Dr. Chacko Comes to Lahey Clinic

UPDATE: Please also check out my new book, The Definitive Dossier on PTSD in Whistleblowers, for only $3.99, in which I dedicate chapter four entirely to the exploits of Dr. Anna Chacko. 

In the early part of 2001, Dr. Anna Chacko took over as head of radiology at Lahey Clinic in Burlington, Massachusetts. So began a trek between Dr. Anna Chacko and Lahey Clinic that lasted almost six years wound up being litigated and caused multiple colleagues to develop Post Traumatic Stress Disorder and some were even on the verge of suicide. In fact, Dr. Anna Chacko nearly didn't get hired at all. The head of the search committee, Dr. William Healy, received a call from a former colleague of Dr. Chacko's in the military. This individual wanted to warn Dr. Healy about Dr. Chacko but Dr. Healy never followed up with the call. Dr. Huda Monemarano, who worked in the radiology department at Lahey Clinic but also was a former colleague of Dr. Chacko's, described Dr. Anna Chacko as a "controversial figure" when asked by the committee. Dr. Monemarano went to another hospital within a year and a half of Dr. Chacko being hired. The only two radiologists on the committee both voted against hiring her and both had moved on as well within a year of her hire.

When Dr. Chacko arrived to take over the department, the radiology department was a functioning but terribly inefficient radiology department. Dr. Chacko immediately cut out the inefficiency and red tape. This not only caused the department to be more efficient but exponentially more profitable. Furthermore, the inefficiencies within the department caused frustrations for doctors from other departments that worked with radiology. By making radiology more efficient, it also cut out a lot of their headaches.

As such, Dr. Anna Chacko's status, stature, reputation, and power also grew exponentially by the end of 2001. Because of this, the hospital, and especially the administration, didn't notice some troubling behavior that Dr. Chacko was developing. First, she painted her office not merely red but "blood red". She put several photos of generals including the future head of the VA system, Lt. General James Peake, on her wall. This created an environment in the office that was very intimidating. Often, she would bring in staff into the office for general conversations. In the middle of the conversation, Dr. Chacko would pick up the phone and proceed to scream at whoever was on the other end (if there really was someone on the other end). She would threaten the unknown recipient, verbally abuse them. and yell uncontrollably into the phone while the colleague stood in horror.

Dr. Chacko would bring individual doctors into her office and ask them why another doctor "hates you". She would do the reverse with the other doctor. Often, Dr. Chacko would verbally abuse and bully doctors in front of their colleagues. Dr. Chacko would also bring in female radiologists and say, "you have to make a choice between your career and your family and I suggest you choose your career.".

Here's how a former colleague of Dr. Chacko's described one infamous tongue lashing. This was directed at a resident in front of more than a dozen other doctors at a staff meeting. (I will remove the names and clean up some language not only to protect the innocent but to make sure my source isn't revealed through word patterns)

The resident, an American educated daughter of immigrant Indian professionals, was a resident in Radiology in our department from July 01 to June 05 and had first hand trauma from her. She made a minor error, tiny and not clinically significant. But she had resisted Dr. Chacko's effort to make a big deal out of it. She did not become
subservient and grovel. At the next staff meeting, the resident was assigned to attend and Dr. Chacko laid into her, called her lazy, careless, stupid, etc. We, the staff, sat in horror, too amazed to speak up. We looked at each other in shock, and just as we were about to say enough, lets move on, she stopped and discussed another issue. But she swung that issue around to residents and then began the attack this resident anew. We were too shocked to say anything, we looked around like “are we hearing this correctly, this is too much”. We were whispering and about to say move on when she stopped, started on another item. The item was again artificially swung to residents in general and then on to this resident again. We again listened and were about to speak up and the cycle repeated itself 6 or 7 times, each time a shorter echo but no less personally violent.

