Episode #77 – Lessons in Leadership – with the Honorable Secretary David Shulkin

Dear Friends & Colleagues,

A common characteristic of the guests I invite on this podcast is their courage in and commitment to creating unprecedented positive change in healthcare. They don’t just do things right, they do the right things. And, while the content in these interviews centers on transforming healthcare, there are also lessons on humanistic leadership woven throughout. That’s not a coincidence because the act of reframing – of creative disruption – requires that type of leadership. 

Our guest this week, Secretary David Shulkin, exemplifies courageous, transformational, principled-based leadership. Dr. Shulkin served as a member of President Trumps’ cabinet, as the 9th Secretary of the US Department of Veterans Affairs. Previous to that he served under President Obama as Under-Secretary for Health. In both positions, he was confirmed by a unanimous Senate vote – an unusual testament to his competence and integrity. Prior to entering the government, Secretary Shulkin had a long distinguished career in the private sector. He served as CEO at Beth Israel Hospital in NYC and Morristown Medical Center in Northern NJ; and also held senior leadership positions at distinguished institutions such as the University of Pennsylvania Health System and the Hospital of the University of Pennsylvania. He has been named as one of the Top 100 Physician Leaders by Becker’s Hospital Review and one of the “50 Most Influential Physician Executives in the Country” by Modern Healthcare and Modern Physician. He has also been named by Modern Healthcare as one of the “One Hundred Most Influential People in American Healthcare”. Secretary Shulkin recently published a book entitled, ‘It Shouldn’t Be This Hard To Serve Your Country’, a memoir of his experience serving under two US Presidents. 

In this interview, you’ll hear:

• The important and unique role the VA system serves for military veterans, as well as its contributions to our larger healthcare system.
• The bold leadership maneuvers that Dr. Shulkin deployed to solve for immediate national VA healthcare crises and to navigate the entrenched culture of a slow moving and highly political bureaucracy.
• The lessons that Dr. Shulkin believes the US healthcare system can adapt from the VA.
• How Dr. Shulkin initiated the modernization of the VA system through the single largest electronic medical record (EMR) deployment in history.
• One of the major reframes that Dr. Shulkin introduced into the VA system, which was a shift from being a “pure provider of care” to becoming the “network coordinator of care”.

The remarkable characteristics of Dr. Shulkin’s leadership approach are apparent in this episode. First – he focused on solving specific, patient-facing healthcare problems such as improving access to care and eliminating hepatitis C. Second – he fearlessly made decisions based on principles and evidence, followed with swift action. I say “fearless”because he was acting in a pathologically political environment, and many of the decisions he made were followed by highly publicized personal attacks on his character and integrity. Third – he focused on delivering measurable and meaningful outcomes, with a relentless push to transparency.  

For me, the main story here is about a high-integrity, humanistic leadership approach coupled with a results-oriented, outcomes-based management style – singularly focused on creating unprecedented and differentiating value for patients and healthcare consumers. It seems ironic that we find one of the most brilliant examples of ‘consumer-obsessed’ leadership in the government-run VA system. Yet, there it is. 

I’d like to conclude these notes with a very personal message of gratitude.  I would like to sincerely and publicly thank our Veterans for their service and their sacrifice. I had the opportunity to spend the first seven years of my medical career providing care to Veterans at the Bronx VA Hospital in NYC. It was an experience that shaped my perspective and professional trajectory, leaving me with an indelible sense of humanistic mission and purpose.

Until Next Time, Be Well.

Zeev Neuwirth MD