Who's the Extremist?

Let me see if I get this right. Democrats passed a 2000 page radical overhaul of health care, a 2000 page radical overhaul of our financial system, spent nearly $1 trillion to "stimulate" our economy, and almost passed a 2000 page radical overhaul of our energy policy. Yet, it's the Tea Parties that are extremists because they want to reign in government, cut spending, and lower taxes. Good luck with that strategy.

Crist Stumbles on Healthcare

Over the last couple months, the Florida Senate race has been a battle of messages between Charlie Crist and Marco Rubio. Both have been very effective and thus the race has been tight with each having their share of polls showing them leading.

Rubio has continued to ride his message of American exceptionalism, small government and free markets. Meanwhile, Charlie Crist has ridden a message of the independent politician not beholden to either party.

Both would have been perfectly happy staying on this message until November. Recently, however, Governor Crist has stumbled in trying to explain his position on Obamacare.

Florida Gov. Charlie Crist (I) is walking back comments he made in an interview earlier today about the recently enacted healthcare law.

Crist is mounting an independent bid for Senate against Republican Marco Rubio and Democratic Rep. Kendrick Meek.

Crist told a local TV station Friday that he would have voted in favor of President Obama's healthcare proposal were he in the Senate. That was a reversal of his previous position against the healthcare law.

"I would have voted for it," Crist said in the interview. "But I think it can be done better, I really do."

Crist has said just about everything on Obamacare recently. He's said he would have voted for it and against it. He's said he'd repeal it and he'd just improve it. He's been taken totally off message. Meanwhile, Rubio carries the Republican Party line of repeal and replace and so he stays on message and attacks Crist as a flip flopper.

This race will be very tight and it will come down to exactly these sorts of errors. Rubio has won this round. If he's flawless going forward, victory is in hand.

Obamacare Chickens Coming Home To Roost

The themes from this recent O'Reilly Factor Talking Points Memo are not likely to go away. Health insurance rates are on the rise. The health insurance companies are blaming Obamacare for the rise in costs. This part in particular will prove politically deadly for President Obama.

As we stated Wednesday night, American health insurance companies are building in the anticipated costs of Obamacare. For the next four years until the Obamacare program completely kicks in in 2014, all Americans are going to be hammered as the insurance companies try to make as much money as they can before the federal rules are imposed.

I don't know about you, but I never heard this part of Obamacare. I was never told that my insurance rates were going to run wild.

Were you told that? Did President Obama mention that? I don't believe he did.

If you believe Dick Morris, the President wants rates to go up so that he can institute single payer in 2014. Of course, he won't be around in 2014 because his policies are all a colossal failure and we are seeing the beginning of that abject failure in real terms with Obamacare right now.

The fact is that Obama claimed that Obamacare would bend the cost curve downward and instead rates are skyrocketing up and the insurance companies are blaming Obama. So, the economy is horrible. Unemployment is near ten percent. The border is a mess. Afghanistan is a mess. Now, health insurance premiums are skyrocketing as a result of the very policies that Obama claimed would make them come down. To add to that, both Charlie Rangel and Maxine Waters may have their congressional trials in September. That's an unmitigated Democratic disaster. ob

Missouri Invalidates Health Care Mandate

Yet another state sent Obamacare a message.

Missouri voters on Tuesday easily approved a measure aimed at nullifying the new federal health care law, becoming the first state in the nation where ordinary people made known their dismay over the issue at the ballot box.

The measure was intended to invalidate a crucial element of President Obama’s health care law — namely, that most people be required to get health insurance or pay a tax penalty. Supporters of the measure said it would send a firm signal to Washington about how this state, often a bellwether in presidential elections, felt about such a law.

“My constituents told me they felt like their voices had been ignored and they wanted Washington to hear them,” Jane Cunningham, a state senator and Republican who had pressed for a vote, said Tuesday night. “It looks to me like they just picked up a megaphone.”

The legalities of all this are murky. The politics couldn't be clearer. The administration is on a collision course with dozens of states on this mandate and it will end up in the Supreme Court. It will pit individual states against the federal government. While this is happening, the Obama administration is on a separate collision course with Arizona and other states vis a vis illegal immigration.

Miller and Chacko

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

The Pittsburgh Tribune has the story.

A letter to Shinseki from Sen. Richard Burr, R-N.C., and Rep. Brad Miller, D-N.C., centers on allegations from a former VA physician who says he was forced out of the agency in retaliation for raising questions about money for brain injuries, the "signature injury" of the wars in Iraq and Afghanistan. The Defense and Veterans Brain Injury Center reports 10 percent to 20 percent of troops with combat exposure there suffered concussions from roadside bombs.

Then, there are parallels drawn between this and Dr. Anna Chacko.

Van Boven's case appears to parallel that of radiologist Anna Chacko, who says VA officials ousted her from her post at the Pittsburgh VA facility in Oakland after she questioned spending and treatment practices.

I'm left confused. After all in May of 2009, the same Congressman Miller said this of Dr. Anna Chacko.


Senate Letter 2009-05-19[1][1][1] -

Then as Chacko was about to get terminated in January of this year, he said this.

He said that assuming the VA followed proper procedures in Chako's termination, he did not plan further involvement.

Chacko had been suspended from her job in the spring but was reinstated in late summer, only to be placed on administrative leave in October. The termination letter was issued last week.

While they have declined to comment on the issues leading to Chacko's suspension and termination, VA officials said an internal investigation refuted claims by Chacko that patient care might have been compromised by excessive radiation during treatments.

So, does Congressman Miller think that proper procedures were followed in the case of Dr. Chacko? It was apparently neither asked or answered. Miller does hint at it in the latest article.

Miller said told the Tribune-Review he is troubled by "an emerging pattern" of VA administrators using boards of inquiry to punish and silence whistleblowers.
"I would encourage the VA to look into whether the process is being abused," he said.

If that's the case why didn't he step in before Chacko was fired? That was also neither asked nor answered. Here is the statement from Senator Burr's office about the "emerging pattern" that Congressman Miller spoke about.

The “emerging pattern” that Rep. Miller referenced in his comments to the Pittsburgh Tribune-Review were made independently of the specific issues raised jointly by Sen. Burr and Rep. Miller in the letter to Gen. Shinseki. I strongly suggest you take up your concerns with Rep. Miller’s staff as they may have more insight into the reasoning for Rep. Miller’s comments.

Here's the full letter that Burr and Miller drafted to Shinseki and Chacko is not mentioned in it. Both Shinseki and Miller's office have yet to respond for comment.

Shinseki Ltr

Here's the full dossier of Anna Chacko.

Virginia Passes One Hurdle Re: Health Care

A Federal judge gave the state of Virginia a small victory in its battle with the U.S. government.

The state of Virginia can continue its lawsuit to stop the nation's new health care law from taking effect, a federal judge ruled Monday.

U.S. District Court Judge Henry Hudson said he is allowing the suit against the U.S. government to proceed, saying no court has ever ruled on whether it's constitutional to require Americans to purchase a product.

"While this case raises a host of complex constitutional issues, all seem to distill to the single question of whether or not Congress has the power to regulate -- and tax -- a citizen's decision not to participate in interstate commerce," Hudson wrote in a 32-page decision.

This is a long way from over. I won't predict the outcome but can someone explain why the Federal government is taking on so many of its states. It's absolutely amazing how many lawsuits that pit the Federal government of Barack Obama are currently ongoing in which the adversary is an individual state. Here's the statement from the White House.

Since the enactment of health reform legislation in March, several state Attorneys General have filed lawsuits challenging the constitutionality of the Affordable Care Act. Having failed in the legislative arena, opponents of reform are now turning to the courts in an attempt to overturn the work of the democratically elected branches of government. This is nothing new. We saw this with the Social Security Act, the Civil Rights Act, and the Voting Rights Act – constitutional challenges were brought to all three of these monumental pieces of legislation, and all of those challenges failed. So too will the challenge to health reform.

Couldn't you turn that statement around on the White House re: the Arizona immigration law?

This Chart Says it All

Welcome to the world of Obamacare.

My colleague Soccer Dad has more.

What Brian Casey Missed in His Anna Chacko Article

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

In his article on the radiological website, Aunt Minnie, Brian Casey listed the charges by Dr. Anna Chacko against the Pittsburgh VA in detail. Most of it comes from the memo she had published on the internet. Here's one of the charges repeated by Casey of Chacko's against the Pittsburgh VA.

Chacko and Melhem also butted heads over clinical issues, such as the hospital's use of technetium-99m, the radiopharmaceutical that's been in short supply due to repairs at the Canadian nuclear reactor that produces most of North America's supplies.
Chacko said that due to its lower radiation dose compared to an alternative radioisotope, thallium, she preferred that VA physicians work around technetium supply shortages to ensure that patients were scheduled when the radioisotope could still be used. But Chacko said she found cases in which orders made by nuclear medicine physicians for technetium studies were changed without their knowledge to use thallium instead. Substituting radiopharmaceuticals without the prescribing physician's knowledge is a serious violation of U.S. Nuclear Regulatory Commission (NRC) rules, she said.

In fact, the VA was asked about this specific charge and here's they responded to other media about it.

Frantz said the VA Medical Inspector General investigated whether the radiation doses affected patient care and concluded that "no issues were identified."

Yet, the fact that this specific charges was investigated by the Inspector General's office and found to be without merit is NOT mentioned anywhere in the piece. Casey has also not responded to multiple emails for comment on the ommission.

