David Shulkin, MD, Confirmed as New VA Under Secretary for of Health

By Sandra Basu

WASHINGTON — The VA is set to welcome a new leader to the Veterans Health Administration. David Shulkin, MD, became the new VA undersecretary of health after the Senate confirmed his nomination by voice vote late last month.

In his new position, Shulkin will oversee the largest integrated healthcare system in the United States with more than 1,700 sites. Carolyn Clancy, MD, has been serving as interim under secretary for health since last July.

During a hearing on his nomination in May held by the Senate Committee on Veterans’ Afffairs, Shulkin pledged to work with lawmakers “to restore trust and pride in our VA healthcare system.”

“I recognize the gravity of the mission before us,” he told the Senate Committee on Veterans’ Affairs during his nomination hearing.

At that same hearing, lawmakers sought to know why he would want the position, given the controversies that have embroiled VA.

David J. Shulkin, MD, right, as nominee to be the VA’s Under Secretary for Health, testified before the Senate Committee on Veterans’ Affairs this spring. VA Photo by Robert Turtil

David J. Shulkin, MD, right, as nominee to be the VA’s Under Secretary for Health, testified before the Senate Committee on Veterans’ Affairs this spring. VA Photo by Robert Turtil

“A lot of the members of the VA, particularly over the last couple of years, have come here and sat before this committee and have been hammered with bad press and things like that,” Sen. Dan Sullivan (R-AK) noted.

Shulkin responded that he believed it is his “duty” to “serve those who have served our country and secondly because I believe I can help them.”

The past president and CEO of Beth Israel Medical Center in New York, Shulkin served most recently as president of Morristown Medical Center, a tertiary care hospital in northern New Jersey that is part of the Atlantic Health System. He also previously held leadership roles as the chief medical officer of the University of Pennsylvania Health System, the Hospital of the University of Pennsylvania, Temple University Hospital and the Medical College of Pennsylvania Hospital.

Trained as an internal medicine physician and a researcher in health policy and the assessment of clinical outcomes, he also has experience with the VA. During medical school and in his residency training Shulkin said he did stints at the Philadelphia VAMC, the West Haven, CT, VAMC and the Pittsburgh VAMC.

“Given that experience and continued engagements with VA during the course of my career, it was difficult for me to have watched from the sidelines last year as the failings of the system came to light,” he told lawmakers during his nomination hearing.

Asked if he was prepared to take over a system as large as the VA after coming from a medical center with only 658 beds, he responded, “It is a massive system … I can’t tell you that I have ever taken on a challenge like this, but I do believe that the principles of leadership are transferrable.”

When asked what his priorities would be, he cited addressing the access problem as among them.

Sen. Thom Tillis (R-NC) wanted to know if he had a plan to do that.

“Absolutely, this is what I have been doing throughout my career. This is operations,” Shulkin answered. “This is being able to expand capacity, being able to use weekend and evening hours … We have 11% no-shows in the VA, and I know how to deal with those issues. I think we can continue to make progress.”

As for recruitment and retention of clinical staff, he spoke of the value of loan repayment, competitive pay and recruitment bonuses.

“You have to have an environment that people want to come to work,” he said. “VA is blessed by training 70% of all doctors … If they see that the environment is one that puts the patients first and cares about the people who work there, they are going to want to stay there.”

Delay in ApprovalThe hearing for his nomination was held nearly a year after former VA Under Secretary for Health Robert Petzel, MD, resigned from the position amid the discovery of access delays at VA facilities last year.

After the Senate Committee on Veterans’ Affairs approved his nomination, Shulkin’s confirmation process met a brief snag after three U.S. senators put a hold on the required Senate vote. The hold on the legislative body’s full confirmation vote, as allowed by Senate rules, was put into place by U.S. Sens. Sherrod Brown (D-OH), Jeff Merkley (D-OR) and Ron Wyden (D-OR).

They explained the hold would not be lifted until the VA released a final decision on extending benefits to qualifying reservists who served on Fairchild UC-123 Provider (C-123) aircraft and might have been affected by Agent Orange. The issue of whether the veterans could have been exposed to Agent Orange has been controversial, with VA denying them compensatory coverage in the past.

