V E TE R AN S AFFAI R S & M I LITARY M E D I CI N E O UTLO O K
good type of care that’s being delivered on a daily basis hundreds of thousands of times a day across the country. People aren’t open to hearing from you when they think that you’re not addressing the crisis. They’re not open to hearing the full picture of all the amazing things that are happening in VA. So it’s been a challenge to adequately and accurately represent the scope of activities, and really what we do on a daily basis, because so much attention’s been focused on the negative or on the crisis aspects. One of the challenges that has resulted from that has been the morale of our workforce, who is demoralized by seeing how much negative attention has been put on the VA over the past couple of years. And that’s resulted in us seeing a decrease in applications for people wanting to come to work for the VA. So at the very time that we need to be attracting the best and the brightest and filling all of our spots, we’re actually seeing a decrease in applications related to this morale issue.
VA PHOTO
■■ VA Under Secretary for Health David J. Shulkin, MD.
What do you consider the biggest challenges at the moment that you’ve had to face? Well, I think there are really a couple. The first is that our biggest challenge is to regain the trust and confidence of veterans and the American public in what VA is doing. And having gone through this crisis, which began in VA in April 2014, we clearly lost a lot of that trust and confidence. And if you’re going to be a health care organization, one of the key ingredients, in fact what I call our currency since we don’t operate in a financial forprofit sense, our currency is really the trust and confidence of those we serve. So that’s really been our biggest challenge: to show people that we are being responsive and doing everything that we can to address the health care needs of veterans. And that’s how we’re going to regain trust. One of the challenges is that when you’re going through a crisis like VA has gone through, it’s been very hard to get the word out about the unbelievably
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We certainly have written stories about the quality of the health care in the VA. Whatever the issues may be with keeping up with appointments and wait times or what have you, once the person is being taken care of, it’s the best care anywhere, practically. You can’t do better, really. Well, I think that every health care organization should strive to do better, and we’re no different. We have many, many areas where we are seeking to improve our performance. Even in areas where it is good, we’re looking to make it even better. So it’s not that we’re a system that is perfect. We’re far from that. But we are doing and should be proud of many, many parts of our health care system that are doing extraordinary things. Even in the area of access and wait times, I will put our wait times up against the leading health care centers anywhere in the country, and I think that we perform as well or better in terms of access. What I think is challenging is that there are parts of the country where it just is very, very hard to hire health care professionals – parts of the country that are very rural where we don’t train medical students and where we don’t have medical schools. And getting people to move to those parts of the country and to come to work for us is very, very challenging. No other health care system has the scope of responsibilities that the VA does, which is to deliver care to every part of this country where veterans live. And therefore, the standard that we’re being held to is really one that doesn’t compare well with any other private-sector organization. That’s a good point. More than a year ago when you were sworn in, you had some priorities you put forward that you wanted to address. Where have you found success in advancing those priorities? 11