Mayo-Smith Calls for Release of Investigations of Manchester VA

Apr 5, 2018

Dr. Michael Mayo-Smith, shown here speaking at a congressional field hearing in September of 2017, when he was director of the VA New England Health Care System.
Credit Peter Biello/NHPR

Allegations of substandard care at the Manchester VA have largely gone unchallenged, at least publicly, since whistleblowers came forward last summer. And now we are learning why. 

Dr. Michael Mayo-Smith was the leader of the VA new England Health Care System until last month, when he abruptly retired. He says the VA chose to take a no-response approach and wait for public interest in the allegations to wane. Now that he's retired, he's able to speak publicly about what happened behind the scenes from his perspective.

Dr. Mayo-Smith spoke Thursday with All Things Considered host Peter Biello about the allegations and the investigations.

In your op-ed today in The Concord Monitor you called for the immediate release of the Department of Veterans Affairs investigation into what happened in Manchester. What do you think that investigation will reveal?

Well, there are two investigations that Dr. Shulkin called for. One of them is by the Office of Accountability and Whistleblower Protection, and that was to investigate the performance and conduct of senior leadership. My impression from talking to people in reports that I've gotten as a network director is that they did not find problems with the leadership. They found the leadership was engaged, it was proactive and they have not recommended any disciplinary action. The second report is by the Office of Medical Inspector. They did an initial report which was recently released and is available on the Office of Special Counsel website. But Dr. Shulkin asked for a more extensive report.

The preliminary report by the Office of Medical Inspector showed the Office of Special Counsel referred three items to the V.A. to be reviewed out of the long list that was sent in by the lawyer of the whistleblowers, which concluded many, many, many issues that they raised. The Office of Special Counsel identified three that they felt met their criteria for further investigation. And of those three, the inspectors from the Office of Medical Inspector did not find any systematic problems with care with the patients. So I anticipate the longer report covers many, many issues. I'm sure they're going to find things that could be improved. But I do not think that they will support many of the allegations about care that were raised.

We have a limited amount of time with you today, Dr. Mayo-Smith. I'll mention briefly that whistleblowers, some of them at least, do take issue with the way the OMI handles their investigations. We can get into that some other time. Are there accusations made against the Manchester VA, or against you personally, that you would like to take this opportunity to rebut?

The allegation that one of the whistleblowers had contacted me repeatedly and that I failed to take action. When this allegation was made and has been brought up on multiple occasions, the office of the I.T. at the VA searched the e-mail records for any, any other e-mail between myself and the whistleblowers, and they only came up with three e-mails that were of any relevance to this issue. One of them was an email sent 10 months before the letter from the whistleblowers came, and that one was titled the "Chief of Staff" issue, and that related to concerns that one whistleblower had about a failure to get a promotion.

That was the only email that was sent before they sent in their letter to the Office of Special Counsel.

At the field hearing in September of last year with many members of the New Hampshire congressional delegation present, you were asked if you knew about the problems at the Manchester V.A., and you replied, I'm quoting here: "There were a large number of issues raised in the Boston Globe report and some of them I was aware of before and others I had not been aware of until they were brought up in the Boston Globe." So regardless of who told you, which ones were you were aware of, and which ones were new to you?

I was aware that Dr. (William) Kois was concerned about the care of myelopathy patients.  I was aware of some of the problems in the operating room. I was aware that Dr. (Edward) Chibaro did not feel that he was getting support and that he needed as chief of surgery. But there were - the other ones - off the top of my head, and there were many of them, most of them had not been brought to my concern - to my attention. 

In your op-ed you wrote with respect to the Manchester VA  issues, the VA adopted "a philosophy of no response, hoping the public interest would fade." Was this the right response in your view?

Well, I don't think it worked out perfectly. I think that if they had gone through with the investigation and they had shared the results of the investigations that were done in a timely manner, I think the public, the veterans, the congressionals, the staff at the VA, would have been able to get the information that they needed and deserved to understand the issues in a more full sense than they have had an opportunity to.

You're talking to me now in part because you have you have the freedom to do so. What does that say about the system - that that people who are knowledgeable people who can understand and explain it are only comfortable speaking once they've left the system?

Well, it's a large organization and they do want to control the, you know, the communication and the flow of information and there are pluses and minuses to that. And when I was a network director, I was a senior official in a very large organization. And I couldn't speak for myself. I do feel that in this case it really was ended up being detrimental, that there was a lot of information that was not getting out. And I think that was detrimental.