David Cowgill VISN 4 PAO receives “I don’t care award”

Its time for VAmalpractice.info to recognize those who have contributed the most to covering up what has been going on at the VA. Few people realize that the VA spends millions of dollars each year on its publicity machine. In fact the VA employs a group of spin doctors who make big tobbaco’s publicity efforts seem honorable. The VA probably does have some legitimate need to have a staff who can respond to media inquires and compose informational public service announcements, but do the taxpayers really benefit when the VA advertises that its” better than the best?”

Our first winner is David Cowgill whose efforts included producing a series of TV ads advertising that VISN 4 was “Better than the best.”Let’s face it takes guts to claim that your “better than the best” when your the subject of a Congressional investigation into an outbreak of Legionnaires’ disease, but then again this is the way the VA publicity machine deals with the VA’s problems: declare victory and go home!

During the height of the Legionalla outbreak these ads featured Michael Moreland claiming that the VA had taken on the leading hospitals in the country and had beaten them in various measurements.

When VISN 4 compared its ability to provide quality health care with the best hospitals in the United States, we equaled or exceeded our competition in every category. This is proof that our nation’s heroes are being provided the quality of health care that they richly deserve.

The measurement of things like “patient satisfaction” is subjective and comparison with surveys conducted at nonVA hospitals is difficult and gave the VISN 4 free reign to use fuzzy math at its finest! Interestingly the spots never mentioned that VISN 4 has the worst ventilator acquired pneumonia rate in the VA system. In fact it was far worse than the 22 other VISNS in the VA, but when your ads are not accountable to any agency for false advertising you can get away with things like this!

If this wasn’t enough his department made liberal use of the VA’s police department to keep Anderson Cooper’s colleagues out of the Pittsburgh VA and prevented members of the media from using recorders when they interviewed Michael E. Moreland, to record the interview. This is a standard reporting practice, which allows reporters to double check to make sure that they are actually quoting someone correctly, was prohibited by Mr. Cowgill and enforced by the VA’s armed police officers! So much for freedom of the press in VISN 4.

VA OIG confirms medical malpractice at the Erie, PA VA & Pittsburgh VAMC in treatment of cancer patient.

VA declares victory over quality of care issues, despite the facts: or

“Maybe they’re drinking too much of their own Kool-Aid”

The September 25, 2013, VA OIG’s report “Quality of Care Issues: Erie VAMC & VA Pittsburgh Health System” is yet another in a series which should be called “More news from Michael Moreland and VISN 4.” The OIG’s 11 page report tells a sorry story about the medical treatment that a veteran received from August 15, 2102 through October 1, 2012 for his liver cancer, it tells an even sorrier tale about the “treatment” that this veteran and his family received from an institution that has the audacity to spend the taxpayer’s money to advertise that “it is better than the best.” These six weeks turned out to be the only medical care that the veteran would ever receive from the VA, as he died on October 6, 2012. The OIG found: We substantiated the allegation that VA providers did not diagnose the patient’s cancer.. We found VA providers missed opportunities to identify the patient’s cancer and determined several factors that may have contributed to providers not making the cancer diagnosis… We substantiated the allegation that the patient’s pain was not fully addressed… We substantiated the allegation that there were scheduling delays in the patient’s referrals and follow-up care… We substantiated the allegation that this patient did not receive comprehensive oversight through the continuum of his care… During interviews, many referring providers from the CBOC, Erie VAMC, and Pittsburgh HSC told us it was difficult to communicate with the gastroenterology and Hematology Clinic specialists. They told us their phones calls occasionally go unanswered and the specialists did not always return phone messages. Unfortunately none of these finding are surprising; but what is amazing is the indifference to reality that allows the VISN 4 leadership to continue their tireless campaign of self-promotion and disinformation at the expense of the taxpayers. Let’s look at the dates of this veteran’s treatment and a few other things that were happening in VISN 4:

• 8/15/2012 Veteran’s first contact with VA system
• 9/30/2012 End of VA’s fiscal 2012 year (This is the year that Michael Moreland received the $63,000 presidential award for)
• 9/30/2012 VISN 4 is rated the worst in the country using the VA’s own ASPIRE quality measurement system for Ventilator Acquired Pneumonia
• 10/01/2012 Veteran’s last of 13 contacts with VA system since 8/15
• 10/06/2012 Veteran Dies
• Fall 2012 VISN 4 “Vision for Excellence” features stories proclaiming that healthcare provided to veterans in VISN 4 is better than the health care provided by the top 5 hospitals in the nation.

Despite the tragic care that this veteran received, the fall 2012 “Vision for Excellence” had no trouble extolling the quality of the medical that VISN 4 delivered to veterans and pointed out that its ad campaign “Better than the Best,” informed Veterans that the quality of VISN 4’s care is equal to, or better than, the top five hospitals in the Nation. I’ve seen this ad and it unilaterally declares that VISN 4 “beat” the competition in vague areas like “patient satisfaction” by statistically insignificant percentages. With no explanation if these figures were gathered in the same manner at VA and nonVA institutions, Mr. Moreland enthusiastically claims that VISN 4 took on the likes of Johns Hopkins and won! The odds are pretty good that the veteran in this OIG report, along with a few who died from Legionnaires’ disease probably didn’t return their patient satisfaction surveys, but if they did they might disagree with Mr. Moreland’s evaluation. No matter what you’ve got to give Mr. Moreland credit, not everyone can get up and say that we are better than the best when you’re in the midst of a Legionnaires’ disease outbreak, a congressional investigation and you have the worst record in the entire VA ventilator‐associated pneumonias.

Ironically, nowhere in this “public service announcement” does Mr. Moreland mention that VISN 4 had the worst ventilator acquired pneumonia rate in the entire VA system. Out of the VA’s 23 VISNs, VISN 4’s record was twice as bad as the second worst VISN. This sort of head to head meaningful comparison would have provided veterans with meaningful information and would have been a “public service” because it would have warned veterans that they would have been better off going to any VISN besides VISN 4 if they were concerned about possibly getting ventilator‐associated pneumonia. Instead Michael Moreland just uses a lot of fuzzy math and unilaterally declares victory over all quality of care issues in VISN 4 and led veterans to believe that all is well. This superior level of chicanery did not go unnoticed in Washington, where this sort of thing is considered career enhancing and resulted in appropriated recognition:

…“Better than the Best,” informed Veterans that the quality of VISN 4’s care is equal to, or better than, the top five hospitals in the Nation. This campaign won first prize in VHA’s annual communications awards program in 2012.

• 9/6/2013 Michael E. Moreland endorses the OIG report for the veteran who was treated so poorly at the Erie, VA, prior to his testimony at the 9/9/2013 HVAC hearing to examine preventable deaths and accountability at the VA. That must have put him in the right mood for the hearing. Maybe that’s why he looked so green?

Despite the overwhelming evidence contained numerous VA OIG reports and congressional investigations confirming patient safety lapses in VISN 4, during the last five years, VISN 4 continues to spend money explaining how it has done such a wonderful job dealing with patient safety.The VISN 4 web site continues to boldly state:

When VISN 4 compared its ability to provide quality health care with the best hospitals in the United States, we equaled or exceeded our competition in every category. This is proof that our nation’s heroes are being provided the quality of health care that they richly deserve.

Its most recent issue of “Vision for Excellence” it again extols how much VISN 4 has done in this area. This will be the subject of a future post called “VISN 4’s medical care “quality” publicity blitz, twisting the facts: Delusional fantasy, or indictable fraud?