Legal Meets Practical

If you caught my blog last week, you learned that on January 11, President elect Donald Trump announced his intention to nominate Dr. David Shulkin to be VA Secretary. Here are the top ten things you need to know about Dr. Shulkin and his appointment to this important position:

1. Dr. Shulkin currently serves as the Undersecretary for Health at the VA, a position he has held since July of 2015. The Undersecretary is the highest official directly responsible for the Veterans Health Administration.
2. When Dr. Shulkin took over as Undersecretary, these were his top five priorities: Fix access; staff and physician engagement; consistency of best practices and resource prioritization; development of a high performance network; and restore trust and confidence. Of these, he expressed that restoring trust and confidence was the most important.
3. A practicing physician, Dr. Shulkin continues to see patients despite his role as Undersecretary.
4. The following is his biography in a nutshell: numerous chief executive roles in medical facilities and organizations; numerous physician 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; numerous academic positions including the Chairman of Medicine and Vice Dean at Drexel University School of Medicine. The question, of course, is whether these roles prepare him for his biggest one yet: to lead our embattled and beleaguered VA.
5. Unlike every previous VA Secretary, Dr. Shulkin is not a veteran.
6. Dr. Shulkin has said that his number one priority as Secretary will be increasing veteran access to health care.
7. Dr. Shulkin has mentioned the need to apply “best practices from the private sector” to the VA.
8. Dr. Shulkin oversaw increased use of private care outside VA with mixed results. As Undersecretary, Dr. Shulkin has nearly doubled the amount of health care that veterans receive through private doctors. But he has also rejected calls for broader privatization, saying that it would cost untold billions and undermine the hospital system — a stance that puts him at odds with President Trump.
9. Dr. Shulkin has not spoken in detail on his intentions to implement/follow the Kingdomware decision as it relates to the Veterans First Program.
10. In the weeks to come, the Senate Committee on Veterans Affairs will hold a hearing on Dr. Shulkin’s nomination.

The VA needs process improvement, and I have the hope that Dr. Shulkin can bring this to our embattled VA. However, consider the red tape and broken system he faces – even the best pick for Secretary has struggles ahead.

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Will Trump’s pick for VA Secretary make us happy?

Or unhappy? Time will tell. . .