By the middle of 2002, Dr. Chacko was working on a new revenue source for the radiology department at Lahey Clinic. She was working on getting a contract to provide radiology services to the West Roxbury VA hospital. All the while, her behavior became more and more unbalanced. First, Dr. Chacko brought with her several folks that had worked with her at previous hospitals: Dr. Bob Shah, Dr. William Arndt, and Tom Shook (who was a sort of business manager for the department). Meanwhile, the department began to be divided between her cronies, who could be counted on to not only back up everything she did but report on their colleagues to Dr. Chacko. As such, the most mundane conversations would get back to Dr. Chacko and then Dr. Chacko would use the contents to bully, harrass and intimidate those she didn't like.

By the beginning of 2003, Dr. Chacko had secured the VA contract. She began sending those she didn't like to the VA hospital. This had several implications. First, it isolated those she perceived as her enemies. The VA hospital was about 50 miles from Lahey Clinic so it would often create a long drive for the individual. Finally, the VA hospital didn't have nearly as expansive a radiology department. As such, often those sent to the VA hospital couldn't work in their sub specialty. This made it more difficult for them to build up enough hours in their sub specialty to maintain their credentials in their sub specialty. More than one doctor quit because of these strains.


By this time, another situation developed. Doctors from other specialties, like internal medicine, began to notice a troubling amount of missed abnormalities on radiolgy charts and exams. This caused several near misses and often maladies and diseases wouldn't be caught right away because radiologists had missed these abnormalities in their initial radiology exam. While more than one radiologist was identified, one was singled out. (again I was told under no circumstances to reveal their name to protect the innocent and guilty) Doctors complained both verbally to Dr. Chacko and in letters that reached the administration.

Without approval from anyone in the administration, Dr. Chacko hired a doctor to do quality control in radiology. That doctor was her sister, Dr. Elizabeth Zacharia. Her sister did a review of several files including the files of the troubled doctor. Her sister determined that this particular doctor had done nothing wrong and instead determined a series of errors that also, coincidentally or not, Dr. Chacko considered enemies or rivals. (like those she shipped to the VA hospital) Meanwhile, the administration decided to do their own review after it was revealed that Dr. Chacko hired this QC person, her sister no less, without their approval. The administration's review determined that while this doctor's charts did have significantly more mistakes than most, it wasn't "too far from the median" because they also had more volume. (though administration never defined what too far from the median meant)

Following this, the first thing Dr. Chacko did was hire her sister full time as a radiologist on staff. Then, she made it clear that whistleblowing would not be tolerated. She did through several different strategies. For instance, she would approach potential whistle blowers and say

if you knew this was going on all along, then you, yourself, are in violation for not reporting it earlier

Dr. Chacko also began to make complaints about radiology colleagues directly to the upper management of Lahey Clinic. She began to threaten colleagues with lawsuits and made veiled threats that she would have their medical licenses revoked if they crossed her. Administration also discouraged whistle blowing by stressing that more times than not it's the whistle blowers that ultimately face hardship.

Meanwhile, when the Boston winter hit, Dr. Chacko's sister tired of the cold. (she had spent many years in Hawaii) She moved back to Hawaii. So, Dr. Chacko bought a PACS machine (Picture Archiving Communication System), hired an installation team, and flew both out to Hawaii. This cost Lahey Clinic about $70,000 and it wasn't approved by the administration.

Throughout her time at Lahey, Dr. Chacko was involved in the purchase of tens of millions of radiology equipment. For instance, Dr. Chacko bought an entire PACS system from Fuji for a cost of about 10 million Dollars. Later, administration discovered that within weeks Dr. Chacko's son was given a job with Fuji in their London office. (this ultimately lead to her removal but more on that later) She also bought tens of millions worth of radiology equipment from General Electric. This included mammography equipment, MRI's, and cat scans. Dr. Chacko always seemed to have a very chummy relationship with GE. Here's how a salesperson with a rival company described a story he often heard her repeat.

Shortly after a meeting where Joe Hogan (then CEO of radiology at GE and in the future CEO of GE Health care) went to Lahey,he and his entourage went back to the Corporate Jet which was sitting at Hanscom airfield in Lexington, MA. She said that she was in her office and the phone rang. It was Joe Hogan telling her to go outside and look up. Allegedly he had the pilot "dip" the wings back and forth as they passed low overhead. She was very proud of that one. I'm sure she's told it to plenty of others.

