VA secretary makes medical recruitment pitch at Duke

Aug. 29, 2014 @ 06:23 PM

The U.S. Secretary of Veterans Affairs told medical students, doctors-in-training and faculty at Duke University’s School of Medicine on Friday that he was there for one reason: to try to recruit them.

Robert McDonald, the former Procter & Gamble chief executive who was confirmed as secretary July 29, spoke at a medical conference that’s held weekly at Duke. McDonald had also visited the Durham VA Medical Center on Thursday and spoke at the American Legion 96th National Convention in Charlotte on Tuesday along with President Obama.
He told physicians and others Friday that the VA needs new doctors, nurses and physician assistants. The reform legislation signed by Obama this summer added to an education debt repayment program for medical professions, he said. And he said he spoke to the president about increasing pay for VA medical staff.
“We want to pay off your student loans,” McDonald said. “In the recent bill that was just passed by the Congress, we’ve doubled the (loan amount) that we can pay off. We’re also looking right now at increasing the salary bands for all of the medical professionals in the VA. We need your help.”
McDonald said he’s been on the road visiting VA facilities. There’s a need for medical staff at Phoenix, which is considered the “epicenter of our crisis,” he said, as well as in Las Vegas and in Memphis. He also said later that veteran population shifts have stretched resources in Durham, Phoenix, Charlotte and Las Vegas.
“We need over 1,000 medical professionals in Phoenix alone,” he said. “In Las Vegas (we) need 500 … I went to Memphis, we need 300 in Memphis.”
He also highlighted a particular need for mental health professionals.
“We simply don’t have enough mental health professionals in the VA or in this country to take care of them,” he said.
McDonald said he’s asked employees to recommit to the system’s mission and values. Known by the acronym “I.C.A.R.E.,” the values are integrity, commitment, advocacy, respect and excellence.
He also said VA officials have a responsibility to be transparent with lawmakers and the president about the system’s financial needs and what the risks are for not meeting those. He said the system has had a series of years in which it’s not gotten the budget support it needed. And he said in the past, others have said “yes we’ve got enough.”
“The wonderful thing about this is, I don’t need this job,” he said.
In addition, McDonald also outlined efforts to streamline performance metrics, as well as to respond to space needs. Space was an issue brought up at the Durham VA Medical Center, he said. McDonald said he’s been working to improve the leasing process.
“Space is a big issue,” he said. “We have appropriately moved to a leasing strategy rather than a building and owning strategy. Most companies in the world are doing the same thing because as the population and business shifts, you don’t want to be stuck with a concrete edifice that you can’t move. I think that’s appropriate.”
In response to a question about steps taken to address problems publicized in Phoenix, he said the medical center there has new leadership, it has expanded clinic hours to include weekends, help from mobile teams to eliminate the backlog and training for schedulers.
“Expanded hours, more overtime -- but all of these are not sustainable,” he said. “That’s the point. That’s why I’m here recruiting.”
Another attendee asked about efficiency since he said he’s been “buried under processes” while working in the system.
In response, McDonald the VA has a “great strategic plan,” but when he goes to the organization he “can’t find evidence of it.” He said he’s been asking for sites that he visits to give him a list of barriers getting in the way of them accomplishing their mission of caring for veterans.
Dr. Dean Taylor, a professor of surgery in Duke’s Division of Orthopedic Surgery and an Army veteran, said he believes inefficiency is the greatest disincentive for surgeons to work for the VA.
Taylor said he likes to surgically operate, but inefficiencies limit the number of cases surgeons can take on per day at the VA. Taylor said while pay raises would be an incentive, what he believes the VA needs is a culture change. He said McDonald’s approach to change the culture is “the right idea.”
“You want to be in an environment where you can provide for a large number of patients and help a lot of people,” he said in an interview. “It’s a variety of things. It’s the staff that’s committed to working together to take care of patients, and (that) stay late if needed because things in medical care aren’t predictable.”