Funny Sorts of Ombudsmen at the CDC

We have previously posted (most recently here) about allegations of mismanagement at the US Centers for Disease Control and Prevention (CDC).

The Atlanta Journal Constitution just reported an unusual exchange between Dr Julie Geberding, the head of the CDC, and US Senator Charles Grassley, the senior Republican on the US Senate Finance Committee. It seems that Senator Grassley requested a briefing from the newly hired CDC ombudsmen, but Dr Geberding refused the request.

In a March 5 letter to Grassley, Geberding said the two contract employees the CDC has hired to serve as interim ombudsmen believe that briefing the senator would violate standards of practice for ombudsmen and render them unable to continue to do their jobs effectively.

'While I am respectful of your desire to get further information, I am also sensitive to these principles — especially because CDC's Ombudsman Office is in a critical stage of development,' Gerberding wrote.

The big problem with that argument is that the ombudsmen already had agreed to brief Geberding.

Grassley's letter questions the validity of the ombudsmen's reasoning, stating that he is neither the subject of the ombudsmen's inquiries 'nor a potential cause of employee angst at CDC.' He notes that the ombudsmen have met and briefed Gerberding. Many employees blame Gerberding and her leadership for problems at the agency.

'Dr. Gerberding, am I missing something here?' Grassley asked in his letter. 'Why would two individuals claim preserving their objectivity as Ombudsmen requires refusing to brief Congress, but allows meeting with you to discuss their findings?' Grassley wrote, adding that he's not surprised that few CDC employees have 'felt comfortable approaching these two men to seek their help on their problems with CDC management.'

In my humble opinion, it's a funny sort of ombudsman who reports to the leader of his or her government agency, but cannot report to Congressional oversight. I would imagine any half-way rational CDC employee would be very hesitant to say anything to the ombudsmen that might be the slightest bit offensive to the leadership of the CDC.

Thus, the CDC still appears to be an agency whose leadership does not easily tolerate criticism. Given the scientific basis of the agency, this would appear to be yet another example of mission-hostile management, US government agency style.

But it seems that in many kinds of health care organizations, not just in the US, not just government agencies, the worst sin is to criticize the management. Given the ineptness, and worse of the management of many health care organizations (some of which has been featured on Health Care Renewal), is it any wonder that health care is in a mess?