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Interview With Rep. Phil Roe, M.D.

Chairman, House Committee on Veterans’ Affairs

Rep. Phil Roe, M.D., represents the 1st Congressional District of Tennessee. A resident of Johnson City serving his fifth term in Congress, he has a strong work ethic and is committed to working on behalf of the 1st District and the nation. 

A native of Tennessee, Roe was born July 21, 1945, in Clarksville. He earned a degree in biology with a minor in chemistry from Austin Peay State University in 1967 and went on to earn his medical degree from the University of Tennessee in 1970. Upon graduation, he served two years in the U.S. Army Medical Corps.

He is chairman of the House Committee on Veterans’ Affairs. Additionally, Roe serves on the House Education and Workforce Committee. 

As a physician, Roe has become an active player in the effort to reform our nation’s health care system. He is the co-chair of the House GOP Doctors Caucus and a member of the Health Caucus.

Prior to serving in Congress, Roe served as the mayor of Johnson City from 2007 to 2009 and vice mayor from 2003 to 2007. He ran a successful medical practice in Johnson City for 31 years, delivering close to 5,000 babies. Roe has three children – David C. Roe, John Roe, and Whitney Larkin – and is a proud grandfather. He is a member of Munsey Memorial United Methodist Church.

 

Veterans Affairs & Military Medicine Outlook: You’re a Vietnam veteran. Have you received medical treatment at a Department of Veterans Affairs (VA) facility? If so, what kind of care would you say you received?

Rep. Phil Roe, M.D.: I am a Vietnam-era veteran who served near the DMZ [demilitarized zone] in Korea for about nine months and at the 121 Evac hospital in Seoul for about three months. I do not receive care through VA, but I did spend time training at a VA medical center in Memphis, served in the 2nd Medical Battalion – both at an evac hospital and treating patients in the field – and saw patients in consultation with VA during private practice.

 

How have those experiences with VA influenced your service on the House Committee on Veterans’ Affairs and as a representative? 

Because of the experiences I’ve been fortunate to have with VA throughout my life, I think I have a unique perspective on the needs and strengths of VA. There are many things VA medical centers and clinics do second to none, but there are also areas where VA must improve. I believe we can utilize the expertise of the private sector while building on what VA has to ensure veterans receive the best care available. That is my top priority as chairman of the House Committee on Veterans’ Affairs.

Roe visit

Rep. Phil Roe, fourth from left, made an unannounced visit to the Washington, D.C. VA Medical Center on July 19, 2017, to discuss the facility. On July 12, 2017, the House Committee on Veterans’ Affairs held a hearing in which Roe called for a review and realignment of VHA capital assets. House Committee on Veterans’ Affairs photo

 

You co-sponsored the Department of Veterans Affairs Accountability and Whistleblower Protection Act that was signed into law on June 23. One aspect of the comprehensive law will give VA Secretary David J. Shulkin, M.D., more power to discipline, recoup bonuses, and fire employees for misconduct. Why was it so difficult to fire employees for bad behavior before? 

VA’s arcane civil service laws inadvertently protected bad apples within the department. When I first sat down with Secretary Shulkin, one of the questions I asked was what tools he needed from Congress to bring wholesale reform to VA, and he mentioned how his hands were often tied when it comes to disciplining and firing employees, even when there was clear negligence. In instances where VA has tried to take disciplinary action against an employee, the process was so administratively complex and lengthy that such action can take more than a year, often times being delayed indefinitely. A GAO [U.S. Government Accountability Office] study found that, on average, it takes six months to a year to remove a permanent civil servant in the federal government, though it often takes longer. Just last year, former VA Deputy Secretary Sloan Gibson testified at a hearing that it was too hard to fire bad employees at VA. We can’t expect VA to change course if the secretary doesn’t have the tools he needs to weed out bad employees to make room for new ones.

“As chairman of the committee, I have a responsibility to both veterans and taxpayers. As I mentioned before, my No. 1 priority is ensuring our heroes have timely access to quality health care – period.”

 

In several reports, you stated you could be sure that the vast majority of VA employees serve and treat veterans with respect and dignity. Does the new law authorize recognition of good employees, with merit increases or awards for example? 

