Veterans Health Chief Gets Committee Nod for VA Secretary

David Shulkin, MD, President Donald Trump's choice for secretary of Veterans Affairs (VA), won an easy, bipartisan nod from a congressional committee today that sends his nomination to the Senate floor for a final vote.

The 15 members of the Senate Committee on Veterans Affairs voted unanimously to approve Dr Shulkin's nomination. The decision lacked the partisan drama surrounding Senate committee votes on other Trump cabinet nominees.

The chief executive of the VA's Veterans Health Administration (VHA) since July 2015, Dr Shulkin would be one of the few high-ranking holdovers from the Obama administration to be on Team Trump if confirmed. Former President Barack Obama brought in Dr Shulkin to help clean house after scandalous delays in veterans receiving medical care forced then VA Secretary Eric Shinseki to resign in May 2014. Some VHA personnel had conspired to falsify appointment records to make wait times look shorter.

In a confirmation hearing before the Senate VA committee last week, Dr Shulkin lamented how "a few employees who deviated from the values we hold so dear have been able to tarnish the reputation of so many." He promised to reform and transform the VA, in part by extending and improving the Veterans Choice Program, which allows veterans to receive care from non-VA physicians and hospitals in their community when using a VA provider would mean significant delays or trips beyond 40 miles. He told lawmakers that the percentage of healthcare services for veterans delivered outside the VHA had increased from 21% to 31% during his watch.

However, Dr Shulkin, an internist, said that veterans' healthcare "would never be privatized under my watch" but rather remain a public/private hybrid as it is now.

Besides making community clinicians and hospitals more available to veterans, Dr Shulkin has tried to improve access to care by permitting advanced practice registered nurses (APRNs) to treat patients without physician supervision. That independence doesn't apply, however, to certified registered nurse anesthetists. APRNs hailed the decision as a win/win for patients and themselves while some major medical societies objected, saying that patients are better off when APRNs function as members of physician-led teams.

Sen. Johnny Isakson (R-Ga), who chairs the Senate VA committee, said in a news release after today's vote that Dr Shulkin’s "prior experience will prove indispensable." The committee's ranking Democrat, Sen. Jon Tester (D-Mont), also spoke highly of the nominee.

"It is clear to me that Dr Shulkin is committed to our nation's veterans," Tester said in a news release.

Before joining the VA, Dr Shulkin held several high-level executive positions in healthcare, notably as president and CEO of Beth Israel Medical Center (now Mount Sinai Beth Israel) from 2005 to 2009. The magazine Modern Healthcare ranked him among the nation's 50 most powerful physician executives in 2008, 2009, 2011, and 2016. He also served at one time as chief medical officer of the University of Pennsylvania Hospitals and, later, the University of Pennsylvania Health System.

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Cite this: Veterans Health Chief Gets Committee Nod for VA Secretary - Medscape - Feb 07, 2017.

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