Secretary Shulkin’s Five Priorities

By Herb Rosenbleeth

At a recent meeting in the Omar Bradley Conference Room in the VA Central Office, I got to hear Secretary David Shulkin present his five most important priorities for reforming the Department of Veterans Affairs:

The Secretary’s first priority is to increase choice for our veterans. “We think that is an important way for reforming the VA,” said Shulkin. Veterans are going to be allowed to have much greater choice in their decision making when seeking medical care. Shulkin reported that the VA is working with Congress to redesign the Choice program so that veterans will have much greater choice in interacting with their providers and in making decisions about where it is best for them to get their care, either in the VA or in the community, or a combination of both.

The second priority presented by Dr. Shulkin is to modernize the VA. The system has experienced years, if not decades, of neglect. The VA must keep up with today’s technology and business practices. For example, the electronic medical record, which is thirty-five years old and extremely expensive to just maintain, needs to be updated.

The VA is getting rid of some 1,100 vacant, under-utilized buildings, some dating back to the Civil War, and even the Revolutionary War, which are extremely expensive for the VA to maintain. Updating of business practices, particularly accountability to hire and fire is crucial. (As I am writing this column, the VA has fired the Director of the VAMC in Washington, DC.)

VA’s third priority for reform is to improve the timeliness of its services. The VA is making progress on this and they now publish wait times on the internet for everyone to see. VA is trying to improve the timeliness of its benefit claims and appeals. Over 90,000 disability claims are over one hundred and twenty-five days old, which is too long. The time involved in the appeals process is being greatly reduced.

Secretary Shulkin’s fourth VA reform priority is focusing VA’s resources.  Many of the VA’s services cannot be replicated in the private sector. VA delivers world class services in polytrauma, spinal cord injury and rehabilitation, prosthetics, and orthotics, traumatic brain injury, PTS treatments and other behavioral health programs.

The VA’s top clinical priority and Shulkin’s fifth reform priority is the prevention of suicide. “This is our most serious concern,” stated Shulkin. He added that twenty suicides a day are twenty too many. The VA will be expanding its suicide prevention crisis line service, working more closely with communities and looking at social media to identify veterans that may be asking for help.

Secretary Shulkin certainly has things in focus. He has the vision, the managerial experience, and the professional medical skills to make him a truly great Secretary of Veterans Affairs.

Volume 71. Number 3. Fall 2017