Dr. David Shulkin, the Obama administration's nominee for undersecretary of health at Veterans Affairs, told lawmakers Tuesday he would work to create a VA medical system that would provide veterans superior care while attracting top talent to its ranks.
Shulkin, president of the 687-bed Morristown Medical Center and an internist who has served as chief medical officer or CEO of major medical facilities since 1991, said the VA's failings in the past year – appointment wait times, bloated construction costs, lack of accountability and more – and its fledgling transformation efforts have created a ripe environment for "dramatic change."
"The VA needs change. The VA needs more doctors, more nurses and greater efficiency from its current systems," Shulkin said during his confirmation hearing before the Senate Veterans' Affairs Committee.
In what was largely an amicable hearing, senators nonetheless quizzed Shulkin on several current VA black marks, including the $1 billion construction overruns at the VA hospital in Denver, veterans sickened by Agent Orange years after serving in Vietnam and the VA Choice program, which doesn't allow veterans to use the system if they live within 40 miles of a VA health facility, even if the facility doesn't offer the services they need.
Calling the ongoing $1.73 billion construction debacle a "monument to ineptitude in construction," Sen. Richard Blumenthal, D-Conn., asked Shulkin what he thought of VA's plan to use a portion of construction money included in a sweeping reform bill last year to complete the project.
"I would make sure any solution doesn't come at the expense of treatment of veterans," Shulkin said.
Shulkin would be the first permanent replacement to the post since Dr. Robert Petzel took early retirement during the heightening scandal at VA last year over appointment wait times.
The internal medicine specialist, who earned his medical degree from the Medical College of Pennsylvania and served as chief medical officer of his alma mater and Temple University Hospital as well as CEO and President of Beth Israel Medical Center, said he would use his business skills to work with VA Secretary Robert McDonald to eliminate gaps in quality and improve care.
Among the other issues Shulkin addressed and said he would work on include: the VA Choice program, to capitalize on its public-private partnership; mental health treatment, to include alternative therapies; and suicide prevention.
"The mental health of our veterans is paramount. The continued statistics of the number of suicides and people suffering is something none of us can be satisfied with," Shulkin said. [There are] several areas of mental health that are a priority: surveillance, so we known how big the problem is; identification of risk factors; and then, multiple interventions."
When asked why he wanted the job, he told senators of his family history, which includes his father, Dr. Mark Shulkin, who served as an Army psychiatrist, and his grandfather, a pharmacist at VA.
"I believe it is my duty to serve those who serve our country and I believe I can help," he said.
Sen. Johnny Isakson, R-Ga., said he was grateful that a nominee with such experience would be willing to take the job. But he warned that VA is a "monolithic organization" that would be a challenge for anyone to manage.
"VA needs to be improved and be a responsive organization. ... Quite frankly, there's an attitude within the Veterans Health Administration of denial in terms of some of the problems that exist in the system," Isakson said.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