Another Chacko Update

UPDATE: Please also check out my new book, The Definitive Dossier of PTSD in Whistleblowers, in which Chapter 4 is dedicated entirely to the exploits of Dr. Anna Chacko. 


In the Aunt Minnie piece, Dr. Chacko suggests that she may try and get her old job back.

Ironically, Chacko claims that the Pittsburgh VA has put Chacko's former job as chief of radiology out to bid for the second time after failing to find a candidate in its first search. A representative with the Pittsburgh VA declined to comment on personnel matters at the facility, citing privacy concerns.
With the political winds appearing to shift in her favor, Chacko says she's considering whether to apply for the Pittsburgh VA job again.
"I'm going to apply," Chacko said. "I know the corruption in the VA better than anyone else. I want to make the VA safe for veterans."

In March of this year, Dr. Chacko was terminated as head of radiology at the Pittsburgh VA. The position has not yet been filled. Dr. Chacko is claiming that she plans on applying again for this position. Here's how a congressional source with knowledge of the situation characterized her chances.

I’m confident that it’s beyond the realm of possibility for someone who’s been terminated from the VA for cause to get another job there – especially the job from which they were removed!

...
On that note, here's how one veteran radiologist described the medical profession.

there are high percentages of the entitled, sociopaths, arrogants, and logic-challenged in the medical field. Take your pick!

That may explain in some small way the whole Dr. Anna Chacko affair.

Dr. Anna Chacko and Saul Alinsky

UPDATE: Please also check out my new book, The Definitive Dossier on PTSD in Whistleblowers, for only $3.95, in which I dedicate chapter four entirely to the exploits of Dr. Anna Chacko. 

Anyone who has watched even five minutes of Glenn Beck knows that he has no use for the current President of the United States. If you've watched him for ten minutes, you also know that he has no use for Saul Alinsky, the famed community organizer and author of Rules for Radicals. Beck is especially fond of harping on two of Alinsky's techniques. First is his rule number thirteen.

Pick the target, freeze it, personalize it and polarize it.

The second involves throwing out so much information all at once into the media that it distracts from your true intentions.

Obama perfected the tactics that so-called community organizers like ACORN use every day. It's the tactic of misdirection.
The community organizer mentality — the ACORN mentality — is to distract you from their main goal, so even though some people are looking at their voter registration fraud, we should follow the money, too.
While politicians talk about 46 million people without health care, what's their real agenda? And what's the effect on the 255 million with health care?

Both these strategies should be kept in mind as I again analyze the tale of Dr. Anna Chacko. In October of 2008, Dr. Anna Chacko arrived in Pittsburgh to work at the VA hospital there. She arrived there following a fourteen month stint at St. James Hospital in Butte, Mt. Prior to that, she spent just over a year at the Boston University Medical Center in Boston. That means that Pittsburgh would be her third job in her third city since 2006. At this time, Dr. Anna Chacko was 64 years old.
Almost immediately, there were complaints about Dr. Chacko. These complaints were filed by members of the administration like Dr. Mona Melham. They were also filed by members of the radiology department. The complaints included accusations that Dr. Chacko threatened legal resident aliens with calls to immigration if they crossed her. There were allegations of threats, lies, and bullying behavior. One doctor complained that Dr. Chacko called their other employer and spread lies about them there.
This is not merely accusations made by me. In fact, radiologists testified to all these threats in not one but two investigative boards held against Dr. Chacko by the Pittsburgh VA. In January of 2009, a doctor working at the Pittsburgh VA slipped in their driveway and fell. She thought her wrist was broken when she came to work at the Pittsburgh VA. Dr. Mona Melham approved for this doctor to have her wrist x rayed even though she was an employee and not a patient.
Upon hearing this, Dr. Chacko complained to the Inspector General's office of the VA and claimed that Dr. Melham committed fraud. She then demanded that an administrative investigative board be formed to determine if Dr. Melham be removed. Only by then, Dr. Chacko had alienated most of the radiology department that the Pittsburgh VA held an ABI to determine if Dr. Chacko herself should be removed herself. That's exactly what the board recommended in March.
Then, Dr. Chacko hired a lawyer and reached out to Congressman Brad Miller of North Carolina. Congressman Miller had his own history with both the Pittsburgh VA and Dr. Melham. He'd conducted an investigation into this Pittsburgh VA over some destroyed strands of legionella in 2006 and determined that Dr. Melham had acted with malice in destroying them. It appears that Dr. Chacko had in fact convinced Congressman Brad Miller to side with her because on May 15th, 2009 he wrote to General Shinseki on her behalf.


Senate Letter 2009-05-19[1][1][1] -
After this Dr. Chacko was given her job back and returned on August 1st, 2009. Her behavior didn't improve and several employees of the Pittsburgh VA began reaching out to her former colleagues at St. James. One such employee, using a dummy email account, reached out to an individual with whom I was communicating. They became my first source on the story.

I wrote my first article on September 2nd, 2009, and wrote several more throughout the month of September. At the end of September, Dr. Chacko was put on indefinite administrative leave and terminated the following March. This time her political friends wouldn't stand up for her, and Congressman Miller would only explain his involvement this way.

Miller said he wrote the letter because "it appeared that a VA hospital which was given to infighting was proceeding in the same way again."
He said the 2008 investigation showed management at the Pittsburgh VA "appeared to be chaotic and a very valuable collection was destroyed out of spite."
The congressman said the Legionella investigation concluded that local VA officials "proceeded in the wrong direction for the wrong reasons."
He said that assuming the VA followed proper procedures in Chako's termination, he did not plan further involvement.

Neither Miller nor Shinseki have ever responded to my repeated requests for comment about their involvement with Chacko. Since her termination, Dr. Chacko has reached out to anyone with a sympathetic ear with claims that she's a whistleblower and that she was only fired as retaliation. First, she found a sympathetic ear in Dr. Vijay Mehta who allowed her to publish a manifesto on his site detailing the charges made by her against the Pittsbugh VA. Curiously, Dr. Chacko demanded that he take this manifesto down when Roche reported on it in the Pittsburgh Tribune.
Then, Congressman and Senatorial candidate Joe Sestak referenced Chacko in his press release for his bill the Transparency for Heroes Act.

Until March of 2010, Dr. Pamela Gray was a rheumatologist at the Hampton VAMC. It is her contention that she was subsequently terminated as a VA employee as a result of her actions to stop the over-prescription of Schedule II narcotics. Dr. Gray joins Dr. Anna Chacko formerly of the Pittsburgh VAMC and Dr. Robert Van Boven formerly of the Central Texas Veterans Healthcare System in alleging retaliation for exposing practices they believed negatively affected patient care. I respect the fact that these physicians put their careers and reputations at risk to advance the treatment of our Veterans.

Then, the radiology website, Aunt Minnie, wrote a largely sympathetic article in which her charge were listed in detail while my charges against her were characterized and retold like this,

But what's more, it characterized her as a "psychopath" and included a laundry list of accusations that included salacious details allegedly drawn from Chacko's personal life.

While systematically listing the charges, the author, Brian Casey, failed to mention that one of them, Chacko's assertion that thallium was being used to great harm to the patients, was investigated by the VA IG and it was found that there was no problem. Furthermore, the article failed to mentioned that Dr. Chacko has financial interest in Moly99Montana, a company which manufactures molybdenum, which just happens to compete with thallium.
Chacko has also received support from others including those that go onto my site. In a recent posting, someone identifying themselves as FBI said this.

Keep the entertainment go on while Moreland is forced to taking early retirement, Mona Melhem is forced to step down from ACOS and Jain is detailed against his wishes in DC. You follow the money{hope you are getting paid from one of the above}, she follows the money, the above members are following the money, the veterans suffer and the truth is lost. For some of us who witness this daily at VA, it is just an entertainment played by some educated fools called Radiologists, Pathologists, investigative journOlists and of course the dietitians at VAPHS.

Shame to all of the above for bragging how rightful they are while ignoring the plight of the veterans. Watch Veterans watchdog for more entertainement and 60 minutes!!!

All of it is meant as misdirection. Chacko is attempting to go after the Pittsburgh VA because they're an easy target. After all, the VA system has a history of corruption. The Pittsburgh VA itself has been the subject of a congressional inquiry. She dumps all sorts of charges in their lap. It's all very Alinsky like. Pick a target, isolate, freeze them, and escalate. It's all beside the point. Corruption in the VA, and at the Pittsburgh VA specifically, is not the issue. The charges against Chacko have nothing to do with corruption but bullying, lying and manipulating.

Furthermore, and much more importantly, the Pittsburgh Va is not the first place where these charges have been made. While at St. James, the radiology manager, Kristi George, also claimed that Dr. Chacko was attacking her in a systematic attempt to sully her reputation so that George would get fired. In fact, Kristi George filed charges against St. James, while both she and Chacko, were still working there.
5[1][1].29.09 Second Amended Complaint and Demand for Jury Trial

In this complaint, George says that Chacko's attacks became so brutal that she had to take a leave of absence in order to seek psychological help. Furthermore, Chacko began to attack Kristi George before they'd technically even worked together. Chacko's first day, Kristi George was still on vacation but that didn't stop Chacko from going around the hospital and complaining that Kristi George was incompetent. This case was eventually settled and the dispostition sealed. It's one of five lawsuits involving Chacko during her time at St. James. She was only there for fourteen months.

Then, there's Linda Murphy, the only person that would put their name to charges against Dr. Anna Chacko. Murphy is Chacko's former secretary at St. James. Murphy told me that Chacko would routinely call her at 2 or 3 in the morning and demand that she get out of bed to fix Chacko's computer or other minor task. If Murphy didn't answer the phone, Chacko would call over and over until she did.

