Audio recordings reveal doctors' concerns about patient safety at St. Cloud VA

ST. CLOUD, Minn. (KMSP) - Problems within the VA medical system are not new. But for the first time, audio recordings from doctors at the center in St. Cloud, Minnesota describe their concerns about conditions there. The recordings, obtained by the Fox 9 Investigators, give an unfiltered look at what's happening inside of the medical facility and what it means for veterans.

A SOLDIER'S STORY OF CARE AT THE ST. CLOUD VA

Even in the most joyful of moments while enjoying his three daughters, Ross Cameron struggled to feel any emotion.

The Iraq War left him stranded in an emotional desert. After he came home to Minnesota, he tried to live a normal life but the demons of the battlefield continued to stalk him.

While in serving in Iraq, he saw buddies die and he narrowly escaped death from a roadside bomb.

"He said ‘I had a child pointing a gun at me. We were instructed to shoot,’”  his wife Heidi told Fox 9.  "He would tell me all the time, ‘I want to feel something, anything.’"

He sought help at the St. Cloud VA for post-traumatic stress and a deep depression.

"Because you're not missing a limb doesn't mean you're not wounded," said Heidi.

According to his wife, it was hard to get medical appointments, his care was inconsistent and he would sometimes have random doctors.

In January, Ross was hospitalized briefly after he woke up in a garage with the car running.  In June, his car ran off a road and hit a tree.  Investigators estimated he was going nearly a hundred miles an hour.

Heidi and her three daughters are now frequent visitors to his grave site in Central Minnesota.

"At what point does he get a steady doctor, steady physician that's actually going to put time and effort into his case? They just didn't," she said.

ARE VETERANS IN DANGER?

Some members of the medical staff fear the quality of care is deteriorating to a point that's putting veterans in danger

"The workload is so intense and so great that I feel patient care is compromised," said an insider who agreed to talk to the Fox 9 Investigators as long as the person was not identified.  "They want to do their best for their patients but they're not able to because of the system."

The "system", according to insiders is a toxic culture where senior management retaliates against anyone who questions why too few doctors are being assigned too many patients

"The providers are basically set up for failure," said the insider.

More than 30 providers have resigned since 2011. An exodus which a VA investigation found was driven in part by burnout from the demands of working 13 hour days.

"There are some tensions that are arising inside the workforce," said MN Representative, Tim Walz (D).

The relationship between staff and senior management is so strained that last month two congressmen paid a visit to the St. Cloud VA to find out what gives.

"I think there's a trust issue on both sides," said MN Representative, Tom Emmer (R).

MEETING RECORDING

A recording obtained by the Fox 9 Investigators of a 2009 meeting between a group of doctors and the St. Cloud VA's top brass shows the rift has been festering for years.

Meeting recording: "We've got some real serious concerns about patient safety."

Doctor in meeting recording: "A lot of very experienced physicians are saying we can't take this much longer. We are working long days under a lot of pressure and mistakes are being made. People have been harmed because there's just this avalanche of material coming at us."

The doctors claim the number of patients in their care is dangerously high, nearly 40% more than the VA's own safety recommendations.

Doctor in meeting recording:  "You're trying to go through 20 zillion things, you don't even know the patient. The set up for error there is high, it's just really high."

They question the Medical Center's Director, Barry Bahl about why staffing records show patient to doctor ratios lower than they truly are?

Doctor in meeting recording: "We have probably a couple thousand patients who are assigned to doctors who haven't worked here in years. Patients assigned to doctors who either no longer work here or never did see patients."

That remark is in reference to so-called "ghost panels."

Doctor in meeting recording: "Can I just outright ask, is this legal, having ghost panels? Yes."

The doctors believe the ghost panels are a kind of book keeping trick. Patients are assigned to physicians who really aren't able to see them.

They suspect it's a way to make it appear as though the rest of the staff's workload is lower, more in line with the VA's recommended levels.

Doctor in meeting recording: "Could it be that our situation looks rosier to the outside world or to the VA at least because of these panels assigned to other people?"

Barry Bahl in meeting recording: "You guys are obsessed with this ghost panel stuff. Don't even fret, don't even think about it. All they want us to do is see all the patients in a timely manner and do whatever it takes to do that."

What, if anything, does management have to gain by playing this numbers game?

"To make it sound like we're stellar, we do a great job," said the insider.

VA executives can earn performance bonuses. Through a Freedom of Information Act request Fox 9 discovered Bahl got a $7,500 bonus in 2009 when those doctors were raising questions about ghost panels.  In the years since then, he's received a total of nearly $52,000 in awards and incentives.

His medical chief of staff received $18,000 in bonuses in 2009, since then a total of $97,000 in awards.

A spokesperson for the St. Cloud VA says to his knowledge nobody would get a bonus based on patient panel sizes.

We wanted to interview the director of the center about all the issues our investigation has uncovered.  He declined.

VETERANS SPEAK OUT ABOUT CARE

"They treat you like a number, they really, really do," said Chris Stiles, an Iraq War veteran.

Appointments for complex health issues last maybe 15 minutes.

"They treat the symptoms the easiest, quickest way they see fit and you're out the door," said Sean Vaugh, also a veteran from the Iraq War.

They are frustrated by the high turnover of doctors.

"I know they're extremely busy," said Vaugh.  "I've had four different primary care providers and I've never met a single one of them."

Despite past and present staffing issues, the St. Cloud VA maintains it consistently delivers both "timely and high quality" care for patients.