Government and Regulations

Shulkin Nominated to Replace McDonald at VA

In a surprise move, Donald Trump nominates David Shulkin, MD, to head the VA.


 

In a surprise move, David Shulkin, MD, the current under secretary for health at the VA, has been nominated to take over as the VA Secretary to replace Robert McDonald. If confirmed, Dr. Shulkin would be the first nonveteran to head the agency.

Amid conversation about privatizing the VA, Dr. Shulkin had been a vocal proponent on Capital Hill and in medical journals for why the VA had a special responsibility to care for veterans. He has argued that the VA is especially qualified to handle the unique medical needs of veterans. Dr. Shulkin has also offered a number of strategies for reducing wait times, including expanding the scope of practice for advanced practice nurses , streamlining the adoption of innovative programs, and improving ageing information technology systems .

“As someone who spent more than 25 years managing private sector health care organizations and recently joined VA as its under secretary for health, I’ve had the unique opportunity to compare the health care systems,” Dr. Shulkin wrote in a Federal Practitioner editorial . “Over the past several months, I’ve met with veterans and their families, veterans service organizations, VA clinicians, facility staff, and veteran employees at all levels. Through these meetings and travel to dozens of facilities, I’ve come to realize that many of the essential services provided by the VA cannot be found in or even replicated in the private sector.”

Related: Shulkin Addresses APRN Rule, Health Care Vacancies, and Access

With just days to go before the inauguration of Donald Trump, only 2 cabinet-level positions had remained open. The delay caused worry on a number of fronts. “We cannot afford any lapse in leadership at the VA, especially at the Secretary level,” said AMVETS National Executive Director Joe Chenelly in a statement. “The transition between administrations naturally brings uncertainty, but that must be minimized with a timely decision by the incoming president regarding the VA Secretary.”

Members of Congress share similar concerns. “I am very concerned that the President-elect has yet to nominate a VA Secretary,” Sen. Jon Tester (D-MT) said in a press release. “If he needs more counsel before making this important decision, he should start by personally sitting down with our nation's veterans service organizations. Every day he continues to delay his decision, he jeopardizes the seamless transition that is needed to ensure this nation fulfills its commitment to the brave men and women who served.”

Related: Shulkin: VA "Not a Political Issue”

Who Else Was Under Consideration for the Job?

According to multiple reports, a number of people have been offered the position but have turned it down or were deemed unqualified for the position.

  • Leo MacKay Jr.: A deputy VA secretary under President George W. Bush and currently a senior vice president at Lockheed Martin.
  • Toby Cosgrove: Cleveland Clinic CEO; he also turned down a previous offer from President Obama.
  • ADM Michelle Howard, USN
  • Luis Quinonez, a businessman from Florida
  • Jeff Miller, former U.S. House Veterans Affairs Committee Chairman (R-Fla.): critics raised concerns that Miller was not a veteran.
  • Pete Hegseth: Iraq and Afghanistan veteran who leads Concerned Veterans for America, a conservative VSO, has been criticized for his advocacy for full privatization of VA health care. However, he is still considered to be a potential candidate.
  • Scott Brown: veteran and former republican Senator from Massachusetts was criticized for not having any management experience.
  • Sarah Palin: Former republican vice presidential candidate and Alasksa governor was criticized for not being a veteran or having experience running a large institution.
  • Coast Guard Adm. Thad Allen: while his name has been mentioned in connection with the position, there is little information on his interest or criticism of him.

    Veteran service organizations had been pushing the Trump transition team to consider retaining current VA secretary Robert McDonald, who is a republican.

    Related: A New View for the VA

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