On one occasion, Murphy went on a three day vacation with her son right before he went to college. Murphy told me that Chacko called her repeatedly, forced her to come back a day early, and then made her work a sixteen hour day upon returning. Murphy says that she suffered a systematic psychological torture at the hands of Dr. Anna Chacko. Not coincidentally, the daughter of another of Chacko's secretary's describes a similar experience.

My mom worked for this tyrant, as her admin, for 3.5 years (mom always makes us add the .5 to the 3 yrs as it was torture working for her!). She absolutely sucked the life out of my mother. She finally got relief when AKC was removed from Lahey Clinic. I was not aware that anyone knew how evil this woman is and am relieved to know that the word is spreading. My whole family suffered as a result of the way she treated my mom as well as other co-workers.

According to Murphy, when she was fired, she was told that she was being fired because

You know too much about Anna(Chacko)

Then, there's this story retold to me by a radiologist at Lahey Clinic, where Dr. Chacko worked from 2001-2006.

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.

The target, now working in a hospital just outside Chicago, confirmed this story to me.

Mike, I remember it like it was yesterday

She, like most people, refused to give her name, however.

Finally, there is another former colleague of Chacko's. This doctor also worked with Chacko at Lahey Clinic. They confided in me that they thought of committing suicide after Chacko repeatedly attempted to have their license revoked by repeated complaints to the Massachusetts Medical Board. This doctor hired a private investigator and had to get a second job just to pay to defend themselves against Chacko's charges.

There are thousands of stories like this, from hospitals all around the country. So, of course, Dr. Chacko would like everyone to talk about the corruption at the Pittsburgh VA. That way no one notices a long and documented history of abuse, blackmail, lying, and many other misdeeds.

Epilogue:

This is to all my sources, commenters, and so called cheer leaders. I'm told I'm a rock star at the Pittsburgh VA. I believe the same is true at St. James and at Lahey. That's nice. It's also largely irrelevant. I will protect anyone's anonymity to my grave. I will go to jail before I reveal an anonymous source.

That said, hiding behind anonymity as everyone, short of Linda Murphy, has done is cowardly and all it does is put me in the crosshairs. That's fine, but the truth will never be revealed until someone has the courage to stand up and speak on the record.

I recently spoke to an individual at the Pittsburgh VA who didn't want to do that saying that just wanted to do their job. That's fine. No one signs up to take on Dr. Anna Chacko. I'd just point you all to Emery Joe Yost. He was a Chicago park district instructor when one day he noticed that Kevin Long was exposing himself. He reported Long to authorities and this started a ten year nightmare. It ended when the same Kevin Long was caught with several knives in the Daley Plaza a couple months back. He didn't sign up to be in the eye of the storm of a significantly mentally disturbed individual. He didn't flinch when it happened. That makes him courageous. Hiding behind anonymity is cowardly. As Shakespeare once said,

some men are born great, some develop greatness, and others have greatness thrust upon them.

Greatness has been thrust upon you, and someone has to respond to the call. If you think it doesn't matter, that everyone already knows who she is, there's a thread right now on Aunt Minnie defending her.

Here's the full dossier of Dr. Anna Chacko.

Chacko Update

UPDATE: Please also check out my new book, The Definitive Dossier on PTSD in Whistleblowers, for only $3.95, in which I dedicate chapter four entirely to the exploits of Dr. Anna Chacko. 

The radiology website Aunt Minnie has a piece on Dr. Anna Chacko. (you may need to create user id to read the article)

Incidentally, Congressman Joe Sestak has introduced the Transparency for America's Heroes Act, HR 3843, and in the text of the bill is this,

Until March of 2010, Dr. Pamela Gray was a rheumatologist at the Hampton VAMC. It is her contention that she was subsequently terminated as a VA employee as a result of her actions to stop the over-prescription of Schedule II narcotics. Dr. Gray joins Dr. Anna Chacko formerly of the Pittsburgh VAMC and Dr. Robert Van Boven formerly of the Central Texas Veterans Healthcare System in alleging retaliation for exposing practices they believed negatively affected patient care. I respect the fact that these physicians put their careers and reputations at risk to advance the treatment of our Veterans.

There's no response yet from Congressman Sestak's office about Dr. Chacko's inclusion in the text of the bill. I don't know if Congressman Sestak read my dossier on her before declaring her a hero but here it is anyway.
Finally, Dr. Chacko seems to have a liberal interpretation of our first conversation. In the piece, it's described this way.

The next day she received a phone call from Michael Volpe, a blogger with a self-styled government watchdog website on Blogspot.com called TheProvocateur, who said he was writing an article on Chacko. Chacko spoke with him briefly, but she claims she was shocked when his article appeared, entitled "Clout: Congressman Brad Miller, General Shinseki, and the Pittsburgh VA ."

In her memo, she described the conversation this way.

On September 2nd, a blogger (Michael Volpe) called me at my office and told me that he would be writing up slanderous and very injurious articles about me on the Internet. Since I did not know Mr. Volpe personally, I asked him what his sources of information would be. He claimed and subsequently has stated on his blog that his sources of information would be the VA.

So, to one source she describes the conversation as brief and vague and to another source she claims that I said the piece would be "slanderous." Here's the piece in question.

Real Clear Politics and Health Care Reform

Today's health care section of Real Clear Politics is a microcosm of the problems that the administration faces on health care reform. Today, it links to three different stories and each is a problem for the Democrats. The first story is about how health insurers are pushing for plans that will limit the choices patients will have in choosing their doctors from the New York Times.

As the Obama administration begins to enact the new national health care law, the country’s biggest insurers are promoting affordable plans with reduced premiums that require participants to use a narrower selection of doctors or hospitals.

The plans, being tested in places like San Diego, New York and Chicago, are likely to appeal especially to small businesses that already provide insurance to their employees, but are concerned about the ever-spiraling cost of coverage

But large employers, as well, are starting to show some interest, and insurers and consultants expect that, over time, businesses of all sizes will gravitate toward these plans in an effort to cut costs.

The tradeoff, they say, is that more Americans will be asked to pay higher prices for the privilege of choosing or keeping their own doctors if they are outside the new networks. That could come as a surprise to many who remember the repeated assurances from President Obama and other officials that consumers would retain a variety of health-care choices.

Of course, President Obama billed health care reform as a way to cut costs and expand choice. The reality is of course very different.

The second story, also from the New York Times, is about how the Obama administration has taken to calling the mandates a tax.

When Congress required most Americans to obtain health insurance or pay a penalty, Democrats denied that they were creating a new tax. But in court, the Obama administration and its allies now defend the requirement as an exercise of the government’s “power to lay and collect taxes.”

And that power, they say, is even more sweeping than the federal power to regulate interstate commerce.

Administration officials say the tax argument is a linchpin of their legal case in defense of the health care overhaul and its individual mandate, now being challenged in court by more than 20 states and several private organizations.

It's true that the power to tax is a constitutional mandate of the federal government. The problem is that if this mandate is a tax, then that's a tax on everyone. Yet, President Obama so famously promised that 95% of the country wouldn't be taxed under his administration.

If this mandate is a tax, then it also means that everyone's taxes are going up.

Finally, there's this story from Politico in which both the left and right are pushing back against his abortion policy in health care reform.

The key lines are these: "The Obama administration has decided that no woman in the new high-risk insurance pools will be allowed to obtain abortion coverage beyond limited cases (rape, incest, endangering the life of the woman). Not even if she pays for that coverage with her own money...

"...The president committed his administration to preventing any federal funds from being spent on abortion care. But the fact is, this announcement from HHS goes well beyond that. Nothing in the new health care reform law requires a ban on abortion coverage in the high-risk pools. No law passed by Congress forced this decision. The Obama administration has chosen to place a new burden on ill and medically vulnerable women seeking abortion coverage."

...

Talk dominated conservative news outlets over the last few days that New Mexico and Pennsylvania were going to allow elective abortions as part of their applications for access to the new federal insurance pools. Among the sparks for that round of stories was an AP report in which New Mexico officials initially said elective abortion would be covered under its policies, then started walking that back.

But the National Right to Life Committee sparked an uproar by claiming a similar issue was arising in Pennsylvania. Pennsylvania officials strenuously denied that and Democrats accused the NRLC of creating an issue out of whole cloth aimed at testing an executive order President Obama signed last March.

It still remains unclear if the new health care reform will use federal tax dollars to fund abortions. The president said no and even signed an executive order to stop it. We don't live in a dictatorship and so an executive order is largely useless.

Man Caused Disaster

My cohort in the Watcher of Weasels, Bookworm room, wrote what I thought was an excellent introduction, but it was the whole post. She did, however, give me carte blanche to use that intro and turn it into a full commentary. So, alas...

Reading the news today about, among other things, the Gulf oil spill, Afghanistan, Iraq, the Euro collapse, Iran, Israel, Turkey, the economy, the border, and illegal immigration, I’ve had two phrases that stuck in my brain and refuse to leave. The first is Janet Napolitano’s near-deathless bit of bureaucratese, “man-caused disasters,” one that she and her minions created to obscure the fact that Islamic fundamentalism is the common denominator binding together those mass killings around the world that involve guns, airplanes, tractors, rocket launches, beheadings, beatings, hangings, etc.

The second phrase is Obama’s statement, one with which I fully agree, that “elections have consequences.”

