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Interview: David J. Shulkin, VA Under Secretary for Health

 

 

The Honorable Dr. David J. Shulkin is under secretary of health for the United States Department of Veterans Affairs. As the chief executive of the Veterans Health Administration, Shulkin leads the nation’s largest integrated health care system, with more than 1,700 sites of care, serving 8.76 million veterans each year. The Veterans Health Administration is also the nation’s largest provider of graduate medical education and major contributor of medical research. Shulkin will have oversight over the system that employs more than 300,000 people who work in the health system.

Prior to being nominated by President Barack Obama and being confirmed by the United States Senate as under secretary of health, Shulkin served in numerous chief executive roles, including serving as president at Morristown Medical Center, Goryeb Children’s Hospital, and Atlantic Rehabilitation Institute, and the Atlantic Health System Accountable Care Organization. Shulkin also previously served as president and CEO of Beth Israel Medical Center in New York City. He has held 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. Shulkin has also held academic positions including the chairman of medicine and vice dean at Drexel University School of Medicine. As an entrepreneur, Shulkin founded and served as the chairman and CEO of DoctorQuality, one of the first consumer-oriented sources of information for quality and safety in health care.

Shulkin is a board-certified internist, a fellow of the American College of Physicians. He received his medical degree from the Medical College of Pennsylvania, his internship at Yale University School of Medicine, and a residency and fellowship in general medicine at the University of Pittsburgh Presbyterian Medical Center. He received advanced training in outcomes research and economics as a Robert Wood Johnson Foundation Clinical Scholar at the University of Pennsylvania.

Over the course of his career, Shulkin has been named as one of the “Top 100 Physician Leaders of Hospitals and Health Systems” by Becker’s Hospital Review and one of the “50 Most Influential Physician Executives and Leaders” by Modern Healthcare and Modern Physician. He has also previously been named one of the “One Hundred Most Influential People in American Healthcare” by Modern Healthcare.

 

The Year in Veterans Affairs and Military Medicine: You started 2015 as president of the Atlantic Accountable Care Organization (ACO). Then you got a call from the White House asking you to take over as VA under secretary for health. What made you want to leave Atlantic ACO and take over a federal department with the problems of the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA)?

Under Secretary David J. Shulkin, M.D.: I was sworn in on July 6, so I’m just coming up on nearly three months on the job and learning more and more about VA each day. My experience in the private sector and relooking at business models has allowed me to come in and challenge some of the issues in the Veterans Health Administration that frankly needed to be questioned. Bringing best practices from the private sector will help me achieve our outcome, which is to provide better care to our veterans.

As under secretary, I direct a health care system with an annual budget of approximately $59 billion, overseeing the delivery of care to more than 9 million enrolled veterans. VA, the nation’s largest health care system, employs more than 305,000 health care professionals and support staff at more than 1,200 sites of care, including hospitals, community-based outpatient clinics, nursing homes, domiciliaries, and 300 Vet Centers.

I think what’s relevant to know is that the reason I came to VA, and the reason Secretary [Robert A.] McDonald and President [Barack] Obama asked me to come here, was to tackle head-on the types of issues that did arise in April of 2014 and make sure that we were not only making progress, but that I was able to take a look at this using my experience running hospitals and health systems in the private sector.

 

When you accepted the position of under secretary for health, did you have a personal goal set in mind?

The issues in VHA over the past 15-18 months have been a very public story, and certainly when I read about the wait time crisis, I had the reaction of so many people – disappointment that our veterans were not getting the care they’ve earned and deserve. When I was approached with the opportunity to be part of the solution, I felt that I just could not walk away from something so important to this nation’s veterans and their family members.David J. Shulkin

 

For readers who may not be aware of just how vast an enterprise VHA is, can you please lay out some metrics for them to consider, such as personnel employed, number of facilities, annual budget, number of patients served, and number of medical professionals within VHA?

As under secretary, I direct a health care system with an annual budget of approximately $59 billion, overseeing the delivery of care to more than 9 million enrolled veterans. VA, the nation’s largest health care system, employs more than 305,000 health care professionals and support staff at more than 1,200 sites of care, including hospitals, community-based outpatient clinics, nursing homes, domiciliaries, and 300 Vet Centers.

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John D. Gresham lives in Fairfax, Va. He is an author, researcher, game designer, photographer,...