Interview With Katlyn Nemani, MD 2017-05-16 01:26:21
Leading the Nation’s Largest Integrated Health Care System David J. Shulkin, MD, was nominated by President Donald J. Trump to serve as the ninth Secretary of Veterans Affairs (VA) and was unanimously confirmed by the Senate on Feb. 13, 2017. Prior to his confirmation as Secretary, Shulkin served as VA’s Under Secretary for Health for 18 months, leading the nation’s largest integrated health care system, with over 1,700 sites of care serving nearly nine million veterans. Before he began his service with the VA, Shulkin held numerous chief executive roles at Morristown Medical Center and the Atlantic Health System Accountable Care Organization. He also served as president and chief executive officer of Beth Israel Medical Center in New York City. A board-certified internist, Shulkin also is a fellow of the American College of Physicians. He received his medical degree from the Medical College of Pennsylvania and completed his residency and fellowship in general medicine at the University of Pittsburgh Presbyterian Medical Center. Shulkin was previously named as one of the “100 Most Influential People in American Healthcare” by Modern Healthcare. You are the first ever non-veteran to lead the VA, but won endorsements from most of the major veteran service organizations. You won bipartisan, unanimous support from the Senate Committee on Veterans Affairs. What do you think helped win such an unprecedented wide net of support across parties? I consider my service as Secretary of Veterans Affairs to be my greatest professional honor. The unanimous support in the Senate was a mandate for modernization. No matter how divided America may seem, when it comes to honoring those who served in uniform, we stand united. When I see veterans at VA hospitals and ask them what they want in a leader, they say they want someone who is committed to fixing the system and making it better for them. That’s precisely what I aim to do. You were brought in to run the VA in the wake of a series of attacks from Congress and the press concerning wait times and access to care. How did you go about prioritizing what needed to be done? My first step was to triage the VA and develop a plan to expand access for veterans who have urgent medical needs. These veterans should get the care they need, when and where they need it. When I started, we had approximately 57,000 veterans waiting more than 30 days for urgent consults. We have reduced that figure today to almost none. We have more work to do, but this was and remains a key priority. Over the past two years you oversaw the implementation of the Veterans Access, Choice and Accountability Act. What did this seek to improve and where do things currently stand? The Veterans Access, Choice and Accountability Act was an important first step in improving access to care and helping regain the trust of the veterans we serve. We began to build a high performing integrated network – combining the best of VA with the best of the private sector. VA established the Veterans Choice Program, which would allow veterans to access private sector providers in their community if they lived more than 40 miles from a VA medical facility or waited more than 30 days for an appointment at a VA facility. The program was plagued with issues from extensive wait times and late payments to community providers. We have made significant progress with the Choice Program by modifying Choice contracts 70 times and by working with Congress to amend the legislation four times over the last two years. You have spoken out against privatization of the VA. Why do you think this is the wrong answer to improving care? When I came to VA I was surprised at how different it is from the private sector. The main difference is the comprehensive nature of the services we offer that you don’t normally find in the private sector. When you work in health care in the private sector you’re generally focusing on the physical condition of a patient who is dealing with an acute or chronic injury. But in the VA system, it’s much more than that; it’s treating the physical, social, psychological and economic components and integrating them into a comprehensive model. We need to treat the whole veteran and address their hierarchy of needs. The VA is a unique national resource that is worth saving. VA’s holistic approach to well-being is much broader than what you find in the private sector and plays an important and unique role in the lives of America’s veterans. You served as an executive leader in several large health care systems prior to your position at the VA. What are some of the lessons that carried over and guide you today? My father, who was an Army physician, taught me the importance of being transparent and accountable, particularly when there are mistakes involved. I have practiced this throughout my career and it’s an important lesson that I have carried over to VA as we work to regain veteran trust. What are some of your goals in the coming years in this role? I often talk about the 10 priorities I will be personally focused on as Secretary to implement a bold and aggressive plan to modernize the VA. These include accountability, extending and improving the Choice program, infrastructure modernization, enhancing our core programs, greater VA and Department of Defense coordination, the evolution of our electronic medical records, suicide prevention, appeals modernization and accelerating claims processing. One of the most urgent issues is suicide prevention. Veterans are at a higher risk of suicide than the general public. According to recent research, 20 veterans die by suicide every day. We have found that veterans who engage in VA care are less likely to take their own lives. Certainly, identifying at-risk veterans and getting them into VA’s system of care is a key priority. Working with veterans organizations and Congress, we can continue to expand access to care and open doors for veterans to seek the health care and benefits they have earned.
Published by American College of Cardiology. View All Articles.
This page can be found at https://bluetoad.com/article/Partners+In+Innovation/2789023/409373/article.html.