Shulkin Sails Through Senate on Promise of VA Changes

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.”

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  1. Laura Sams says:

    Mr. Shulkin,
    On behalf of myself and many like-minded health care professionals at VA Medical Centers, I strongly urge you to rethink expansion of the Choice and non-VA care programs. The administration and cost of these systems to improve access are very problematic. Veterans are not satisfied, and doctors, nurses, schedulers, and others are disheartened by the proposed increase in use of this system. It would be far less expensive and more efficient to use funds intended for that program to hire the required staff within VA.

    The current Choice program and non-VA care referrals create many logistical headaches as the folks arranging those referrals lack appropriate medical background and the process is not conducted in a timely fashion. The system wastes a huge amount of tax payer money, as the private sector providers have no incentive to practice cost effective medicine. Patients are often sent to outside providers whose care is substandard, who over-test, and the clinical questions of interest are not the ones answered. Retrieving records from the outside doctors is a nightmare and often the work done is shoddy.
    Only certain conditions are worth sending out, when VA strategically makes a cost/benefit analysis of bringing entire programs in house vs. the cost of feeing the service out (for example, having cardiology or neurosurgery in house). For routine specialty services, Choice and non VA care have made our work at VA as MDs quite dissatisfying and patients are largely frustrated and vent that anger on us, when we lack control over the system. PLEASE RECONSIDER CAREFULLY WHAT YOU ARE DOING. You are going to spend far more by expanding private sector care for veterans, and obtain a lot less service for that.
    Respectfully,
    Laura Sams, MD
    Professor, Neurology
    Cincinnati VAMC

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