The inspector general of the U.S. Department of Veterans Affairs announced Tuesday that the Roseburg Veterans Affairs Medical Center has been performing colonoscopies using outdated methods.
The inspector general reported conclusions based on an investigation requested by U.S. Rep. Peter DeFazio, D-Springfield. DeFazio said he heard from a constituent in 2014 that patients experienced long waits for colonoscopies and problems with the quality of those colonoscopies at the Roseburg VA.
DeFazio issued a statement Tuesday afternoon saying the inspector general’s findings will lead to improved care not just at the Roseburg VA, but across the country. As a result of the investigation into Roseburg’s practices, the inspector general has recommended the Veterans Health Administration’s colorectal cancer screening guidelines be revised. Those standards govern practices used at all VA medical facilities.
“We would never dream of sending our troops into battle with unclear directives and outdated, substandard methodologies and technologies, yet out-of-date standards are being used for their medical care,” DeFazio said Tuesday in a written statement. “The VA needs to be held to the highest standards in all regards, but especially when it comes to veterans’ healthcare.”
The inspector general’s report also indicated veterans had experienced delays in getting colonoscopies at the Roseburg VA, but noted that the VA had taken steps to improve those wait times.
Shanon Goodwin, acting public affairs officer for the Roseburg VA, said patients aren’t experiencing long waits for colonoscopies anymore, and that wait times were cut in half after a new Eugene VA clinic was opened in 2016.
“All in all our patients are happy with our services and the wait times are definitely down. They’re getting in faster,” Goodwin said.
He said he doesn’t recall hearing patients complain about colonoscopies at recent town hall meetings the VA hosts monthly on campus.
“We have actually gotten kudos letters that said when somebody came in to do a colonoscopy that they had a great experience,” he said.
The inspector general looked into allegations that surgeries were performed without appropriate intensive care unit backup, that surgeons weren’t keeping up surgical skills, that access to care was delayed and that patient safety concerns weren’t being reported due to fear of retaliation. Roseburg’s chief of surgery was accused of performing colonoscopies in an unsafe manner, and delays for colonoscopies were reported. Most of these claims weren’t substantiated, the report said.
The inspector general found colonoscopies were performed safely at the Roseburg VA, but in an outdated manner.
According to the report, a chief of surgery the Roseburg VA hired in 2014 was asked to perform colonoscopies to help reduce long waits for the procedure. Soon after he started, members of the gastroenterology staff voiced concerns about his competency and arranged for him to be proctored at a VA hospital in Spokane. Three surgeons and a gastoenterologist there concluded the chief met or exceeded expectations. The inspector general’s independent review of 79 colonoscopies the chief performed found no complications, no missed cancers and no difficulties finding polyps.
However, the chief did use outdated practices, including burning polyps, a practice that “has fallen out of favor due to the risk of colon perforation,” according to the report. Other outdated practices mentioned included making recommendations for surveillance colonoscopies without waiting for pathology results, and in some cases, recommending longer wait times than published guidelines suggest.
“Although we did not find complications during our independent review of the system’s 79 cases, some of these practices had the potential to result in poor patient outcomes,” the report said.
The chief stopped performing colonoscopies in August 2014, according to the report.
The report said the findings in Roseburg “raised larger questions” about the documentation required from VA doctors performing colonoscopies nationwide, leading it to recommend the VHA to develop more stringent requirements.