Changing Systems, Changing Lives: David Shulkin, MD, MCP '86
By Elisa Ludwig
As a physician, entrepreneur and CEO, David Shulkin, MD, MCP '86, has always been driven by the desire to improve patient health and safety. Now as undersecretary for health in the United States Department of Veterans Affairs, he's effecting change on the largest possible scale — serving 8.76 million people annually.
Vice President Biden, MCP alumni Merle Bari and David Shulkin, and President Obama
Time of Turnaround
At the Department of Veterans Affairs, Dr. Shulkin has been charged with transforming the country's largest integrated health system, ushering it out of a tumultuous and controversial era. In 2014, CNN reported that at least 40 U.S. veterans had died while waiting for care at the VA facilities in Phoenix, Arizona, and internal investigations revealed that the problem was widespread.
Shulkin was nominated by President Obama and confirmed by the Senate in 2015. For a physician with decades of experience across the private and academic sectors, the challenge of taking on a $70 billion annual budget and a board of 535 directors (Congress) proved deeply compelling. "I've always been attracted to what I call turnaround situations where I think I can be of help," he says.
In this case, that help means bringing business acumen honed in the private sector to the federal government. It means looking for processes that are cheaper, better and faster. It means questioning the status quo to make sure that the system truly benefits veterans and improves access to care.
A Path to Public Service
Shulkin began preparing for his current role when he applied to the College of Medicine's predecessor Medical College of Pennsylvania. He chose the school for its humane environment and abiding focus on empathy for patients. Medical school not only offered the necessary academic foundation for a career in medicine, but it also gave him his first opportunity to learn about health policy. During the summer of his first year, he went to Washington, D.C., as a health policy fellow and served as staff to the Senate Committee on Aging. "I saw how Washington and health policy can be influenced and influential, and I learned how the whole system functions," he says. "It was a very eye-opening experience."
At MCP, Shulkin also met his wife, Merle Bari, MD, a classmate, whom he cites as having the single biggest impact on his life and work. Dr. Bari is a dermatologist with offices in the Greater Philadelphia area, in Gladwyne, Conshohocken and Roxborough.
In 2002, Shulkin returned to the medical school, now under the Drexel name, serving as chief quality officer of the College and co-chairman of the Department of Medicine. He later became vice dean of the College and helped focus educational and clinical programs as the school found new footing.
Shulkin has held leadership roles at a number of hospitals, including Beth Israel Medical Center, the University of Pennsylvania Health System and Temple University Hospital. Most recently, he served as president of Morristown Medical Center and vice president of its parent company, Atlantic Health System.
Shulkin also founded DoctorQuality.com Inc., a startup that was one of the first organizations in the country to use publicly available data to make assessments about the quality of doctors and hospitals.
While all of these roles presented unique and wide-ranging opportunities, Shulkin sees a strong parallel between them — they each allowed him to make an impact on patient care by questioning and then improving the way medicine is managed.
Leading the Way to Change
While he says that no job could quite prepare him for the scope of his new position, Shulkin's entrepreneurial streak and interest in the convergence of business, medicine and management have provided him with a unique skillset. He has already started to reduce wait times at VA medical centers by improving the intake process, identifying priorities and better distinguishing between urgent and routine needs at the front door. In addition to reducing wait times and eliminating wasteful practices, he's working to make the VA a competitive employer to decrease vacancies and attract more top staff.
Yet there's much about the VA he would like to keep as is. He has spent a lot of time traveling the country and observing the great work at VA facilities. "The VA is a unique national resource, and the type of care we offer, the quality of research we do, the amount of training we offer are all critical to the U.S. health care system," he says. He points to a recent article in the Journal of the American Medical Association which showed that the VA has lower mortality rates than do non-VA hospitals in the hospitalization of older men with acute myocardial infarction or heart failure.
It's also something of a homecoming: Shulkin's grandfather was a chief pharmacist at the Madison, Wisconsin, VA, and because Shulkin's father was an army physician (a captain), Shulkin was born on a military base. He says he has always looked for the chance to give back to the country, so he views this job as an honor.
For Shulkin, the sense of personal responsibility runs deep. Even as he helms his post in Washington, he maintains a medical practice, working in the New York City Veterans Administration, where he meets with patients every Friday and listens to their concerns. Staying in touch with medicine informs his management decisions and keeps his focus on what matters most. "At the end of the day, people never want to feel like a number," he says. "They want to be engaged on a personal level. That's what's stuck with me since my days as a medical student, and that's what it means to be a doctor."
Distinguished leadership in quality, safety and service
During Alumni Weekend in May, David J. Shulkin, MD, MCP '86, will receive the WMC/MCP Distinguished Alumnus/a Award. The award honors a graduate who is acclaimed for excellent service and accomplishments, professional leadership, or scholarly activity that brings recognition to the medical school and its alumni.
As undersecretary for health in the U.S. Department of Veterans Affairs, Dr. Shulkin oversees not only the VA health care system, but also the country's largest graduate medical education program.
A trained health outcomes researcher and former Robert Wood Johnson Foundation Clinical Scholar, Shulkin is a leading expert in health system management, quality and patient safety. He developed the country's first fellowship in quality management and safety; founded a company to help patients select care based on quality; and created the nation's first medical-error tracking system, now used by hundreds of hospitals.
One of the first contributors to pay-for-performance systems, Shulkin was also an innovator in accountable care and population health management. He has held numerous leadership roles in professional societies and on editorial boards, in addition to his positions at academic medical centers and private corporations. He was named one of the 50 Most Influential Physician Executives and Leaders for 2016 by Modern Healthcare.
Throughout his career, Shulkin has maintained his internal medicine practice, staying true to the essence of who he is, a physician seeking to help patients.
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