report said, Tomah VA patients were more likely to have substantially higher dosages.

A small sampling of patients also found unsafe clinical practices and injuries that may have come from prescription use.

Veterans Affairs Deputy Secretary Sloan Gibson met with Tomah VA employees, whistleblowers and area lawmakers on Tuesday. He said an outside organization is conducting a more in-depth review.

“No one or no subject is out of bounds,” said Gibson. “Wherever the evidence leads, we will follow. And my commitment is that we will take appropriate administrative action, disciplinary action where we have the evidence to support it.”

The external review comes on top of at least two internal VA investigations. The Drug Enforcement Administration and the state of Wisconsin are also looking into the facility.

Meanwhile, Gibson said the Tomah VA has been rethinking how it deals with pain management.

“A very large percentage of veterans who come to the VA for care, both the younger generation of veterans and the older generation of veterans, have chronic pain as one of their core problems. If there’s anything we need to have deep core competency in as a health care institution, it’s pain management. And it can’t be a bag of pills all the time,” he said.

Gibson said that in addition to the issue of patient safety and the quality of care at the VA, employees continue to fear retaliation if they question certain practices. He said trust can be earned back slowly through transparency.

Gibson also announced that as of Tuesday, two clinicians at the center of multiple investigations were placed on administrative leave.