U.S. Rep. Bennie Thompson recently toured the hospital after receiving what he described as many complaints from veterans, saying most veterans in primary care are being treated by nurse practitioners instead of doctors.
"Veterans believe the quality of care has suffered," Thompson said. "There's been an overreliance on nurse practitioners."
On June 14, at Kirchner's request, Dr. James Lockyer, associate chief of staff for patient care services, asked VA primary care physicians to sign stacks of requests from nurse practitioners to prescribe narcotics, according to the documents.
Some doctors refused, saying it would be illegal to prescribe narcotics to patients they had never seen.
After doctors refused, according to the documents, Kirchner turned to residents and fellows from the University of Mississippi Medical Center to sign stacks of requests from nurse practitioners to prescribe narcotics.
The UMC doctors questioned why.
Documents show VA physicians also have been asked to sign home health certification forms for nurse practitioners' patients for the same reason. That form requires a doctor to certify that patient is under his or her care.
Some doctors balked at this request, telling administrators that signing would constitute Medicare fraud.One doctor told agents VA administrators would not go to a medical practice that ran like Jackson VA's primary care, saying, "There is no continuity, no sanity, no communication - only ugly, dangerous chaos."