A doctor at a Northern Indiana VA hospital said she was retaliated against when she warned her superiors about opiates being overprescribed to patients.
Dr. Alice Buckley received her undergraduate degree from Cornell University and she’s practiced medicine for approximately two decades, all around the country including on Native American reservations and the inner city of Detroit.
She said no one ever questioned her competence or dedication until she blew the whistle on the overprescribing of opiates at the Department of Veteran Affairs (VA).
Dr. Buckley first joined the Marion Campus of the Northern Indiana VA Medical System on December 29, 2014, as the medical manager for primary care.
As part of her duties, she analyzed patient charts and treatment; from this, she found opiates were being prescribed inappropriately.
“Shortly after I began my employment at the Marion Campus of Northern Indiana Health Systems, I observed an opioid prescription issue of alarming proportions. I was assigned a group of Veterans in March 2015 formerly managed by a Nurse Practitioner(retired mid-December 2014) and I noticed that this particular PACT provider (very beloved by her patients and her PACT nurses) frequently and in strong amounts prescribed high quantities of controlled substances (Percocet, Hydrocodone 10/-, Morphine, Oxycodone/-contin, Methadone, Lorazepam, Ritalin, Xanax Ambien, and Temazepam) for disease states that did not have the medical findings to support the quantities (non-terminal, chronic, non-acute care issues) or had significant contraindications attached,” Buckley said in a 2017 letter to Congress.
She took her concerns up the chain of command but rather than having them addressed, Buckley said she suffered retaliation.
Department of Veteran Affairs, in a statement, said rather than increasing the hospital decreased its opiate prescription: “Since 2012, VA Northern Indiana opioid prescription rates have fallen 51 percent and 99 percent of VA facilities have decreased their opioid prescribing rates.”
The retaliation against Buckley
Buckley said she reported her concerns to her immediate supervisor, who then reported those concerns up the chain.
Rather than having the concerns addressed, Buckley said the hospital took action against her.
First, she was effectively demoted when she was asked to see more patients while her managerial duties were decreased and her pay stayed the same. The hospital told her it was understaffed was the reason.
She said she was given exponentially more duties and then written up for falling behind; she was repeatedly moved to other hospitals on short-term assignments.
According to Buckley, other forms of retaliation included: being berated by superiors in front of patients and one day she was considered absent without leave when she left the hospital to care for her ailing daughter.
She said the hospital took away her privileges, then pressured her to update some charts anyway, and then, wrote her up for accessing charts without privileges.
This all culminated with Buckley being terminated in August 2017.
Buckley’s “clinical practice during VA employment so significantly failed to meet generally accepted standards of clinical practice as to raise reasonable concern for the safety of patients,” according to an internal VA investigation.
The VA stated Buckley’s punishment has been upheld repeatedly: “A disciplinary appeals board composed of Buckley’s peers — as well as the Merit Systems Protection Board — upheld her termination.”
Buckley and the DEA
Unable to solve the problem within the VA, Buckley said she took her concerns to the Drug Enforcement Agency (DEA).
Both the DEA and the VA acknowledged that this triggered an investigation.
“The VHA Northern Indiana Campus was investigated by the DEA diversion section and as a result of that investigation they received a letter of admonition which is an administrative action. It is my understanding that case is now closed,” said Melvin Patterson, Staff Coordinator for Congressional and Public Affairs at the DEA.
“A 2015 DEA investigation found six issues, five of which have since been addressed,” the VA stated.
That investigation included the DEA raiding the hospital on Nov. 30, 2015, using an administrative inspection warrant.
The DEA found failure to separate schedule II from schedule III drugs, failure to provide proper security, and failure to manage against diversion.
Diversion, Buckley said, is when prescription drugs are used for a purpose other than prescribing, like selling prescription medication.
Buckley said that she believes it was the raid, the larger investigation, and not any good longstanding policy by the Marion VA which caused the drop in opiate prescribing.
The VA and the Opioid Epidemic
Buckley said she brought concerns of diversion to the DEA.
She said that in many cases the veteran would not be able to function if they were taking all the medication they had been prescribed.
She believes some may have been selling them.
“That’s how these drugs get into our communities,” Buckley stated.
She said she believes her case is not an isolated incident of how the VA handles policy for prescribing opiates.
“That’s how they operate,” Buckley stated, referring to the VA.
The data on VA prescribing opiates is mixed. In early 2018, the VA released their opioid prescribing rates since 2012 and found a forty-one percent drop in prescribing rates nationwide in the VA from 2012-2017.
But the Center for Investigative Reporting(CIR) found that over a longer period from the state of the War in Afghanistan until 2014, the VA increased its prescription of four highly addictive opiates — hydrocodone, oxycodone, methadone and morphine — by 270 percent.