President-elect Donald Trump on Wednesday named the Department of Veterans Affairs top health official his pick to run the entire veterans bureaucracy, a surprise move that puts a non-veteran in line for the post for the first time.
Dr. David Shulkin, who has served as VA Under Secretary for Health since June 2015, is the first nominee held over from President Barack Obama's administration. Trump made the announcement at his first press conference since the November election, and after a lengthy search which included dozens of potential candidates.
"He's fantastic," Trump said. "He will do a truly great job. One of the commitments I made is that we're going to straighten out the whole situation for veterans. Our veterans have been treated horribly … I think you'll be very impressed with David and the job he does."
In a statement released by Trump's transition team, Shulkin called the nomination an honor.
"President-elect Trump's commitment to caring for our veterans is unquestionable, and he is eager to support the best practices for care and provide our Veterans Affairs' teams with the resources they need to improve health outcomes," he said.
"We are both eager to begin reforming the areas in our Veterans Affairs system that need critical attention, and do it in a swift, thoughtful and responsible way."
Shulkin currently oversees about 1,700 medical facilities and almost 300,000 federal workers in the department’s health system.
Now he'll be charged with looking after the entire $177-billion agency, not only the health care aspects but also benefits delivery and a host of other support programs.
Prior to his time at VA, Shulkin worked as president and CEO of Beth Israel Medical Center in New York City and spent many years as a top health care official at numerous Philadelphia research hospitals.
If confirmed by the Senate, the 57-year-old Shulkin will become the first non-veteran to oversee the department or any of its predecessor agencies. Over the last 94 years, each of the 26 other men to serve in the job boasted military experience.
Shulkin comes from an Army family, and was born on an Army base in Illinois. His father served as an Army psychiatrist, and during his 2015 confirmation hearing he noted his military upbringing "has sensitized me to the psychological and medical needs of those who served our country."
The former internal medicine physician would enter the job with the more medical experience than most past nominees, and with almost two years of first-hand experience with the challenges and failures of VA’s medical care operations.
Trump has promised major changes within the department, including new rules on employee bonuses and a commission to "investigate all the fraud, cover-ups, and wrongdoing that has taken place in the VA" in recent years.
He has also promised a private White House hotline active 24 hours a day devoted to fielding complaints about VA, to guide reform efforts.
And he pledged as a candidate to increase the number of mental health care professionals within VA, a need that health officials have identified but been unable to fill due to nationwide shortages in specialists.
On Wednesday, Trump said that Shulkin will work closely with executives from "some of the great hospitals of the world" to look at ways to reduce wait times, improve access and better veterans care.
The president-elect has stated he wants to look at shifting more VA medical appointments to private physicians, a move that veterans advocates have strongly opposed.
Last fall, Shulkin testified before the Senate in favor of plans to extend the controversial VA Choice Card program past August 2017, but also argued that VA needs to remain "the care coordinator" for veterans’ medical needs.
He has also voiced support for expanding private-care partnerships with VA hospitals, a plan that Republicans in Congress have already endorsed.
Shulkin enjoys a good relationship with veterans groups. In a statement, Veterans of Foreign Wars National Commander Brian Duffy said his group supports Shulkin’s nomination and praised his "willingness to continue serving veterans and making the VA better."
Bill Rausch, executive director of Got Your 6, praised the pick as a chance to build on positive reforms in the department over the last few years.
"Although Dr. Shulkin does not have military experience, we have worked with him closely in his current role and have seen first-hand his unwavering commitment to our nation’s veterans," he said.
"Picking Shulkin shows both a focus on veterans health reform, and a desire to largely continue much of the good work done since (the 2014 wait times scandal), said Phil Carter, director of the Military, Veterans and Society Program at the Center for a New American Security.
"Under Shulkin, VA has slowly and quietly shifted more of its patient load to the private sector, and that has helped VA handle much greater demand. That trend will likely continue, and work better than outright privatization of the VA."
House Veterans’ Affairs Committee Chairman Phil Roe, R-Tenn., lauded Trump’s choice of a physician to lead the department, "especially one familiar with the integrating of private practitioners into the VA's network of health care providers."
Paul Rieckhoff, CEO at Iraq and Afghanistan Veterans of America, praised Shulkin' experience but noted that "his selection is unprecedented. Our membership overwhelmingly supported the selection of a veteran for this critical leadership position"
Rieckhoff said his group will be watching Shulkin's confirmation hearing closely, to see if he supports plans to "expand privatization at VA, which veterans nationwide continue to overwhelmingly oppose."
Leo Shane III covers Congress, Veterans Affairs and the White House for Military Times. He can be reached at firstname.lastname@example.org.