(at other hospitals, Dr. Chacko also bought or attempted to buy millions worth of GE equipment under dubious circumstances) Because the head of radiology is technically not supposed to buy the radiology equipment themselves, early on Dr. Chacko removed the radiology manager at Lahey and replaced them with John Elliot. She and Elliot had worked together before during her military days and Dr. Chacko had Elliot come out of retirement in Colorado and move to Boston to be her radiology manager.

The most infamous purchase of radiology equipment came from the now defunct Fischer Inc. She bought a fairly large amount of mammography equipment from them on one occasion. Colleagues reported that she told some that she wanted to do a favor to a friend so that they could "hit their quarterly numbers". The salesperson had arrived at Lahey Clinic. They were there to supervise the delivery and installation of the equipment. At the last moment, Dr. Chacko called the main office and cancelled the order. The salesperson was furious. Staff could overhear them screaming

It's not good enough for you now. It was good enough for you when our company sent you and your husband to India first class for $16,000

(in fact, Dr. Chacko's radiology equipment has always been dubious. A private investigator once determined that during her days in the military radiology equipment purchases were always followed within weeks, by her purchasing land or opening a trust)

Finally, as 2005 turned into 2006, complaints and erratic behavior had worn on staff AND administration. Dr. Chacko's days were numbered however because administration had been so lax in supervising her for all these years, it was difficult to remove her without opening up all sorts of worms for themselves. Finally, the administrative assistant to the CFO of Lahey Clinic was ordered to become the "business manager" to Dr. Anna Chacko. In fact, this A.A. (who reportedly has recently denied what I'm saying) was sent in to be a spy. They usually worked evenings faxing documents back to the administration. Finally, they created enough paper trail between the purchase of the Fuji equipment and Dr. Chacko's son's subsequent hiring.

Within weeks, security was sent in to remove Dr. Chacko. She wouldn't go quietly. She wasn't escorted out but rather carried out and while being carried out she screamed at the top of her lungs

Kiss my big Indian ass

Much of the hospital, including patients, could hear her. Months later, Dr. Chacko and Lahey Clinic entered into a settlement that included an undisclosed sum of money and a confidentiality agreement that forbade Lahey or any of its employees from making "disparaging statements against Dr. Chacko. Here's how an email following this settlement went out.

Reference is made to the resignation of Dr. Anna Chacko from Lahey's Department of Radiology in April of 2006. Further to the discussions that I have had with a number of you, and in accordance with the requirements of an agreement that Lahey reached with Dr. Chacko in connection with her resignation from the Clinic, I write to remind you that you are not to make any disparaging comments about her.

Thank you.

Epilogue:

Most recently, Dr. Chacko exhibited similar behavior at the Pittsburgh VA. Immediately prior to that, she acted much the same at St. James Hospital in Butte, Montana. In fact, I've laid out a pattern of Psychopathic behavior for Dr. Anna Chacko. The most recent information I've receive was that she was put on administrative leave at the Pittsburgh VA and investigative board had completed a review of her behavior, though I've received no word of the disposition. I can't confirm any investigations either in Congress or outside Congress about her pattern of behavior, her ability to find work despite this pattern of behavior, or the plethora of labor, health care, and military issues that it raises that a Psychopath can find success both in the military and in medicine and they can do it with impugnity. I firmly believe that full and open investigation would reveal a trail of terror that would shock and horrify all. I also believe that a full investigation would reveal a plethora of weaknesses in our medical system, our military system, our whistle blower laws, and all sorts of other policy issues yet undiscovered that would improve society if rectified. Only significant media attention to her case and a full Congressional investigation would make that possible. A Psychopath can't find success in our society. They can't be allowed to terrorize their colleagues, and our system can't allow it to go on with impugnity. That's what happened here, and it happened over and over. it's un American and unacceptable. Until it's fully investigated both individuals and policies responsible for making it happen will be allowed to move forward without being held responsible.

Epilogue:

Here's the definitive dossier on Dr. Chacko.