New VA Secretary Robert McDonald Vows to Reform Healthcare Delivery

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By Sandra Basu

WASHINGTON – Robert McDonald, the former Procter & Gamble president and CEO, was ushered in as the new Secretary of Veterans Affairs last month with unanimous confirmation by the U.S. Senate and hopeful optimism from advocacy groups and others.

“I applaud the overwhelming, bipartisan confirmation of Bob McDonald as our next secretary of Veterans Affairs. As a veteran himself and a proud member of a military family, Bob is deeply committed to serving our veterans and their families,” President Barack Obama said in a statement after McDonald was confirmed.

Robert McDonald, the former Procter & Gamble president and CEO, at the Senate hearing on his nomination as Secretary of Veterans Affairs last month. He was unanimously confirmed a week later. VA photo

Veterans’ service organizations also said they were looking forward to working with McDonald as the new secretary works to reform VA.

“The American Legion is confident that Robert McDonald will apply his experience leading big, complex business operations to the Department of Veterans Affairs, a complex operation that desperately needs a systemwide overhaul right now,” American Legion National Commander Daniel M. Dellinger said in a statement.

Meanwhile, in a written missive to VA employees McDonald said that he recognized “that the last few months have been difficult—and the days ahead will not be easy.” 

“In fact, many tasks that we must accomplish will be difficult, but I assure you that I will be with you each step of the way.  I want to hear your ideas for improving the department, and I will not tolerate those who stifle initiative, seek to punish people who raise legitimate concerns or report problems, or lack integrity in word or deed.  Trust is essential in everything we do,” he added..

McDonald is a West Point graduate and served as an Airborne Ranger Infantry Officer in the 82nd Airborne Division prior to a 33-year career at Procter and Gamble. He was nominated by Obama for the VA secretary job in late June.

He replaces Eric Shinseki, who resigned after information came to light that VA care had been delayed for thousands of veterans who had been put on hidden waiting lists as well as allegations that VA administrators had covered up the practice so that it appeared they were meeting goals necessary to receive bonuses.

Despite the challenges that lay ahead in leading the VA, McDonald said at a Senate Veterans Affairs Committee hearing in July to consider his nomination that he “desperately” wanted the job because he thought he could “make a difference.”

“I think there is no higher calling, and I think this is an opportunity for me to make a difference in the lives of the veterans who I care so deeply about,” he told lawmakers.

He told them that caring for veterans was “personal” for him.

“I come from and care deeply for military families. My father served in the Army Air Corps after World War II. My wife’s father was shot down over Europe and survived harsh treatment as a POW. Her uncle was exposed to Agent Orange in Vietnam and still receives care from VA. My nephew is right now in the Air Force, deployed in the Middle East,” he explained.

McDonald vowed to lawmakers that, if confirmed, he would “take a series of immediate actions over the first 90 days to deliver the needed reforms our veterans deserve.” He also said he planned to travel extensively over the first several months “to hear directly from employees, veterans, and other stakeholders.”

McDonald told lawmakers he planned to establish a board of physicians to advise him on best practices for delivering timely, quality healthcare. The advisory board would include the “very best medical talent in the world,” and that would include medical professionals in both the civilian sector and the VA, he said.

It was clear during his confirmation hearing that lawmakers were impressed with him. Sen. Johnny Isakson (R-GA), a frequent critic of VA care delivery, told McDonald that he is the “right man for the job” who would do “a great job.”

Sen. Richard Blumenthal (D-CT) told McDonald that he believed legislators and others were all “rooting” for him.

“I believe that you have a unique and historic opportunity to get done a job that all of our nation’s heroes will be grateful to you for doing,” Blumenthal said.

            McDonald’s confirmation came the same week that Congress passed a $16.3 billion dollar piece of legislation to reform VA. The bills provisions include:

  • $10 billion to contract out health care for veterans who cannot get an appointment within 30 days or who live more than 40 miles away from a VA facility.
  •  $5 billion for the VA to recruit more doctors and other clinicians
  • $1.3 billion for VA to enter into leases at 27 medical facilities.
  • Authority given to the secretary to fire senior executives based on poor job performance, while providing a 21-day period for due-process and appeals.

 

Comments (1)

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  1. John Corbelli, MD says:

    Dr. McDonald,

    I, like you, have spent the majority of my career in the private sector, ie. 27 years in private cardiology practice and now two years practicing cardiology in the VA.

    In short:
    1. The VA is a good place. I am pleased and proud to be here. My only motivations here are to repond to your repeated invitations for input, coupled with the sincere desire to contribute to improving medical care in the VA.
    2. I would invite you to visit the Buffalo VA Medical Center to discuss our ideas on improving care and patient access. We can and must always do better but change is really slow.
    3.The standard of care in the private sector in western New York, as in many areas of the country, is a “heart and vascular center” and there is interest in developing such a center for the VA at this end of our VISN.
    4. We have apparantly been approved for a cardiac cath lab upgrade plus a new additional EP/cath lab but the process has been mired (? in the NAC)for over two years with no clear timeline. Plus, the plan could be better. Effective progress on this initiative would be good. We would be able to provide more timely and comprehensive arrythmia care within VISN 2 with a lab for EP and moving from contracted part-time to a full time electrophysiologist.

    Some longer term re-engineering considerations:
    1. Adapting private practice business models for optimizing provider availability to see patients and improve work flow, eg. more support staff for scheduling, phone calls, etc.
    2. Improve IT support,eg. there have been problems with programs very basic programs that just fail to be fixed, eg. for retrieving ECGs and obtaining consents.
    3. Improve computer hardware and software to improve work flow. I still see DOS!
    4. Eliminate redundancies in documentation, eg. a discharge order + a discharge note + a discharge summary all with a signifcant amount of overlapping information.
    5. Develop a salary structure that is competitive with the private sector for physicians, nurses, extenders, etc.for recruitment and retention.
    6. Eliminate layers of government bureaucracy and develop a “can do” culture.
    7. Reduce barriers to clinical research.
    8. Break down stifling contracting rules that might protect the air force from buing a $2500 toilet seat but hurt progress in a hospital system.

    PS.
    Nice math question but my dog is able to count to three – kind of!

    Respectfully submitted,
    John Corbelli, MD

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