Combine those two phrases — “elections have consequences” and “man-caused disaster” — and you end up with this, the ultimate man-caused disaster:

This man caused disaster wasted no time. The chief of staff boldly proclaimed that we can't let a crisis go to waste, and the man caused disaster wasted no time. Not two months into his term, this man caused disaster spent $787 billion. That was supposed to keep our unemployment rate below 8% but of course it's hit 10% and hovers near there since. This man caused disaster told us we must spend this money. After all, the solution to a crisis in which families and banks took on too much debt could only be solved by the government taking on too much debt. Voila. Now, the government does have too much debt. This man caused disaster didn't create debts and deficits. Instead, the man caused disaster created debts and deficits 2.0. Now, we have deficits way north of $1 trillion as far as the eye can see. Our debt is nearing in on 100% of our GDP and Moody's is threatening to cut our bond ratings. They're only threatening but these threats haven't changed the mind of this man caused disaster. So, sometime in the next few months, a year, or a few years those threats will be a reality. Then, this man caused disaster will cause a disaster to anyone that wants to borrow for a car, a house, a credit card, or even a student loan.

So far, the only man caused disaster of this man caused disaster's notorious health care bill will be the man caused disaster at the ballot box for Democrats this November. Soon, though, everyone will feel the effects of this man caused disaster. We recently learned that about half of those that have health insurance will lose it. We've learned that health care costs will increase 20% more than they would have without the bill, and we've learned that about 15% of hospitals will go out of business trying to comply with this man caused disaster all caused by the man caused disaster known as Obamacare.

The border is so porous that Phoenix now only trails Mexico City in kidnappings. The state of Arizona is so desperate that they passed their own law to enforce federal immigration laws. The key difference will be that Arizona will actually enforce this law. How does the man caused disaster respond? He won't enforce any immigration laws until we all agree to grant amnesty to up to 20 million folks that entered the country illegally. Oh, and, he'll sue the state of Arizona for having the gall to do the job he refuses to do.

This man caused disaster spent the entire campaign telling Americans that Afghanistan was the good war (as opposed to Iraq which would then be the bad war) So, he escalated the war in Afghanistan. The man caused disaster couldn't leave well enough alone and so as he was announcing an increase in troops he also announced an end to the war. The analysts say this second pronouncement is for "domestic consumption" but our Afghan partner, Hamid Karzai, didn't get the memo. He seems to think that this pronouncement could be a man caused disaster to his own neck. So, he's hedging his bet and he's playing footsy with our enemies all while pledging allegiance to us. Since the closest this man caused disaster came to war policy was an especially rowdy night at the local coffee shop in Hyde Park, he may not realize that it's much more difficult to win a war when our partner is simultaneously partnering up with our enemies.

Of course, our so called ally in Afghanistan must feel in good company. After all, lots of our allies must feel like enemies by the way they're treated by this man caused disaster. Our only true ally in the Middle East, and the only true Democracy, has been disrespected, strong armed, threatened, all while the same man caused disaster has reached to most of her enemies with deference due a nobel laureate. Then again, Israel is in good company. Alvaro Uribe may wind up being Colombia's George Washington, but in the view of this man caused disaster, he takes a second seat to leftist Daniel Ortega. Then, there's the Brits. They've been our partners in war and peace since they were our enemies in war and peace. Churchill, Thatcher, and Blair partnered with FDR, Reagan and Bush to free Western Europe, then Eastern Europe and finally Afghanistan and Iraq from tyranny. Those accomplishments are insignificant in the mind of this man caused disaster. First, he sent the bust of Churchill back, then he gave Gordon Brown some DVD's that didn't work, but finally he sided with a leftist over Britain in a dispute over the Falkland Islands.

Meanwhile, our enemies are stronger and more ferocious. North Korea was feeling bold and so they shot up a South Korean ship. Iran laughs every time a limp Security Council resolution against it is passed, and soon China will own everyone's debt. The answer from this man made disaster appears to be to ask for more limp Security Council resolutions and to borrow even more from China.

Then, there's the ultimate man caused disaster, the oil spill. No one blames the man caused disaster for causing this man caused disaster. Instead, this man caused disaster made that man caused disaster exponentially worse. How much worse...no one knows. Maybe, if this man caused disaster had scratched the numerous White House concerts, fundraisers, and golf outings, the other man caused disaster would have been under more control. Instead, the oil spews, the pelicans choke, and millions watch their livelihoods evaporate. One man caused disaster meets another man caused disaster.

The Obama Presidency Will Redefine the Role of Government

The same people now screaming that government isn't doing enough in the gulf were screaming the government was doing too much months ago.

That's something you've heard President Obama and his defenders, dwindling as they are, say numerously since the Gulf crisis began. Of course, the only people that want no role for government at all are anarchists and while they also criticize Obama that's usually only at G20 meetings.

Until the end of April 2010, the Obama administration was one government expansion after another. We now own AIG, two car companies, Citigroup, and both Fannie and Freddie. Obamacare and financial reform would also be massive expansions of government. If cap and trade passed, that would be yet another expansion of government. There are also those proposals that have no hope of passing like net neutrality that also expand the role of government.

Then, in April, the illegal immigration debate began and president Obama said he can't secure the borders without comprehensive immigration reform. Then there was an oil spill and government was downright impotent. The same government that wanted to expand its powers seemingly everywhere was doing nothing in the two areas that the public wanted action most.

Like I said earlier, only anarchists want no role for government. Everyone else believes that there's some role for government. That's been the debate throughout the Obama presidency. That was at the heart of the health care debate. How much role in health care should the government have?

Now, the same people criticizing Obama earlier for expanding government power are demanding more government action in immigration and the spill. Meanwhile, all the same that claimed the government needed to do more to hold down health care costs and hold banks accountable are saying that government isn't all powerful to seal the border and stop an oil spill.

What we have is yet another debate on the role of government. That will be the legacy of the Obama administration, properly defining the role of government.

Keep Your Health Insurance: Not So Says IBD

President Obama famously often said

if you like your health insurance, you'll keep it

Not so says an Investor's Business Daily study.

internal White House documents reveal that 51% of employers may have to relinquish their current health care coverage by 2013 due to ObamaCare. That numbers soars to 66% for small-business employers.

The documents — product of a joint project of the Labor Department, the Health and Human Services Department and the IRS — examine the effects new regulations would have on existing, or “grandfathered,” employer-based health care plans.

Draft copies of the documents were reportedly leaked to House Republicans earlier in the week. Rep. Bill Posey, R-Fla., posted them on his Web site Friday afternoon. (View the full report here.)

In fact, I made a similar assertion when I analyzed the House version of the bill last summer.

The nexis, if you will, of government control starts on page 72 and page 84. Those two pages establish the government health exchange, define the government's role in it, and define what providers must enroll in it. The health care exchange will be administered by a new bureaucracy, the Health Choices Administration. Any insurer, health practitioner, or hospital in the health care exchange will be subject to the regulations of the exchange as laid out by the Health Choices Administration.

Who needs to be in the exchange? Any health care provider that provides health care that is paid in whole or in part by a third party must be in the exchange. In other words, any hospital that accepts insurance must be part of the exchange. All insurance companies must be part of the exchange. Chiropractors, laser surgeries, and other procedures that don't accept insurance would not be part of this exchange. As such, almost the entire health care industry would fall under the control of the health care exchange. The health care exchange would now be regulated by the Health Choices Administration.

As such, it is totally misleading to say that if you like your health care it won't change. That's only if your current health care plan conforms to whatever regulations are created by the Health Choices Administration.

That's the critical point. There will be well over 100 new regulators and bureaucracies created by the bill. There will also be a new government run exchange. In both cases, the government will decide what is and isn't appropriate as far as health insurance. With all of these new government controls, it's impossible to know what will and won't be appropriate and so this new study is not altogether surprising.

Pelosi Heckled

This video is just plain fascinating.


This came at the beginning of the Democrats hundred million dollar plus PR campaign on health care.

The White House and its allies are launching a massive public relations campaign to convince a skeptical public that its historic health care reform legislation is just what the doctor ordered. But some Democratic partisans say the PR juggernaut wouldn't have been necessary if the administration hadn't lost control of the message in the first place.

"Why is it that 60 percent of the public is confused about health care reform? Is it because they've done such a brilliant job communicating what the thing is about? Of course not," said Ted Marmor, author of "The Politics of Medicare," who was there at the creation of the health care program for seniors.

Given this video, the Democrats had better hope the old adage is true, "there's no such thing as bad publicity". Meanwhile, the President also held a tele town hall in which he touted how health care reform would benefit Medicare.

U.S. President Obama will have a national teleconference town hall meeting with seniors Tuesday to discuss the Affordable Care Act, the White House said.

Broadcast from the Holiday Park Multipurpose Senior Center in Maryland, the teleconference will cover the act's efforts to thwart scams against seniors in advance of the first mailing of $250 rebate checks for people trapped in the so-called "doughnut hole" in prescription drug coverage, the daily schedule indicated.

Before Obama even got in front of the podium, John Boehner was attacking the whole endeavor as a gimmick.

House GOP leader John Boehner (Ohio) went on the offensive Tuesday against an event in which President Barack Obama will promote his signature healthcare reform law to seniors.

Boehner ridiculed an online town hall the president will hold Tuesday morning as little more than a "glitzy PR campaign" to repackage the healthcare bill Obama signed in March.

My nickel's worth of free advice to Democrats is to stop talking about health care. People hate the bill. They'll always hate the bill and nothing anyone says now will change that. So, talking about it only reminds the voters they hate it.

