For the last 94 years, every permanent or acting head of the U.S. veterans benefits bureaucracy has served in the military. But that is expected change in coming days.
President Donald Trump's pick for the next Veterans Affairs Secretary, Dr. David Shulkin, is poised to become the first non-veteran to assume that post, a tradition-breaking move that has produced surprisingly little controversy within the military community.
The 57-year-old physician's father was an Army psychiatrist and his mother an Army psychotherapist. He grew up on a military base in Illinois. He has served as VA Under Secretary for Health since June 2015, and still sees veteran patients in an effort to stay in contact with the front lines of department services.
He's earned praise from veterans groups as a reformer who knows the system, and is expected to face little opposition at his Senate confirmation hearing on Wednesday afternoon.
But unlike his 26 predecessors, Shulkin never spent time in the ranks, a fact that leaves him with significant challenges as he prepares to oversee the 365,000-employee, $177-billion department.
"Every previous secretary, whether they were actually qualified or not, started the job from a position of trust because they were veterans," said Bill Rausch, an Army veteran and executive director of Got Your 6. "The thought is that since they were vets, they'd understand veterans needs."
A membership poll released by Iraq and Afghanistan Veterans of America showed some concern among members about his lack of military experience, with 40 percent of respondents saying they'd prefer a veteran for the post. More than half of those surveyed said having health care management experience was a critical resume line for the next secretary.
"(The issue is) especially important for many, given the secretary's role is also to serve as the nation's leading advocate for veterans," said Paul Rieckhoff, founder and CEO of IAVA. "He also serves as a role model to many veterans nationwide striving to succeed. It's up to Dr. Shulkin to explain to folks not yet convinced why he is qualified to be the first non-veteran secretary in history."
Former VA Secretary Bob McDonald, an Army vet who also served as CEO of Procter & Gamble, said in an interview with Military Times in December that his military experience was invaluable in leading a bureaucracy that currently serves nearly 9 million veterans.
"Almost all veterans, whether in combat or not, have been in extreme situations," he said. "What that does, it creates a camaraderie and bonding that you can’t duplicate. I tried for years to duplicate that camaraderie in business that you get automatically in the military."
Most of the biggest veterans groups didn’t note his lack of military experience in their endorsements of his nomination, though many did publicly encourage Trump to continue the tradition before Shulkin’s name was announced.
Officials at Association of the United States Navy were one of the few to publicly endorse a non-veteran for the post when they threw support in early December behind former House Veterans’ Affairs Committee Chairman Jeff Miller, R-Fla., for secretary.
"To treat a veteran, you don’t have to be a veteran," said retired Rear Adm. Garry Hall, executive director of the association. "It comes down to the compassion you have.
"Being a veteran, that’s a great criteria. But it’s not the only selling point. We liked Miller because he knew the system and showed he wanted to make positive change, and we feel the same way about Shulkin."
Rausch said his group also backed Shulkin because they see him as an extraordinary candidate despite the lack of a military background. "His experience, his business acumen justifies this exception."
For his part, Trump has not made any mention of the tradition-breaking nature of Shulkin’s nomination. He has praised the pick as "an incredibly gifted doctor who is using his elite talents for medicine to care for our heroes, and Americans can have faith he will get the job done right."
In his confirmation for the top VA health job in May 2015, Shulkin acknowledged his lack of military service but said his upbringing and family connections have given him a strong connection to the veterans’ community. He said the 2014 wait times scandal "was difficult for me to have watched from the sidelines" given his knowledge of the systems and the individuals being hurt.
He’ll have a chance to talk about those connections again Wednesday afternoon, when the Senate Veterans’ Affairs Committee holds his confirmation hearing for the top VA post. Follow @LeoShane
Leo Shane III covers Congress, Veterans Affairs and the White House for Military Times. He can be reached at firstname.lastname@example.org.