Quick Leonard Kieffer - Fascinating Person: Dr. Shulkin

Dr. ShulkinFascinating Person: Dr. David Shulkin

Commitment to Veteran Affairs: Future Goals and Hopes as the New Under Secretary for Health in the United States Department of Veterans Affairs.

Dr. David Shulkin is a long-time friend of QLK. As a gesture of appreciation and gratitude for all that he has and will continue to accomplish in healthcare, QLK couldn't think of a better way to congratulate him on his new role other than doing an exposé that not only highlights his goals for the future of veterans healthcare, but gains insights to who he is. Simply put, Dr. Shulkin is nothing shy of fascinating.

Dr. Shulkin, appointed by President Obama in March 2015, was confirmed by a voice vote in the Senate (without debate) on June 23, 2015 as the new undersecretary for health in the United States Department of Veterans Affairs. Dr. Shulkin fills the position that has been vacant for over a year. He, along with Robert A. McDonald (Secretary for Health in the United States, Department of Veterans Affairs), is responsible for 9 million military veterans in nearly 1,000 VA hospitals and clinics nationwide.

As we are all aware, 2014 was a tumultuous year for the United States Department of Veterans Affairs. Manipulated wait times for care and unethical practices among executives at Veterans Health Administration hospitals have been linked to at least 35 veteran deaths in Phoenix alone. In addition, the secretary and undersecretary for health in the United States Department of Veterans Affairs both resigned shortly after the scandal broke.

In his nomination hearing testimony before the Senate Committee on Veterans Affairs, Dr. Shulkin identified the changes that are essential in order for the VA to achieve its goals of providing timely and high-quality healthcare to veterans. He stated, "The VA needs change. The VA needs more doctors, more nurses, and greater efficiency from its current systems. It needs to advance its culture of accountability and eliminate those from the system that have lost their commitment to doing what is right for our veterans."

QLK had the pleasure of interviewing Dr. Shulkin just days prior to his being sworn in as the new undersecretary for health in the United States Department of Veterans Affairs. At the time of the interview, Dr. Shulkin was not speaking on behalf of the Department of Veterans Affairs, but as a leader who has agreed to become an integral part of the mission to restore faith and confidence in the Department of Veterans Affairs. Most importantly, Dr. Shulkin aspires to create a system that provides the best healthcare to all the men and women who have served our country.

Getting to know Dr. David Shulkin: Q & A

Why medicine? What inspired you to become a leading member in the U. S. healthcare community?

I always liked helping people in need. When I grew up, I always wanted to be a fireman. In the end, I decided that medicine would probably be an alternative fit where I could do the same type of thing, which is to help people in need and respond to people when they were having some type of problem. For me, medicine fit that bill.

What do you consider your greatest professional achievement?

My greatest professional achievement has been the people that I had the chance to work with and train who have gone on to lead their own organizations in order to make a difference in healthcare. I always had a commitment to training other physicians in how to be leaders in medicine, and I [have] run a fellowship for them for numbers of years. They have gone on to do important work and great things. I think that's always the most important legacy that somebody [can] have: to help other people to be successful.

How has your 25 years of experience in healthcare prepared you for your next role as Undersecretary for Health in the United States Department of Veterans Affairs?

This next position as undersecretary of health will require a broad spectrum of skills: the ability to pull strings strategically and operationally across government agencies. It is going to require that I draw upon all of my past experiences, whether they were in medical schools, in hospitals, working as a doctor, doing start-up companies, experiences in policy, experiences in research, and in education. I think that this new position really [draws] upon many of these past experiences that I have had over the past 25 years.

How are you going to regain trust and confidence in the VA health system?

The way that anyone gains the trust of the constituents that they serve is to be true to your values, to be clear about what your mission is, and that your actions have to back up what you say you are going to do. This role is very visible, so it's important that you not only say what you mean, but you do what you say. The key is to be transparent about the good things and bad things and to be consistently and constantly communicating what you are saying and what you're planning on doing, so you're not surprising people with your actions. I think that is basic leadership. I think the biggest challenge in this position is the size of the organization. It will be important for me to get out into the field, to visit medical centers, to speak to veterans and veteran service groups, and to be very visible throughout the organization.

How do you plan to ensure that there will no longer be manipulation of wait times?

There are several ways to address that. It will be my job to make sure that we adhere to this. Number one is, the message from the [top] of the organization is that not telling the truth will not be tolerated. It is important to be transparent as a leader in this organization. The second issue is that now a lot of time has been spent to define the right metrics of care, so that everybody has the same definition and understanding of what we are going to be measuring. And the third part of this is that there needs to be responsibility for results so that [there are] clear expectations about how we are going to run the organization, making sure that the leadership understands the values that are important, adding the right measurements of those and accountability in place. I think that those are the ways to prevent this from happening again.

What do you anticipate will be the biggest challenge that you will face in the first year as undersecretary?

The biggest overall challenge is the one that you identified—that is after a period of time where information about the care that was being provided to veterans really shook at the core confidence of the delivery system. The trust of the constituents, the trust of the veterans, the trust of people working the system needs to be earned back, and it needs to be restored. In a system this big, that doesn't necessarily happen quickly. But, I think it's absolutely essential that people feel confident in the way that healthcare is delivered to veterans throughout the country. That's the biggest challenge. I believe that if we have that trust restored, and we have our employees feel good about where they are working, then we could accomplish great things in the healthcare for veterans. That's really my goal, but also the biggest challenge facing us ahead.

In your testimony before Senate Committee of Veterans Affairs, you mentioned Choice Plan and the Blue Print of Excellence. In your opinion, how would implementing these strategies and initiatives improve the VA healthcare?

My view is that if you put the veteran

as the central emphasis on what you are trying to do and get them the right care, you are going to come up with a solution that takes the best of what the VA health system has to offer and the best in which the private sector has to offer. You create a new approach to care that really provides the overall best quality. That is my goal. That's why I agreed to take on this role. This is transforming our current veterans healthcare system to a new system—a new system that takes advantage o

f what we've learned about what hasn't worked and what we learned about what does work well in the system, and really crafting a new system that meets the needs of the people who served this country.

What message would you like to convey to all veterans who are either currently receiving or waiting for medical attention, or veterans who may seek attention in the future. Why should they trust the VA health system?

I think the message that's important, as I spent time talking to veterans groups, veterans service groups, employees in the VA system, US senators, the secretary of the VA, [is that] I am just overwhelmed by the true commitment that is bipartisan and absolutely bottom line to everybody that I spoken to, [and that is ] to fix the problems in the VA system, to make sure that the veterans are getting the healthcare that they deserve. This commitment to mission and the belief that the veterans deserve the very best care is really what gives me the hope that things are going to get better. I believe [this] should give veterans themselves the hope and the trust that the system really is designed and intended to meet their healthcare needs. I am very optimistic and feeling encouraged that with the commitment of so many people that we are going to see a system that people will once again feel proud of. I believe that is genuine in the hearts of the people that work in this system.

What would you like your legacy to be as the Undersecretary for Health in the United States Department of Veterans Affairs?

What I would like to see is that we have gotten the VA health system on a new track, one that is going to have a long-lasting transformation towards continually improving the type of healthcare that we provide in the country, and a sustainable system that has the full trust and confidence of the people that we serve: the veterans. I think there's no better legacy or story to have than to have been part of the effort that has put us on that path.


Contributed by Julie McGehee, Quick Leonard Kieffer