The Chacko Memo

UPDATE: Please also check out my new book, The Definitive Dossier on PTSD in Whistleblowers, for only $3.95, in which I dedicate chapter four entirely to the exploits of Dr. Anna Chacko. 


Here's a copy of Dr. Chacko's entire memo in which she lays out what happened during her time at the Pittsburgh VA. Let's just say she didn't like things much at Shangri La.


The following memorandum will illustrate the many problems with the VAPHS and the VISN 4. There is no doubt that their practices currently adversely affect patient care. Their corruption and malfeasance have flourished unfettered, and have become institutionalized.
I am outlining this document with the VA, VAPHS and VISN – 4 and have organized it into three separate parts:
I. Systemic Issues with the VA
A. Equipment Issues
B. Personnel Issues
C. Patient Care Issues
How I have been retaliated and reprised against.
II. My Issues with the VAPHS
A. Fraud, Waste and Abuse, Misuse of Authority and ensuing Reprisal
B. Non-Merit Based Discrimination
III. Synopsis - Timeline
I would recommend that you peruse Part I - Pages 2 through 6. These will delineate the issues that need to be investigated thoroughly and corrected. Parts II and III deal with these issues as they apply to me and chronicle my arduous process of discovery and disillusionment. I have disclosed no HIPAA information – but would be willing to do so if I can be assured that this is allowed, is prudent and of value.
It will become abundantly clear from perusal of my memoranda, the news and other sources that write about the VHA, that there is little if any motivation or incentive to improve their operations and align them with their purported mission.
The Honorable Secretary is isolated from bad news and surrounded with millions of dollars of window-dressing so that he can “leave behind a legacy”. The careerists, (such as Ms. Wolf, Drs Jain and Melhem and Mr. Michael Moreland, Mr. Schoenhard), who may be corrupt and/or inept continue to work to shore up their jobs. Ultimately, the individuals who suffer are the veteran and the taxpayer.
Certain favored individuals are allowed to run roughshod over areas of concern such as patient care, hiring practices, credentialing, and equipment acquisition. There is no accountability or adult supervision of these individuals or their favored subordinates. While the VA has several handbooks which outline how the agency should be run, little attention is paid to these. As you will see after reading my memorandum, the inner circle makes the VA’s rules.
The VA has apparently developed a well-honed and scripted method of dealing with whistleblowers – humiliation, isolation, character and professional assassination etc. Their goal is clearly one, which is designed to stabilize their jobs, to demoralize and destroy the whistleblower and to silence anyone who would like to see the VA keep its covenant with the veteran. They are supported by yet other agencies, which are infirm, inert or apathetic.
This is to request you to help me expedite any oversight or investigation of the corrupt practices of the VA, specifically of this VA and this VISN that you may have initiated. Given the public interest in healthcare reform, it would be important to use a reformed VA to be the template for healthcare reform rather than the example of a government agency gone to perdition. Please help direct the necessary energies to changing the future for our veterans who are among the nation’s most disenfranchised and those who would minister to them – individuals such as you and I .
Sincerely

Anna K. Chacko MD
COL (ret) USA2359 Railroad St #3101, Pittsburgh, PA 15222

Here is a message from another concerned physician. While it may be hard to decipher who is right between two quarreling parties one thing we can agree on is that inapt organization is wasting tax payer dollars. If all of us who are witnessing fraud and abuse the powers have no option but to fix the system. ~Vijay Mehta

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Systemic Issues at Pittsburgh VA
Post by Vijay Mehta on Today at 11:45am

PART I - SYSTEMIC ISSUES WITH THE VA
A. Equipment – Acquisition, Composition and Maintenance
1. Fraud and negligence in acquisition and procurement of high dollar value equipment.
At the VAPHS and VISN 4, during my tenure as Program Leader in Radiology, the composition of the High Dollar and High tech Committee was chaired by an Internist (Dr. Glenn Snyder COS at Clarksburg VA), who had neither knowledge of the need for nor the elements that defined the purchases in Radiology in the VISN. This accounts for the unnecessary purchases of a third linear accelerator, the fifth Gamma Camera or the low field strength Orthopedic Scanner.
2. Oversight by the VACO.
This was not evident in any judgment exercised in the equipment purchased.
For instance, a) when the 1.0 T Orthopedic Unit was acquired and upgrade to the 1.5 T unit was available and could have been purchased. Currently with the 1.0T scanner, few if any scans are performed. Patients who have been scanned in the 1.0T unit are then rescanned in the higher strength units. This translates to a wasted sum of ≈ $600,000 for the purchase of the unit and an expenditure of 10% of the purchase price for maintenance.
b) A second example is the acquisition of a fifth SPECT scanner when the need is for a SPECT-CT unit was clearly obvious. This has resulted in a number of cases being “fee-based” to UPMC or elsewhere for SPECT-CT scanning.
3. No input from Subject Matter experts –
Neither Dr. Melhem who was the Service Line VP nor the Committee accepted any input from radiologists who worked with the equipment and had the requisite training. Instead input was solicited from non-radiologists such as the Administrator of the Radiology Department and the Business Manager of the Service Line who are trained Dieticians and the Service Line VP who is a pathologist. For e.g. a) The Storage device purchased for the Nuclear medicine and PET scans are a system, which does not provide the features, which are fundamentally needed for retrieval for comparison purposes.
b) The Nuclear medicine physician had provided input regarding the purchase of a SPECT-CT unit. His input was ignored. I provided input and was fobbed off.
4. Inadequate optimization for purchased equipment.
The necessary firm/hard and software for equipment is not addressed in a consistent fashion.
The most notable omission in the acquisition of new equipment was the additional purchase of Uninterruptible Power Supply (UPS) for the scanners. With the frequency of thunderstorms and power outages in the city, equipment is frequently affected. Without adequate maintenance contracts, the institution has to spend substantial sums of money to have the repair contractors arrive to restart the equipment causing not just expenditure of unnecessary sums of money but also waste of time.
MRI Scanners were purchased to address the issues of cardiac disease, breast cancer, degenerative joint problems etc. Omitting the purchase of the necessary software and coils for imaging the body parts in question is a serious error.
5. Acceptance testing
The acceptance testing on the equipment purchased at the VAPHS in Radiology is sporadically applied. In the case of the PET-CT scanner, I am told that no acceptance testing was done. The same is allegedly true of the CT scanners. The vendor was asked for their input in the acceptability of the equipment and their word was taken in lieu of acceptance testing.
6. Faulty equipment
When there have been persistent quality problems with equipment, there is no advocate for the physician who will make the company provided the necessary repairs/upgrades in order to make the equipment functional.
For e.g. a) the Fat Suppression sequences on the Siemens 1.5 T scanners have been unacceptable. I was not allowed to demand that the company make the necessary changes in order to render the image interpretation safe.
b) The calibration of the CT scanners and the reporting of the Housnsefield units on the CT scanners were consistently faulty. This precludes the accurate tissue characterization of various pathologies and organs. I was prevented from insisting on that the vendor affect necessary repairs and changes.

B. Personnel Issues – Hiring, Workload, Board Certification, Credentialing, Peer review, Disparate incomes etc.

1. Hiring of Radiologists and Nuclear Medicine Physicians.
This has been extremely arbitrary and based on nothing other than the whim of the Assistant chief of Staff.
For e.g.: a) Dr. P, a Nuclear Medicine physician was purportedly based on the fact that he walked in through the door and asked for the job
b) When I was hired, there should have been interviews with members of the Executive Leadership Board or the Medical executive Board.
c) Inadequate documentation and follow-through on checking on credentials. When I insisted on checking on the training and the certification of the training of one the doctors in the department, I was told to “lay off”. She had completed only 1.5 years of training in an ACGME certified fellowship. The required additional training of 0.5 years was not completed at an ACGME certified program. She also claimed that she had completed one year of PET-CT fellowship, which was inaccurate.

2. Enticement with inaccurate representation of the position and remuneration.
No mention has been made to some of the physicians that there would be a probationary period of TWO years.
Although a relocation bonus was promised, it was not given. The plea has been that this was not allowed – one should question as to why this was even raised and promised.
One of the physicians was told that she would be making more than the chairman of Radiology at the University – which was a gross misrepresentation of fact.

3. “Sweetheart” deals made for some of the physicians:
The Assistant chief of Staff who has been given free reign in making promises to hires allowed them to set their pick of what they would do. For instance, when a Nuclear Medicine Physician is hired, it is expected that they would do all aspects of the specialty particularly when there was a need in the department.
The Assistant Chief of Staff has also claimed that she makes it a point to hire women even if they were not the best candidates so that she could help with removing the glass ceiling for women.
IV. Unfair implementation of standards of payment
One of the female physicians (of Asian extraction) has habitually and deliberately never completed her work within the specified time of 24 hours. Despite this Dr. Melhem made no issue of her lack of performance. By contrast, a male Caucasian physician was docked a significant amount of pay for minor tardiness.

Physicians with less experience and in some instances, an inferior work ethic have been compensated at a higher rate merely because the ACOS decided it was so.

