It's been a tumultuous couple of weeks at work and somewhat at school. At work we're hopefully near the end of a cycle that saw one of our doctors going off the rails. She was named an acting chief while they were looking to a hire a new permanent chief after the illness related departure of our former permanent chief. To distill it down to a few sentences, let's just say she had a bit of a power trip and was butting heads and attacking several people in the clinic.
We had been friends and supportive co-workers for many years but had a falling out a few months ago when we disagreed about implementation of the Gulf War illness policy. She's relatively new to government service and thought it was within her authority to implement the policy as she saw fit. It isn't, and she can't. But, in most cases we're willing to let individual providers rationalize their own opinions on cases as long as they understand they'll have to defend it if it's appealed or a complaint is filed. But in this case, and as part of her newly acquired (if temporary) authority, she decided the policy needed to change for the whole clinic and had directed our schedulers to change they way they scheduled these exams.
This is where our big disagreement arose. She has this idea that if a claimed condition doesn't fit within a medical diagnostic criteria, then it's not valid. Something I've tried to explain to her for years is that our specific corner of government service is not strictly concerned with medical criteria. We work in disability claims and it's equal parts legal and even political. The entire philosophy of our claims is based on uncertainty. Our opinions typically include the statement "at least as likely as not", which basically says that if our determination of a claim is that it's fifty/fifty parts for and against the claim, then we grant the claim.
Compared to what's happened between her and other people in the clinic, this has been pretty tame. Until she decided to go around me and accuse myself and our program analyst of inflating exams unnecessarily. I have been a fee basis provider for over a year. This means that I am compensated by the exam. In the case of Gulf War exams, they tend to generate not only exams for conditions but also opinions for each condition. So, if a veteran claims four conditions, it results in eight total worksheets and I'm paid for each. The typical claim can generate from ten to twenty exams. Occasionally, that number can go significantly higher.
I had an exam a month or so ago that was for around twenty claimed conditions but it also generated an equal number of direct opinions as well as fourteen or so Gulf War opinions. It ended up totaling fifty three worksheets. This is the highest number I've ever completed, and it's not typical by any stretch. A typical day for me is around twenty exams. I'm not sure if this is the exam which she questioned, but if not it was a similar one. I've had a few in the forties and many in the thirties. It should be noted that the FTE often don't reach these numbers in the course of a week, much less a day.
My previous post history tells the story of the relative level of productivity among regular federal employees. Let's just say that they typically underachieve, at least compared to my levels. To make a long story short, she basically accused me and the program analyst of stealing money. Because she questioned the validity of the claims (going back to our fundamental disagreement of Gulf War), then she surmised that meant that any Gulf War related claims/opinions were invalid and shouldn't be billed. Like I said before, she doesn't have this authority. No one at our level has this authority. This is national policy and you're not allowed to take away from a regulation to suit your own needs. For what it's worth, my performance of these exams and opinions was directed before I was ever fee basis and had specific approval by the former chief (on more than one occasion), not to mention that the whole policy was directed by VBA personnel outside our clinic. It's a well established and approved policy that has been in place for a long time before she got here.
All of this scenario is rather tame to what else she has been doing. To keep it short, let's just say she's accused others of outright fraud, abuse, and even having sex in the clinic. It's all bullshit and an attempt by her to discredit and destroy anyone who's crossed her path. I avoid psychoanalyzing in general, and also because I'm not qualified, but I think her specific pathology has something to do with growing up in an authoritarian regime which tends to encourage similar behaviors in those victimized or oppressed once they possess any power. She's demonstrated a feeling of superiority over others, including her own MD/DO peers. She has never understood that her authority as a doctor is strictly clinical. In the federal system, and in our country for that matter, we don't recognize social castes. Although we do have great inequalities in our country, we don't recognize our defer to people because they are part of a ruling class or aristocracy. She seems to think differently. Although some actions are still pending, it seems apparent they are going to remove her from the temporary position and her application for the permanent position would likely be dead in the water. Honestly, I hope she has enough personal shame to resign from the department if not the government as well.
Although I know myself and our program analyst didn't do anything untoward or dishonest, it's still stressful to have those sorts of accusations hanging over you, because if they were true they would likely result in termination as well as a permanent black mark on our records. Mostly the stress derived from uncertainty to how far the accusation would go, and that the people passing judgement would be strangers who might be given incomplete and biased information. It appears that nothing will come of this for now, but it's still very troubling to face a sudden unexpected threat to your livelihood. As I have discussed with our program analyst, this was the ultimate betrayal and bridge burning offense from which a person will never come back.
