Shulkin Sails Through Senate on Promise of VA Changes

by U.S. Medicine

March 10, 2017

By Sandra Basu

After his appointment received unanimous support from the U.S. Senate last month, David J. Shulkin, MD, was sworn as VA Secretary by Vice President Mike Pence, left. VA photo

WASHINGTON — David J. Shulkin, MD, stepped into the role of VA secretary last month after receiving unanimous support from the U.S. Senate.

“I am pleased that the Senate has confirmed Dr. Shulkin as secretary of the U.S. Department of Veterans Affairs, and I look forward to working with him immediately on our committee’s priorities to enhance the Choice Program, decrease wait times in the appeals process and improve health care for our veterans,” said Senate Committee on Veterans’ Affairs Chairman Sen. Johnny Isakson (R-GA).

Shulkin, the first nonveteran to head the agency, is no stranger to VA. He comes to the job after serving 18 months as the VA under secretary of health in the Obama administration. He took on that position when new leadership was sought to help solve severe access problems.

“I came to VA during a time of crisis, when it was clear veterans were not getting timely access to high-quality health care they deserved,” Shulkin said during his confirmation hearing in early February. “I soon discovered that years of ineffective systems and deficiencies in workplace culture led to these problems. I concluded it would take years to fix the problems, but because veterans’ lives were at stake, there was no time to waste.”

Prior to joining VA, Shulkin was president of Morristown Medical Center, a tertiary-care hospital in northern New Jersey. He is the past president and CEO of Beth Israel Medical Center in New York and also previously served in leadership roles including 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.

Shulkin was trained as an internal medicine physician. During medical school and in his residency training, he did stints at the Philadelphia VAMC, the West Haven, CT, VAMC and the Pittsburgh VAMC.

In response to his confirmation, National Commander Charles E. Schmidt said The American Legion “has confidence that Dr. Shulkin possesses the skill set, compassion and commitment to restore the trust that veterans need to have in the department that was created to serve their needs.”

Veterans of Foreign Wars National Commander Brian Duffy said “veterans are very fortunate to have Dr. Shulkin voluntarily stay in what has evolved into the most scrutinized and criticized position in the country.”

No-Fuss Promotion

Trump’s nomination of Shulkin sparked little fuss, unlike some of the president’s nominees. At his confirmation hearing before the Senate Committee on Veterans’ Affairs, both Democrat and Republican lawmakers expressed that they were pleased with Shulkin’s work as under secretary of health.

“You’ve done great so far in your present position. You have brought new leadership and vision to an agency that needs it,” Sen. Richard Blumenthal (D-CT) said.

On his part, Shulkin described to lawmakers an agency that is already in the midst of making progress.

“We’ve dramatically reduced the number of people waiting for urgent care. The VA now has same-day services in primary care and mental health at all our medical centers to make sure our veterans get the urgent care they need, when they need it most,” he said.

Several lawmakers sought reassurance that Shulkin would not take steps toward privatizing the VA. Trump had proposed during his campaign that that all veterans eligible for VA healthcare should be able to bring in their veteran’s ID card to any doctor or care facility that accepts Medicare and receive free care.

Shulkin said there should be “no doubt” that he would seek major reform and a transformation of the agency. Under his “watch,” VA will not be privatized, he said.

“I am a strong advocate for the VA. The services that are available in the VA are not available in the private sector,” he testified. “My view of where the VA needs to go is an integrated system of care taking the best of VA and the best in the community, and that is what I would work toward.”

During the hearing, Shulkin told lawmakers that, while the amount of care delivered in the community increased from the time he began his tenure as under secretary for health from 21% to 31% that “veterans still tell us that, even with the ability to seek care in the community, they want VA services.”

Meanwhile, Sen. Dan Sullivan (R-AK) pointed out that Shulkin was part of the outgoing administration and said some of his constituents have questioned whether his appointment as secretary would simply be “more of the same.”

Shulkin assured him that would not be the case and that change would occur.

“I don’t have a lot of patience, and I am going to be serious about making these changes and regaining that trust. If I don’t do it, I should be held accountable and you should replace me,” he said.

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