When the job title has changed to a higher one, the institution does not make any restitution to pay the employee at the higher rate – merely because the employee is a whistleblower.
V. Workload and compensation
A female physician (VAG) with very little experience is compensated at a higher rate than those with more experience and qualifications.
In order to reward her for aiding in harassing physicians who were not in favor with Dr. Melhem and Dr. Jain, she has been rewarded with a promotion to the Section Chief.
VI. Tours of duty memoranda and comp time
Some of the favored physicians are allowed to arrive at work and leave at their convenience – frequently working a mere fraction of the time that they were supposed to work.
Some of the physicians are allowed to arrive late to work while the VAPHS pays for the ancillary staff who have to wait around not doing any work due to the tardiness of the physician in question.
Comp time is allowed for physicians who do minimal work on call despite the fact that allowing for comp time is apparently not allowed according to HR regulations.
VII. Credentialing and Privileging
Certain of the physicians had been allowed privileges in practicing in areas which they clearly had neither expertise nor experience, while this was denied to a male Caucasian physician who had the necessary boards and certification – merely needed supervised or mentored work.
VIII. Peer Review
Certain physicians have been allowed to practice without regard to the number of complications that have accompanied their practice.
These physicians have been allowed to make specious accusations regarding the competency of others who may not have been in favor with Drs. Melhem and Jain.

Continued

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Systemic Issues at Pittsburgh VA Page 2
Post by Vijay Mehta on Today at 11:45am

C. Patient Care Issues: Abandonment, Practising on patients without privileges/credentials, Excessive and indiscriminate radiation

1. Work not completed on time
There have been some radiologists/Nuclear Physicians who have not completed their work in time and not had to face any consequences. As a matter of fact, they have actually been rewarded (for testifying and complaining against physicians in disfavor) despite their problematic work ethic.

2. Abandonment of patients
One of the female physicians left her post while on call telling the clinicians that she would not be available for the rest of the day – leaving the hospital without coverage. When I attempted to hold her accountable, I was severely chastised for getting the physician to be accountable.
Referring clinicians have complained bitterly about her non-availability, refusal to perform studies that were necessary, unacceptable and unprofessional interactions. These were transmitted to the COS and ACOS to no avail.

3. Administration of excessive and unnecessary radiation to patients
When there was a temporary shortage of radioactive Technetium 99m, two of the subject matter experts advised that the material be acquired from other sources. These orders were countermanded by individuals (Dr. Melhem, Ms Weihrauch and Ken DiSibio) who were neither subject matter experts nor authorized users. This resulted in subjecting eight veterans to 2.5+ times the body radiation dose. Additionally the images obtained were suboptimal and did not provide the information needed.

4. Allowing technologists to prescribe the procedure in Nuclear Medicine and CT scanning
For the administration of radioactive material or prescribing procedures, which deliver a significant radiation dose to the patient, it is imperative that the physician (radiologist/Nuclear Medicine) be involved in the prescription. Assigning this task to a technologist is a dangerous process.

5. Presence of a physician at the time of injection of radioactive material
The appointed Nuclear medicine physician was rarely ever present at the time of the injection of the patients in PET Scanning. This task was generally unmanned. There was no accountability exercised or enforced by the leadership.

6. Unhygienic and unsafe facilities
Despite the fact that there was a leakage from pipes in the ceiling, the only changes made to repair this was in the physician reading area. There was a continuing leakage in the patient scanning area – with contaminated water leaking over the biopsy table and equipment. Any changes I asked for ignored and the Engineering Department was instructed not to follow through.
I asked for certification of the area as being safe. The COS and the ACOS deliberately misrepresented the issue and claimed that the Engineering facility had “deemed it clean”. I discovered that this was a deliberate falsehood and the the COS and ACOS had full knowledge of the lack of certification on the issue.

7. NRC Violations
The hot lab door in the PET Scanning area was unsecured for several months – despite the fact that I made several appeals to the ACOS to instruct that this be repaired – my please were ignored and I was severely penalized for raising an issue of patient concern and possible violation of NRC regulations.

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Dr. Chacko's Issues with Pittsburgh VA
Post by Vijay Mehta on Today at 11:47am

PART II - MY ISSUES WITH THE VAPHS;
Anna Chacko Vs. Dr. Rajiv Jain, Dr. Mona Melhem, Ms. Terry Gerigk Wolf of The Veterans Administration Pittsburgh Healthcare System (VAPHS) and Mr. Michael Moreland of VISN – 4.

These fall into two categories:
A. Retaliation and reprisal for blowing the whistle on fraud and abuse
B. Retaliation and reprisal for having exercised my EEO rights.
I am listing the pertinent issues with the VAPHS and its leadership. I had brought these to their attention with disastrous consequences to my career and me.
A. Retaliation For Blowing The Whistle: Fraud, Waste And Abuse And misuse of authority
I exposed the following issues and was reprised and retaliated against:
1. Fraudulent use of Government Resources - Doctors not adhering to their tour of duty memoranda. Doctors abandoning patients to attend to their personal affairs (Gupta, Kanderi). This has cost the VA large sums of money. When VA doctors are not available – patients get sent to University of Pittsburgh Medical Center at prohibitively high costs to the taxpayer.
2. Improper use of Radiopharmaceuticals: - Unauthorized users overturning the prescriptions of authorized users. Violation of Nuclear Regulatory Commission guidelines. Violation of ALARA (As Low as Reasonably Achievable) principles
3. Flawed healthcare provided to veterans – Multiple complications by practitioners. I was not allowed to put measures in place, which would have made healthcare safe for the patients. Multiple complications by one practitioner (Dr. Vidhi Gupta) who has a protected status per orders of Dr. Jain.
4. Inadequate documentation and implementation of patient safety issues – I was prevented from documenting or remedying safety issues – re practitioners in the department. I was ordered not to set up a Magnetic Resonance safety Committee by Dr. Jain.
5. Disparate compensation – There is unchecked discrimination against Caucasians in the department. Favoritism is rampant and is perpetrated by the leadership. One of the neuroradiologists is compensated far less than the other Neuroradiologist despite having the additional qualification of being a neurointerventionalist.
One of the Nuclear Medicine doctors is allowed to appear for work at any time it suits her. She is also allowed to pick and choose what she will do despite the fact that she has been recruited into a specific subspecialty – Nuclear Medicine.
6. Intimidation and Harassment – Use of ABIs, SRBs for intimidation and harassment for blowing the whistle and for exercising EEO rights. This appears to be modus operandi for the VA pursuant to media articles. It is well known that the ABIs, SRBs and other investigative tools fall into one of three groups: witch hunts, whitewashes, and fair and balanced. My personal experience indicates that the two ABIs and the SRB were virtual witch-hunts. I believe that the Boards had been given verbal marching orders to find a basis for terminating my employment. Consequently, they exceeded their scope.
7. Retaliation and Reprisal for approaching the congress and the senate for further scrutiny. I went though the chain of command and got no response and was therefore left with no recourse.
8. RICO – Using slander and libel to threaten and intimidate whistleblowers - in my case to besmirch my professional reputation. A blogger (Michael Volpe – a stranger to me) has been solicited to publish derogatory information, half-truths, and innuendoes and outright lies, which were fed to him. Every one of his allegations can be proved to be wrong. He has identified some one in the leadership of the VA being his source of information. He disclosed this fact to a third party and to that individual he indicated that his source was Dr. Melhem.
9. Perjury –Director Terry Gerigk Wolf has informed me that she canceled the first Administrative Board of Investigation because it was improperly conducted. It has become clear to me that it was done expressly for the purposes of
a. Concealing the erroneous and possibly perjured statements made by Dr. Jain, Dr. Melhem, Dr. Gupta, Dr. Bandi, Dr. Kanderi, and Ms. Weihrauch.
b. Concealing the fact that the ABI exceeded the scope of their charge letter.
c. Concealing the fact that Dr. Melhem had engaged in fraud which had been condoned by the leadership - Dr. Jain (the chief of Staff) and Ms. Terry Wolf, (the Director of the VISN).
10. Disparate implementation of peer review standards –Dr. Jain has deliberately applied different professional standards for different physicians, anonymized complainants’ identities in order to protect doctors who made spurious complaints to harass colleagues who happen to be veterans. I had provided him with information regarding the multiple errors made by Dr. Gupta and the complaints made about her by referring clinicians. He acknowledged receipt of these yet did nothing about it.
11. Flawed hiring process: The VA provides VISA-waivers and work permits for doctors. These individuals are required to obtain their board certification. There are individuals in this department who have yet to be board certified (Dr. Mourad). I understand that the VA has to re-advertise the position in the trade journals every two years. While the VAPHS may have done this – there is no indication that they actively considered any Americans for the positions. We accuse private companies of out-sourcing – the VA is guilty of handing over jobs to non-Americans while better-qualified Americans are looking for jobs. This has been a deliberate action instituted by Drs. Melhem and Jain.
12. Rewarding fraud: - Dr. Vidhi Gupta has been protected by Dr. Jain et al despite complaints from multiple sections of the hospital that she was a subpar physician, and often abandoned her post to the detriment of veteran care. Her record of adverse outcomes has been unmatched in the department – yet she is retained despite my protests as the department Chief.
Dr Kanderi – There is ample evidence that she has NEVER been to work on time or been available in the hospital to supervise when patients were being injected with radioactive material. There is also ample evidence that while working at the VA she performs only a small fraction of the work she performs while at her other job at the University of Pittsburgh Medical Center – Hillman Cancer Center
Furthermore, when the VAPHS decided to make the position a full-time one – no economic analysis was performed. The position was not advertised which, according to HR personnel, was against regulations. It was done as a ploy to compensate Dr. Kanderi for testifying against me. . She has now been given a full time position at the VAPHS. I understand that she continues to be tardy as usual. I also understand that there has been no commensurate increase in the number of patients seen after the increase in her status.
Continued

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Dr. Chacko's Issues with Pittsburgh VA Page 2
Post by Vijay Mehta on Today at 11:48am