“These veterans have waited too long to receive the healthcare and disability benefits they deserve,” Brown said in a statement announcing the hold on the vote. “Dr. Shulkin is extremely qualified, but we can’t move forward to confirm an under secretary for health at the VA until this pressing veterans’ health issue is addressed.”

On June 18, however, the VA published a new regulation that expanded eligibility for some benefits for the veterans in question, which resulted in the hold being lifted.

“Opening up eligibility for this deserving group of Air Force veterans and reservists is the right thing to do,” VA Secretary Robert A. McDonald said in a written statement. “We thank the IOM [Institute of Medicine] for its thorough review that provided the supporting evidence needed to ensure we can now fully compensate any former crew member who develops an Agent Orange-related disability.”

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In addition to Shulkin’s confirmation, LaVerne H. Council’s nomination to serve as VA assistant secretary for information and technology was approved by the Senate last month.

In the past, Council has served as a Johnson & Johnson vice president and CIO and has held executive positions at Dell.

At a hearing on her nomination in May, lawmakers wanted to know how she would address the issues of interoperability of the EHR between the VA and DoD.

Council suggested the best way forward would be to address the interoperability of the data, rather than interoperability of the two different systems.

“If confirmed, I will spend time with the team to lay that out. It would be a part of the roadmap that we would put in place,” she said.

Sen. Richard Blumenthal (D-Conn) asked that Council provide the committee with a timetable and specifics about how she will address the issue.

“We’ve heard a lot about plans, blueprints and roadmaps, and the problem as you observed continues to this day,” Blumenthal noted.

Council assured him the committee would have “a roadmap,” adding, “One of the reasons I think I was called for the job was because of my reputation of being able to do what I said I will do.”

Comments (8)

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  1. James Swanstrom, US Navy Veteran says:

    I am ecstatic to learn of the new Under Secretary appointment by President Trump. Things can only get better for the VA. It has fallen into terrible disarray and the management of it has allowed that to happen.

    I pray that Mr. Shulkin will be given the support needed so that he can repair the decayed Veterans Administration! I also hope that he will gut the entire management system of the VA and replace 50% of that mgmt with DOCTORS AND NURSES!!!

    Get rid of the foolish and overburdensome weight caused by the middle management that is unnecessary and useless! Get rid of the programs within the VA that are intended to make it look productive but detract from it’s ability to BE productive.

    Look strongly at the homeless Veterans and work hard to help them. I realize you cannot make them live in houses but many of them want to and cannot afford to. That is in large part due to alcohol and drug use as well as having fallen into financial hardship. I pray you will work hard to find ways to help them correct their situations!

    Myself, I am a 100% disabled Vet that got so angry and fedup with the VA system that I petitioned my State Rep. to help me and he did, quickly, efficiently, he found a way to transition me to the state medical aid. I immediately jumped ship to that system and am currently in an efficient and affective Pain Management system where the doctors LISTEN to me, vs deny my need for help and medications for pain!

    I was proud that day I walked in and volunteered to go to Nam. I wasn’t happy that I missed the cutoff and I waited to join the Navy a few years later. It was the best experience I could have asked for as a young male. It helped me transition out of my families house into to real world. I learned a skill that I moved forward with into life, and am proud to have learned and utilized.

    We have a great and wonderful country that is on the cusp of failing…between President Trump’s desire to fix it and a society that needs to hear his motivations, please, repair the gaping holes in our Government and infrastructure! We need to go to work NOW and fix a system that if ignored, will collapse. Not maybe, not if. It WILL!

    God bless America and you,

    James R. Swanstrom
    25894 County Road 3
    Merrifield, MN 56465

  2. Robert A Buono says:

    Glad to see that the C-123 crews got recognition for presumption to agent orange but what about the 90,000 or so Vietnam Vets that make up the Blue Water Navy Vietnam Vets and those that served in Laos Cambodia and Guam? There is definitive proof that these Vets were exposed yet the VA still has denied their presumption. Now that he is tapped to head the Veterans Affairs by Mr Trump, are they going to put the pressure on the VAA to extend the presumption to those Vets also? This had been brewing for more than 10 years! Another 10 years and they will all be dead! It is ludicrous, if not criminal!

