Doctor refuses to acknowledge VA doctor

  1. I work in a long-term care facility. Our medical director doesn't have the best bedside manners, but he is our medical director and we should have some respect for his position.

    Yesterday a resident came back from a visit with his VA doc and was given a 30 day supply of pain medication. Our nursing facility MUST call our medical director and get an ok from him before we can give the medication. Medical director says we can only give the resident 5 days of the medication and no more. Resident is so upset that he is refusing to take the medication at all now. This really upsets me. The resident is in pain. (He was hurt in Korea and has a bad knee). I see this type of behaviour all the time from this doc. Very arrogant and teetering on the malpractice side. Families are mad, complaining and I hear the brunt of it all. It's maddening to try to make these residents happy and be a good RN, then to have a doctor to make life miserable for our residents. Is this normal behaviour of a medical director?
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  2. 26 Comments

  3. by   TazziRN
    No. This one sounds like he's on a power trip. The families and residents need to lodge complaints about him to anyone that will listen or nothing will get changed. The nursing staff could do it also, but it depends on how strong your admin is and how much it cares about its nursing staff. What he's doing is inexcusable beyond belief.
  4. by   GingerSue
    what is a higher authority to whom they could complain?
  5. by   Karynica, RN
    Quote from TazziRN
    No. This one sounds like he's on a power trip. The families and residents need to lodge complaints about him to anyone that will listen or nothing will get changed. The nursing staff could do it also, but it depends on how strong your admin is and how much it cares about its nursing staff. What he's doing is inexcusable beyond belief.

    TazziRN, I am beyond understanding on this matter. You are correct, the medical director is on a big power trip. He is over riding what the VA doctor is doing. The administration is not going to say anything to the medical director because they are worried they will lose him. (like that would be a big loss) It makes no sense to me that our residents should even go out to see their own doctors if the medical director is just going to ignore the advice of another physician. The resident, a veteran, is in pain and it hurts me to know that he is hurting, went to see his own VA doctor and now can't take his needed pain medications. We have another doctor who see's a few of our residents, and he has never denied a resident VA's doctors prescriptions. If one of our residents has eye surgery or any surgery for that matter, if the surgeon orders a certain medication, it still has to be okay'd by the medical director. It's like pulling teeth with this medical director. I am just glad I am off a few days so I can regain some composure and get some much needed rest. Thanks for your reply, I appreciate it.
  6. by   Lacie
    Can the families contact the Public affairs officer at the primary VA hospital. Although they deal with mainly issues there they also deal with outside complaints. I know I had issues with a VA Clinic and notified the Public affairs officer at the state VA hospital and things were taken care of very quickly. I was very surprised. It was also refusal to get a medical issue taken care of in a timely manner which is my knees and service connected. I feel for the gentleman as I also have chronic pain as a result and have had 3 surgerys to repair. I couldnt imagine being refused my pain meds or I wouldnt be able to walk much less function or perform my daily adl's. I'd definitely be seeking out some alternatives to stop this. It may be worth a shot to contact them and they at least may be able to point you in the right direction. Maybe also contact the prescribing physician who is most likely his primary doc at the VA and get him involved. Some do take up for thier patients.
  7. by   Jolie
    I would also consider contacting the State Board of Medicine, as well as the credentialing board of the local hospital where this doctor has admitting privileges. Failure to collaborate with a patient's primary physician, and failure to adequately conrol pain are serious issues.
  8. by   babynurselsa
    What about contacting the Ombudsman for the Nursing home. The family can do this.
  9. by   tddowney
    Quote from porcelina
    I work in a long-term care facility. Our medical director doesn't have the best bedside manners, but he is our medical director and we should have some respect for his position.

    Yesterday a resident came back from a visit with his VA doc and was given a 30 day supply of pain medication. Our nursing facility MUST call our medical director and get an ok from him before we can give the medication. Medical director says we can only give the resident 5 days of the medication and no more. Resident is so upset that he is refusing to take the medication at all now. This really upsets me. The resident is in pain. (He was hurt in Korea and has a bad knee). I see this type of behaviour all the time from this doc. Very arrogant and teetering on the malpractice side. Families are mad, complaining and I hear the brunt of it all. It's maddening to try to make these residents happy and be a good RN, then to have a doctor to make life miserable for our residents. Is this normal behaviour of a medical director?
    Is your medical director saying your resident gets cut off after 5 days of pain meds, or is he saying he wants to re-evaluate the resident after that time?

    If the latter, he could have legit reasons for doing so.
  10. by   indigo girl
    Doctors have been removed as medical directors of nursing homes before by the state. It could happen at your facility. Denying pain medication could be
    considered abusive.

    Sometimes nurses have to be an advocate for the patient. There are ways to do this without your administration not knowing for sure who did the notification, but someone needs to step up to the plate.
  11. by   kukukajoo
    It really sounds fishy- maybe so they can charge for a visit or something? This pt has rights and they are being abused. I think this would put the home in great liability!

    I agree with other posters, call the state and the ombudsman and whoever else will listen. I dont think they can dictate who the pt sees at all!!

    When I saw the heading before I read the post, I was thinking that maybe the VA doc was not a real licensed doc- if you work for the govt you dont need a license to practice- Doctor, nursing, and aides!!
  12. by   Jolie
    Quote from kukukajoo

    When I saw the heading before I read the post, I was thinking that maybe the VA doc was not a real licensed doc- if you work for the govt you dont need a license to practice- Doctor, nursing, and aides!!
    This statement is inaccurate. Physicians, nurses, physical therapists, pharmacists, and all other licensed healthcare professionals working for the federal government, military healthcare system and/or VA must indeed be licensed. It is not required that they hold a license issued by the state in which they are practicing, but they must hold a current license issued by a state or territory of the US. This is a matter of practicality, as employees of the federal government, military, and VA are often transferred, which would present an undue burden if they were required to re-license in order to practice in another state or territory.

    Physicians, nurses and other healthcare professionals practicing in our federal system are "real", they are not inferior to those of us practicing in the private sector.

    Nurses aides are not licensed anywhere. Certification is required in some states, not all, and is not equal to licensure.
  13. by   Simplepleasures
    Who is the attending doctor for this patient? Does the medical director have to OK all orders from other docs too? Since this is a LTC, and if the administration wont get to the bottom of it, I agree contact the ombudsman AND the DOM. Does the patient have family involved?
  14. by   kukukajoo
    Quote from Jolie
    This statement is inaccurate. Physicians, nurses, physical therapists, pharmacists, and all other licensed healthcare professionals working for the federal government, military healthcare system and/or VA must indeed be licensed. It is not required that they hold a license issued by the state in which they are practicing, but they must hold a current license issued by a state or territory of the US. This is a matter of practicality, as employees of the federal government, military, and VA are often transferred, which would present an undue burden if they were required to re-license in order to practice in another state or territory.

    Physicians, nurses and other healthcare professionals practicing in our federal system are "real", they are not inferior to those of us practicing in the private sector.

    Nurses aides are not licensed anywhere. Certification is required in some states, not all, and is not equal to licensure.
    Exactly- the doc may not have a license in that state. And there have been cases where the docs do not have ANY license to work in federal. One example would be a retired doc.

    You are incorrect about Nurse aides- they are LICENSED in NH, ID, WY, WI- they are called LNA's in NH now and you do need the license to work. There are several other states that require licensing as well.
    Last edit by kukukajoo on Jan 6, '07 : Reason: Clairification

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