B. Non-Merit Based Discrimination
1. Hiring
When the VAPHS hired me – the process was flawed from the start. I, however, not having been a GS employee, had no idea of the flawed nature of the recruitment or the magnitude of the flaws.
I was never informed in writing that this was a two-year probationary period. I learned of this probationary issue in May 09 - 8 months after the hiring when Dr. Jain handed me a copy of my SF-50. I had never heard of an SF-50 until then.
I was told that I would be making more in compensation than the Chairman of Radiology at UPMC. I have this in writing on email from Dr. Melhem. I discovered later that he makes over $750.000. While I did not expect to make in excess of the VA imposed cap on salaries, I believe that it is discriminatory and fraudulent that I was deliberately lied to,.
I was promised that I would be the radiology expert for the VISN because the current chair of the Radiology committee is an internist and has "no knowledge " of radiology issues - which accounts for the profligate spending of money at VAPHS.
2. Abusive and disrespectful language and behavior:
Employees/subordinates have used abusive language against me – both directly as well as in staff meetings. When I approached Dr. Jain and asked for assistance on multiple occasions, I was denied any relief.
3. Refusal to grant supervisory privileges and access to computers. When I was detailed to Butler VAMC, Dr. Jain left instructions that I was to read 5 studies per day. However, he refused to allow me to have privileges to access the computer. This was done in a deliberate attempt so that he could accuse me later of not following orders.
Once I had returned to VAPHS in August, It took several weeks before I was granted access to supervisory menus on VISTA. This was done deliberately and not granted despite several requests. This was yet another attempt to entrap me.
4. Professional and academic oppression:
After being appointed professor at University of Pittsburgh, in March 09, I was invited to lecture to the BioMed engineering students at UPitt. Dr. Melhem who has used this venue for giving lectures several times in her own career, refused to give me permission to lecture. She put several roadblocks in the way including demanding that I get an official letter on letterhead from the University. This was an acute embarrassment to me.
Dr. Gupta who is one of the staff radiologists received permission to take off for two weeks in August 09 to “study” MRI at University of Pittsburgh Medical Center. Although I was the Chief of Radiology and was back at the VA at the time, I was not notified of her absence. She purportedly went for a course. When I inquired, I found that this was not a formal course, no continuing education credits were attached to it.
By contrast, I had secured permission to attend the Radiological Society of North America annual course in November 09. Dr. Jain had given me permission and I registered for the course and paid for the hotel reservations ahead of time. At the last minute, he withdrew his permission and Ms. Wolf refused to let me go. I had to take leave and pay for the entire course personally.
By placing me on administrative leave for more than 8 months, the VAPHS has significantly affected my professional future. I have not practiced any radiology except from the computer and from textbooks.

5. Inadequate preparation for supervisory role.
• I was given every assurance that I would be given the tools to do the job.
• The COTR training was promised in July 09 but not provided.
• When I joined the VA Pittsburgh as the chief of Radiology, I was given no preparatory courses. No training in the VA’s supervisory modules was provided. In December 08, I met with Dr. Jain and asked if he would let me go for one of the courses where the material was presented in the form of lectures. He was silent about this and waited until the time for registration was over – so that I could not go.
• When the chiefs of Radiology across the VA were gathering for their annual meeting in May 09, I was not allowed to go. A very junior radiologist was sent in stead. After much protesting, I succeeded in getting permission to attend the meeting.
• There is a two-week leadership seminar provided in Shepherdstown for new supervisors. After booking me for the two weeks, the VAPHS withdrew the booking for the first week claiming that they would rebook me for a later date. This should have been done almost immediately. They failed to do this. It is my contention that they planned to kill my career from the very outset even though they had canceled the first ABI and re-instated me.
• I brought this to the notice of VACO – to no avail.
6. No Authority to perform my job: I was NEVER given any actual authority to perform my job as the Chief of Radiology, or support from higher management.
• To evaluate any of the personnel employed in the department,
• To implement any tour of duty memoranda for the physicians in the department
• To supervise the timekeeper who was falsely documenting the time that physicians came to work
• To insist that the equipment vendors correct problematic issues with the department.
• To correct or optimize the millions of dollars of equipment that had been purchased by the VAPHS. Any suggestions that I made were canceled or disregarded by Dr. Melhem and the Radiology Hi-Tech equipment at the VISN level.
7. Inadequate office and administrative support:
• I have spoken with other Service Chiefs - specifically Dr. Wilson. He told me that he was hired to improve the department of Surgery. He was given every tool that he needed to build a world-class department. I was given no such support.
• While he and other Service chiefs were provided Business Managers, I was given a poorly trained and poorly performing Administrative officer. I had a GS-5 administrative assistant who had to be shared with the rest of the radiology staff where all other service chiefs were provided at least more than one administrative assistant.
8. Action taken before conclusions of the ABI:
• Even before the ABI was concluded, Dr. Jain announced in the Executive leadership counsel that he was looking for my replacement. This occurred in early October 09 and was reported to me in writing by one of the attendees. It has been abundantly clear that this has always been a witch-hunt. The ABIs were given direction that they were to find a basis to terminate me.
• The administration at the direction of Ms.Wolf downloaded my hard-drive to look for incriminating evidence while all the while coming to the table for an ADR.
• There was a thorough and exhaustive search was made of my phone records wherein every phone number was traced to the party I called.
9. Summary judgment before investigations (SRB) was concluded.
The VAPHS posted the job for Imaging Service Line Chief even before the SRB published their recommendations as can be seen by the job number. This again demonstrates that the VAPHS never intended to give me a chance to succeed at my job despite the ADR.
10. No VP designation after appointing me as Service Line Chief
The Clinical Service Line Chiefs are designated as Vice-Presidents. This was not provided to me.
11. No provision of supervisory access to Administrative Computer systems
After I returned to work at VAPHS, I was not given access to the supervisory menus on the Computers despite repeated requests to Dr. Jain. Nothing had improved; as a matter of fact it had gotten worse.
12. No pay increase even after changing my job title.
When I was returned to my position in June of 09 as Imaging Line Service Chief, I was not given the commensurate increase in pay of ≈ $50,000 per annum. However, when this position was advertised, the notice in USAJOBS posted the pay for a Service Line Chief as being $50,000 higher than a Program Leader,
13. No evaluation, No pay increase based on performance
I had to define the elements of my own position since Dr. Melhem had no idea of what these might be. Despite the fact that I had identified severe issues of fraud and abuse, and provided methods for correction etc, no performance pay increase was given to me. This appears to be a tactic that has been used by the VAPHS administration in the past.
Dr. Melhem wrote to the Radiology community in Feb/Mar 09 and asked if anyone had a narrative of the job for a Chief of Radiology. Of course, she excluded me from the universal email to the Radiology Chiefs. Paradoxically she gave me a glowing appraisal on March 6th, 09. Not surprisingly, when I asked for a copy of the document, nobody seemed to be able to find it. Finally in March 2010, when the VAPHS sent me my personnel and personal papers out of the Department secretary’s office, it was there with Dr. Melhem’s signature.
In summary
i. I was not given the tools to affect change,
ii. I was actively subverted in affecting the change
and then
iii. I was accused of attempting to make any changes with the limited resources I had.

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Dr. Chacko's Timeline Part 1
Post by Vijay Mehta on Today at 11:50am