  3. Karen says:

    Hate to say it but I hear that the government. Is denying the agent orange for as long as they can hoping that the vets will die off so they don’t have to pay. With all the barrels they dug up on Okinawa they still say no agent orange. Like we are stupid or something. Its crazy that they made these young boys leave their family’s and go off to fight for nothing and then deny them of benefits as they slowly die off in the sun set.My husband is one of them and it makes me sick how government. Has passed him over like he doesn’t matter. He sure mattered when he was young and they needed him but now its he was used and forgotten.. I will say we are happy with the Va care he gets and thank god for that but the agent orange is slowly. Killing him and its not fare that he has to suffer the consequences and hear government deny what the eyes can still see.

  4. Robert McKee says:

    Because my income and social security was below the threshold i got my va visits and meds exempt of copay. we got 3% cola increase also an increase in medicare part a&b payments, my social security check did not change one penny, but now i am not exempt any longer and the copays are too much for me, I need blood pressure and back pain meds everyday, now I am not taking any meds at all and living on $1081.00 a month my sole income. Why isn’t the threshold based on net income and not gross income?

  5. Kenneth C. Tennant says:

    I pray for his leadership to correct the VA system of deception, delays and denials. PLEASE see Gary Null’s documentary: AMERICAN VETERAN: Discarded and Forgotten. Military VACCINES were a major factor in “Gulf War Syndrome.” Studies have proved that 4 of 5 vets, like me, with FM, CFS, etc. were: Army National Guard, Trained as Combat Medics and did NOT deploy. The VA in IOWA told me I would “DIE” before they awarded my claim. For complaining, they sent AGENTS to “ARREST” me on a trumped up charge. My children were terrorized and wife was vomiting in distress. We still have nightmares over this and the retaliation that continues in IOWA. Search: Kenneth Tennant, USA vs Veterans and the First Amendment. The VA made some corrections (100% S-C rating) but kept all of the COLA increases and the other benefits like Veteran-Disabled Life Ins. My claim has been languishing for years and is now back at CAV-C (16-0346). It has been HELL In IOWA. see VACCINES REVEALED and Emperor of Hemp. What is wrong with the US for their corrupt stance against marijuana while they push poison pills and TOXIC VACCINES into our babies, Troops and elderly ? see: BOUGHT and VAXXED: From Catastrophe To Cover-Up. America’s trojan horse are the Prescription Medications / Vaccines pushers / corporations and the CONgressmen who take campaign CONtributions from them. – Kenneth Tennant, Communist IOWA, [email protected],com

  6. Linda Harrelson says:

    If we veterans are to truly get a fair deal,how about holding staff as accountable for cursing patients,lying to and about,doctors discriminating and both prejudicial and bigoted attitudes. Patient who have been misdiagnosed and staff refuses to apologize doctors who are plain narcissistic in their action coercing pts into contracts or no care,then lying. Once assigned a veteran is stuck for one year with this same Dr who forced the veteran to sign or get ZERO treatment,yet they terminate everything and refuse to listen.
    Veterans had a building where outpt. VETS could interact NOW it’s ALL about the staff having convenience but crap on the veterans. Sometimes,just having interaction with other veterans,does more for another veteran because we understand. Everything we had has been preempted for staff. Sorry,this guy showed nothing under Obama,why believe until he proves himself and his words to be real. MORE FOR THE VETERANS,LESS FOR STAFF. THE LAZY,USERS NEED TO BE TERMINATED ON THE SPOT.

  7. Marilyn Barefoot says:

    My husband served on Okinawa from September l970 to February l972. He was stationed at Machinato Service area on Okinawa.
    This was a very contaminated area. I know that he was exposed to
    many toxic substances including agent orange. He now suffers from Parkinson’s Disease. We filed for benefits over a year ago.
    and to date we have not had a response to his NOD. How long does
    he have to wait. He does not have the 6 years to wait for an
    appeal. FOIA documents confirm the toxic substances he was exposed to yet we are still being denied. I hope the new administration will help.

  8. James S Head says:

    VA policy on opoids is be hurting veterans that needs the pain medication for service related injuries. The VA Hospital doctors are refusing to prescribe the needed pain medication for the veterans

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