You’re Fired! Dr. David Shulkin is out the door as VA Secretary as of Wednesday evening. US Navy Rear Admiral Ronny Jackson, MD has been nominated for the position. In the interim, while confirmation takes place, Robert Wilkie, currently the Undersecretary of Defense for personnel and readiness, will move to VA as Acting Secretary.
Dr. Shulkin’s downfall was an Inspector General report last month that criticized his personal actions on a recent Europe trip (e.g. gratis Wimbledon tickets), actions (too much time spent on personal travel/personal time for the funding of the trip), and the poor way he handled the publicity around the report. Other issues centered on internal turmoil as he attempted to reform VA practices. As late as Tuesday, things were looking up based on White House statements, though Chris Ruddy of Newsmax was far less sanguine last Sunday on ABC. Our extensive coverage on Dr. Shulkin’s tenure at the VA is here. Our Readers who are engaged with US telehealth knew him as an IT ‘maven’, but from this Editor’s perspective, the rocky process of contracting in the Home Telehealth area and the downgrading of the program in recent years was dismaying.
Dr. Shulkin’s subsequent appearances in the pages of the NY Times and on TV were also less than stellar, overly personal, and to this Editor, ill-considered, blaming privatization and stating he did not resign.
The announcement was made yesterday evening from President Trump’s Twitter account. An (unnamed) White House official said the embattled Shulkin was no longer effective in his role, saying his “distractions were getting in the way of carrying out the President’s agenda.” according to CNN.
Rear Adm. Ronny L. Jackson moves from being personal physician to both President Trump and previously for President Obama. It is a White House tradition that personal physicians are from the Navy. He has combat medicine experience, having been deployed during Operation Iraqi Freedom in charge of resuscitative medicine for a forward deployed Surgical Shock Trauma Platoon in Taqaddum, Iraq. In 2006, during President G.W. Bush’s administration, he joined the White House Medical Unit. His official Navy biography is here. In moving to VA, he gives up a nomination for promotion to Rear Admiral (upper half) and must retire from the Navy, as a VA Secretary must be a civilian.
The critique on Adm. Jackson will be that he has never run an organization the size of VA, though in the Navy he was responsible for running medical units, has first-hand combat medicine experience, has outstanding experience, and as a younger nominee, will have the energy to move VA forward, unlike prior Secretaries who have been older or retired from previous military or executive positions. This Editor doubts that Adm. Jackson will fold like G.W. Bush’s ill-fated nominee, Harriet Myers. The speculation is that Mr. Wilkie will remain in some capacity at VA as well.
And the fate of Cerner, pushed very hard by Dr. Shulkin to replace VistA? We will see. Military Times. We’ll cite CNN since overnight reports are few, though their report and their bio of Adm. Jackson have their usual slant and are poorly written.