Brahm has served since October 2015 as acting director of the southwest Wisconsin hospital once described as “Candyland” for its opioid prescription practices.
While VA officials are praising Brahm for her leadership and celebrating her appointment, sources inside the medical center say prescription drug abuse and other health care delivery concerns remain a problem.
Brahm stepped into the acting leadership role following months of turmoil at the Tomah facility.
Earlier this month, a state agency took away the medical license of Dr. David Houlihan, the former chief of staff and acting medical director at Tomah. Houlihan, who was known as the “Candy Man” after multiple federal investigations found he overprescribed painkillers, was fired in November 2015. He is prohibited from practicing medicine in Wisconsin again, and Houlihan’s disciplinary action will be entered into a national physicians database.
The initial story, broken by the Center for Investigative Reporting, documented the death of a 35-year-old Marine Corps veteran who died in August 2014 of a toxic cocktail of prescription medications while at the hospital.
Brahm was brought in as a “fixer.”
One source who works at the hospital told Wisconsin Watchdog that many of his fellow employees read the recent news about Houlihan as a step in the right direction, but much at the facility is still in need of fixing.
“While this has changed some ways drugs are processed, the problem with over-prescribing and veterans’ abuse of medication still lingers,” said the source, who asked not to be identified for fear of retaliation. “We have many veterans who lash out at the pharmacy and pharmacist and technicians who see the dispensing practices as insane.”
Matthew Gowan, USN (Ret.), public affairs officer for the Tomah VA medical center, said there is no doubt in his mind that quality of care and veterans’ satisfaction with their care have improved under Brahm’s leadership.
He said the VA’s Opioid Safety Initiative has been very successful, although hospital officials hear criticism on “both ends of the spectrum.”
“We have some who say, ‘You’re just stoning veterans out of their minds over here,’ and then you have others who say, ‘You’re just taking needed medications away from veterans,’” Gowan told Wisconsin Watchdog Monday. “It’s really more something in the middle. Each veteran is being looked at by multiple teams. We’re talking about prescription practices attempting to deal with people suffering with chronic pain plus mental health issues.”
There are no one-size-fits-all solutions, the VA official said. It’s an individual treatment plan to fight both pain and addiction.
“I see nothing but a bright future for Tomah and firmly believe in our collective team,” Brahm wrote Friday to the medical center’s employees in an email obtained by Wisconsin Watchdog.“Will there be some tasks we have to face? Sure, and we’ll continue to pursue the ‘harder right’ and do what’s best for our nation’s heroes that we have the honor of serving.”
Not everybody was that optimistic.
Ryan Honl, a former Tomah VAMC employee and federal whistleblower, said the “foxes who protected Houlihan” are now officially in charge of the hen houses at Tomah.
Honl and others have been critical of the VA for bringing in Brahm to lead the medical center.
In a sworn deposition released last year, VA regional office Network Director Renee Oshinski, said that before the Tomah scandal broke, Brahm had received significant evidence of opiate abuse. Brahm, who was the regional office’s nurse executive at the time, determined that there was no truth to the reports, according to the deposition.
“I was astounded that they were all unsubstantiated,” Oshinski told investigators from the Senate Committee on Homeland Security and Governmental Affairs, as reported in the Daily Caller.“With the number of things here, I would have thought there would have been some partially substantiated or whatever. I mean, just based on the number, that it’s not a normal response that we would have.”
Myriad federal investigations and media accounts have since proved valid the whistleblower reports of abuse inside the medical center.
“An ongoing look at Dr. Houlihan’s prescribing practices” was “something that Vicki Brahm and Donna Leslie (VISN 12 Pharmacy Executive), were involved in” as part of their duties in the regional office, Oshinski said in the deposition.
Oshinski said Houlihan and Brahm worked closely on hospital matters.
“Dr. Houlihan would choose to call (Then-VISN 12 Network Director) Dr. Murawsky [the regional office’s director] or Vicki Brahm,” she said under oath.
On Friday, Oshinski was “pleased to announce” that Brahm was officially selected as director of the Tomah VA hospital.
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