The law is focused on getting the bad employees, who have tainted the names of all VA employees for too long, out of the picture. I believe this will go a long way to improve morale within the department. Further, the law includes increased protections for employees who blow the whistle on wrongdoing within VA. Whistleblowers are incredibly important to exposing VA’s shortcomings, and I’m glad both President Trump and Secretary Shulkin have made this a priority for the administration. I also believe you can’t fire your way to success, which is why I’m glad the legislation just passed by the House and Senate to extend funding for the Choice Program includes provisions to ensure VA can hire and retain the providers needed to ensure veterans have access to quality care. This provision was unanimously passed out of my committee, and I’m confident it will improve VA’s hiring capabilities.

The VA has identified more than 1,100 facilities nationwide that are underused or vacant properties that could be closed, saving approximately $25 million each year. In a White House briefing in May, Shulkin said that under the National Realignment Strategy, the VA may seek to close some facilities. Is your committee considering shuttering some VA facilities? And if so, what would be the disposition of them?

As chairman of the committee, I have a responsibility to both veterans and taxpayers. As I mentioned before, my No. 1 priority is ensuring our heroes have timely access to quality health care – period. The Commission on Care made a recommendation to review VA’s assets, and that’s absolutely something the committee is working toward. VA is currently building infrastructure based off a 1970s model of care, building large, 500-bed inpatient hospitals, but the reality is medicine is not practiced that way anymore. Some facilities probably need to close and be replaced with smaller clinics, but I understand the reality of what closing facilities could mean for the communities with large VA hospitals. That’s why I believe an independent panel should provide an honest review of VA’s assets and give Congress and the administration the opportunity to consider the recommendations. Some will say this is a step toward privatization or something that will harm veteran care, but the reality is this panel could very well find that certain regions need more facilities, not fewer. With that said, we’ll never know until we put in the work to see which regions need more resources and which regions have facilities too large for their veteran population. I’m confident we can get this review done in a way that will increase veterans’ access to care, which I believe is everyone’s goal.

 

How will the Veterans Choice Program Improvement legislation passed in April affect the Veterans Choice Program? In what ways did the Veterans Choice Program need to be improved? What will these changes mean to veterans and veteran patient caregivers? 

Right now, the committee is looking at several ways to improve the Choice Program and consolidate community care. I don’t think you’ll find anyone in Congress who will say the Choice Program rollout went as well as expected. The thing is, veterans have been receiving care outside VA for many years, largely due to the fact that VA doesn’t provide some of the services veterans need. The VA waitlist scandal obviously increased the number of veterans seeking outside care, but I think we can work toward a consolidated community care network that capitalizes on the strengths within VA and the private sector. Again, to me, it’s all about veterans’ access to timely care and improving their VA experience, so right now we’re looking at a lot of different ways to get this done in a fiscally responsible way.

Choice signing Roe

President Donald Trump turns toward Rep. Phil Roe to hand him the pen with which he signed the Veterans Choice Program Improvement Act on April 19, 2017. Dr. Phil Roe Twitter feed photo

 

What do you see as the biggest hurdle facing the Department of Veterans Affairs today? 

With an agency as large as VA – the second-largest department in the federal government, second only to the Department of Defense – it’s going to take time to make the changes needed to bring the department into the 21st century. The federal government historically evolves much slower than the private sector, but the more than 9 million veterans who access care through VA are counting on us to get this right, and to get it right fast. I definitely think that’s the biggest hurdle facing VA, but I don’t think it’s a hurdle we can’t overcome.

 

Where do you see the VA in five years? Ten years? 

I know where I’d like to see VA. I think some at the department have lost track of VA’s core mission: to care for the men and women who [have] borne the battle and their families. I know Secretary Shulkin is dedicated to getting the focus back on that mission, and I commend him for his efforts. In five and 10 years, I’d like VA to have regained the trust of America’s veterans, and for our nation’s heroes to have confidence in the fact that – after the oath and promise they take when they put on the uniform – our country will keep its promise to care for them and provide for their needs. I’d like VA to become a leader in medical innovations and treatment, and to continue its leadership in training medical providers. I’d like to see a transformed information technology system that allows easy access to claims, medical records, and education benefits. There are so many things VA does well, and I strongly believe refocusing on the department’s mission and doing whatever it takes to align the current veteran experience with that mission will transform the department into the agency it can and should be.