Part III. SYNOPSIS OF EVENTS/TIMELINES:
A synopsis of the events that transpired at the VAPHS follows:
1. In and around October/November 07, Dr. Melhem, the Assistant Chief of Staff at the VAPHS actively recruited me for the position of Chief of Radiology at the VAPHS. She claimed that there was a leadership vacuum at the hospital in the department of Radiology. This had resulted (according to her) in major decisions being left to be made by her (a Pathologist) and the Administrative Officer (a Nutritionist). She said that she wanted me to come in and take a look at the inefficiencies in the department, the fraudulent use of duty hours by radiologists and waste of government resources. She said that she wanted me to provide her with “snapshot” and come up with a plan for correcting these issues.
2. In and around May 08: After much discussion and debate, I signed the contract to join the VA as their chief of Radiology. I also spoke with General Peake who was then secretary of the VA. General Peake had been the Army Surgeon General when I was serving – during my last tour of duty. I believed that there was a mission to be accomplished in “cleaning up the department and realizing its fullest potential”.
3. In July 08: I was approached by one of the radiologists (Dr. Robin Prasad) who cautioned me that Dr. Melhem, the Director – Michael Moreland, and Dr. Jain (Chief of Staff) ran a highly dysfunctional hospital. He said that there had been a Congressional investigation of Mr. Moreland Dr. Melhem and Dr. Jain in their harassment of two VA doctors (Victor Yu and Janet Stout) and findings of perjury, harassment and intimidation by the committee.
4. In August 08: I raised questions about this with Dr. Melhem only to be told that it was all false and that she was not at liberty to discuss them. Subsequently I found out that Dr. Melhem had not told me the truth and I had no means of verifying the veracity of her statements.
5. At about the same time: The entire staff of the radiology department took me to dinner and articulated all their problems with Dr. Melhem and Dr. Jain. They said that they had approached Dr. Jain several times regarding these issues only to be verbally threatened and harassed by Dr. Melhem. They also said that prior to my arriving at the VA, four separate chiefs of radiology had stepped down or relieved by dr. Melhem.
6. In September 08 to January 09: I started working for the VAPHS in September 08 as the Program leader for the Radiology program with Dr. Melhem as my supervisor. I was directed to look into all the critical issues in radiology. In my survey, I found several issues including the following;
a. Fraudulent use of leave and
b. Unauthorized use of comp time by the doctors,
c. A very poorly structured peer review program,
d. Arbitrary hiring practices,
e. Inequitable and secret compensation schemes where certain favorites were paid more than others,
f. Possible illegal hiring practices on individuals requiring visa waivers,
g. Purchase of millions of dollars worth of equipment which had not been optimized for use Despite the advice of subject matter experts unnecessary equipment purchase was planned and executed – SPECT Scanner without CT, Low field strength MRI unit which is barely ever utilized, High field Strength MR. unit without adequate safety planning, more linear accelerators than were necessary.
h. Equipment which was inadequately resourced causing problems with patient care (e.g. no UPS on major equipment, no calibration on CT scanners)
7. In the third week of January of 09, I asked Dr. Melhem for a recommendation letter since I had applied for an academic position at the University. She gave me a glowing recommendation.
8. In the first week of February 09: I found that Dr. Melhem was ordering x-rays on an individual ineligible for care at the VA. I spoke to Dr. Jain about this and he told me to “kill it – sweep it under the rug”. At no time did he tell me that this was legal and had been authorized by the VAMC, although he later claimed, as did Ms. Wolf that this was legal. I called former secretary of the VA Dr. Peake and asked him for advice – he suggested I put it in writing and hand it to Dr. Jain.
9. In mid-February 09: Dr. Jain told me that an Administrative Board of Investigation would be convened. What he neglected to tell me was that the ABI was to be convened against me. I went unprepared for the meeting.
The Board refused to accept any additional information and evidence I attempted to provide them,
10. In mid February 09: I also found that Dr. Melhem had violated Nuclear Regulatory Commission guidelines by countermanding our prescription for radioactive materials and replacing them with “2nd string” radiopharma--ceuticals which produced poor images and increased by 3 to 8 times the radiation burden to veteran patients. She had put in place radiopharmaceutical contracts with vendors with no input from the authorized users of radioactive materials. When I complained in writing about this to the VAIG no action was taken to insure that such an event would not occur again.
11. In mid- late February 09: I found that one of the doctors (Dr. Vidhi Gupta) was consistently providing poor care to our patients – with larger number of complications than her peers. I brought this to Dr. Jain’s notice – he told me he would take care of this and that I was not to interfere or investigate this.
12. In early February 09, I apprised Dr. Jain of the fact perusal of the workload and attendance data, some of the doctors notably Dr. Kanderi never fulfilled her time obligations. He told me not to interfere with this since this was Dr. Melhem’s area of concern.
13. In early May 09:
a. Dr. Jain received the recommendation of the ABI and called me for an interview to inform me that I would be terminated based on the recommendation of a Summary Review Board. I was then escorted off the premises with a police escort and told not to return except for medical care at which time I would have to notify them in advance so that they could have me under police surveillance.
b. At this time Dr. Jain gave me a copy of my SF-50 detailing the probationary nature of my employment. This was the first time I had heard of this. He informed me that I was JUST a probationary employee and could be summarily fired. I had never seen this document prior to this. Apparently this should have been in my recruitment package.
c. I also found out that some of the other doctors (for- e.g. Dr. Shah) who had been hired at the same time did not receive their SF-50. Dr.Gupta received her SFG-50 - she had been hired a few days before I was.
14. In mid May 09: Ms Wolf sent for me and said that she was canceling the board and its findings because she was convinced that it was done illegally and that I had been treated unfairly. She also told me that at no time was I to blame and that she knew that Dr. Melhem was to blame and that she would discuss this with me at a later date because it was a long story.
15. In late May 09 and June 09: I was detailed to Butler VAMC until things “had settled down”. During this time she would get an executive coach from the National Center for Organizational Development to assess the situation and help in team building. The coach and her team turned up. They managed to alienate my entire team of technologists who refused to meet with them. I secured Ms. Wolf’s permission to dispense with using the NCOD team to interface with my department while retaining their offices to help me with my issues if any. I understand from outside sources, that Ms. Wolf retained the NCOD to “dig up dirt” on me.
16. In July 09: I was sent for some of the many courses I should have taken as a new supervisor in September 08 but were denied to me by Dr. Melhem.
The radiologists at the VAPHS allegedly met with Mr. Michael Moreland and secured an understanding from him that I would be removed from my position within 90 days. Dr. Prasad reported this to me when I returned to work at the VAPHS

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Dr. Chacko's Timeline Part 2
Post by Vijay Mehta on Today at 11:50am

17. In August 09: I started back at VAPHS now as the Service chief. Dr Melhem was removed as the supervisor of Radiology. I was asked to look into administrative issues in Radiology and to surface them with Dr. Jain. I brought the many issues I found in radiology to Dr. Jain, who said that he would help me attend to these. Dr. Jain set up frequent meetings with me 8/3, 8/10. 8/21. 8/24. 8/28 and 9/3. At no time did Dr. Jain discuss that there was a problem with my management style. He never informed me that there were any complaints. He specifically gave me directions to start setting up the procedures for mammography
18. In September 09:
a. I had filed an EEO complaint against Dr. Jain in May. This came for ADR on September 1st 09. It was agreed upon verbally that Dr. Jain would support me in implementing solutions to problematic issues in the hospital. He would let me know if things were going wrong and suggest course-corrections.
b. On September 2nd, a blogger (Michael Volpe) called me at my office and told me that he would be writing up slanderous and very injurious articles about me on the Internet. Since I did not know Mr. Volpe personally, I asked him what his sources of information would be. He claimed and subsequently has stated on his blog that his sources of information would be the VA.
c. On September 3rd, Dr. Jain and Ms Wolf called me in to tell me that there had been several complaints about me and they would be issuing a letter informing me of forthcoming disciplinary action. She then said that she had not investigated this. She told me that her source was complaints from the blogger. She assured me not to worry and that this letter was not a serious one – it was designed to get my attention. When I asked her why I had not been told that there was an issue, she said that she was telling me now.
d. In mid September: Dr. Jain asked me to perform a focused peer review on several cases read by one of my staff – Dr. Shah. These had been turned in by an anonymous source. I discovered on logging into the system that Dr. Gupta lodged these complaints. She had made several critical errors in reading and in patient care. This was used as a red herring to cloud the issue of her problematic and subpar performance. I had brought this to Dr. Jain’s attention at the time of her evaluation and was directed to give her a good evaluation. I refused and said that at best I would give “damn her with faint praise”.
e. On the 29th of September 09, Ms. Wolf came to my office to tell me that she was on my team to give me a hug and that I should not worry about anything. She said things were proceeding very smoothly
19. On October 2nd: Dr. Jain called me in off leave to tell me that I was the subject of yet another Administrative Board of Investigation. This was convened in the 2nd week of October. It was clear from the Board chairman Mr. Goldman (VA chiropractor) was that they had spent an inordinate amount of time downloading my hard drive indicating that they had started this process prior to any rapprochement they had initiated. This clearly indicates that they had never any intention of supporting me in my initiatives to “clean up” the department – they were waiting for an opportune moment to lower the boom again!!
20. In December 09:
a. I was notified that the ABI had recommended that I be separated from the VA. When they provided me with the depositions that they had considered, it was clear that they had NOT heeded the recommendations of several of the key personnel including the Chief Technologist Hallie Montgomery.
b. I was then summoned before a Summary Review Board (SRB) , which has recently concluded that I be removed. This was to have occurred on January 25th, 2010.
c. The SRB conceded that the issues I had raised were legitimate but they I had not corrected them. There is no mention made of the fact that I was directed not to take any corrective actions. During the period that I was placed on Administrative leave May – August 09 Dr. Jain had ample opportunity to take corrective actions himself which he did not do.
d. Furthermore, the attempts I took to implement corrective solutions were deemed as harassment and I have been punished severely for this.
21. In January ’10:
a. The Detroit Office of Special Counsel transferred my files to the Detroit Office. Mr. Eric Calhoun from the Detroit Office is now handling the matter. They were successful in getting a stay for 60 days from the VA. He tells me that he is requesting records, phone logs and emails from the VA to look at this investigation.
b. I had sent an email to COL Jonathan Jaffin of the Army Medical Department asking if there was a position I could take in Afghanistan for the Army particularly since I knew the culture and was fluent in Urdu, the language spoken in Pakistan. He responded saying that he would send the letter to his executive Office, the chief of Consultants and the Radiology consultant, COL Breitwieser. Dr. Sri Kottapally of VAPHS called to tell me on Friday 29 January 2010 that a copy of my email had appeared on the blogger blogsite with the usual vicious narrative.
c. I called COL Jaffin and found out that he had no idea of who might have sent this to the blogger. He said he would be handing this to the Med COM JAG and to head of Medical Corps with a copy to LTG Schumacher for further investigation. He read the blog and was very distressed at the contents of the blog. But more importantly, he was concerned that an internal AMEDD document was sent to a blogger.
d. I called the FBI, Agent Deborah Mitchell, (412-432-4722) at the Pittsburgh Office and notified her of my concerns regarding the blogger and his use of the Internet to terrorize and intimidate. I also told her that the Chicago Office had indicated that this fell in the realm of RICO and needed to be followed up – but by the field office where I resided rather than where the blogger resided.
22. In March 09
I was informed that I would be separated from the VA on the 25th of January. The Office of Special counsel had taken over the retaliation and reprisal portion of my complaint and is currently investigating it. They secured a stay for 60 days and I was terminated on the 26th of March 2010.

Here is the full dossier of Dr. Anna Chacko.