Learn a lesson from the VA leadership situation

Now that Ronny Jackson has withdrawn from his nomination to head the Department of Veteran Affairs, it may be a conducive time to learn, or re-learn, some of the lessons from the issues that emerged in this situation. It has nothing to do with the politics of this nomination. There is no proof that the accusations of unprofessional conduct are true or not. Rather, it has to do with following ethical principles in medicine and healthcare.

As such, all the recommendations here are embedded in one way or another in the American Psychiatric Association’s Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry.

Issue: Inventory and records of controlled substances
Accusation: Keeping private stocks of controlled substances along with lax record-keeping
Ethical Recommendation: Any organization that stocks easily abused medications must keep strict control of their distribution and usage. Not only is this particularly relevant when we are in an era of an opioid epidemic, but clinicians known to have access to such drugs have overdosed or used them to commit suicide. Outside auditing is necessary to conform appropriate safeguards.

Issue: Prescribing medication to other staff or family

Accusation: Physicians writing prescriptions for staffers, friends or family
Ethical Recommendation: Physicians should not provide prescriptions to anyone with whom the physician has a conflict of interest because that will compromise objectivity. That prohibition should include colleagues, family, friends and oneself.

Issue: Wellness in administrators and clinicians

Accusation: Professionals consuming excessive amounts of alcohol at work-related events

Ethical Recommendation: We know that self-care and wellness are crucial for the well-being not only of behavioral healthcare professionals, but adversely affects patient care. We are our brother’s (and sister’s) keeper and need to intervene when wellness seems impaired at work.

Issue: Burnout in staff

Accusation: Abusing staff subordinates

Ethical Recommendation: Abuse of staff by leadership is correlated with resulting burnout and suicides. Therefore, leadership needs to convey respect, caring and empowerment for staff at all times.

Learning from mistakes—that we or our professional colleagues make—is crucial for improving quality of care for our patients.