Welcome to a special Memorial Day Tribute of Difficult Conversations – Lessons I Learned as an ICU Physician. This week, we will pause and take a moment to honor the men and women who gave the ultimate sacrifice for our country and to also remember our commitment to all of those who have served. This week I chose to replay a previous interview with the Honorable Dr. David Shulkin, who was the 9th Secretary of the US Dept of Veteran Affairs. He was nominated by President Trump to serve his cabinet. Prior to serving as Secretary of the VA, he served as Under Secretary for Health under President Obama. Dr. Shulkin represented 21 million American veterans and was responsible for the nation’s largest integrated healthcare system with over 1,200 sites of care, serving over 9 million Veterans. Prior to coming to the VA, Secretary Shulkin was a widely respected healthcare executive having served as Chief Executive of leading hospitals and health systems such as Beth Israel in New York City and Morristown Medical Center in New Jersey. His book, It Shouldn’t Be This Hard to Serve Your Country: Our Broken Government and the Plight of Veterans. is one of the best books about our VA System ever written.
Dr. Orsini mentions his first encounter with Dr. Shulkin, and remembered how genuine, down to earth, extremely friendly, and very engaging he was. We find out what made Dr. Shulkin take the medicine path and what led him into the leadership role. Dr. Shulkin tells us the single most difficult conversation that he had, and he gives us advice on his approach to communicating bad news. There are so many problems with medical education training right now with communication, and Dr. Shulkin shares with us how we can fix this. Dr. Shulkin’s dedication in his book impressed Dr. Orsini, and he talks about his dad, who was a psychiatrist on an Army base, and if he influenced him in any way. We learn about when he takes on his new position as Under Secretary at the VA in 2015, and what he realized he had in front of him with the wait time issues that were going on. Also, we find how he fixed the issue so quickly. Since he served with both Trump and Obama, we find out the game plan he had to navigate through the two different environments and succeed at it. Dr. Shulkin has been called the “Champion of Patient Experience ” and he shares with us how he was able to start the Patient Experience Program at the VA. Telemedicine is discussed and whether or not it’s here to stay or if we keep doing more and more Telemedicine, if we’re going to miss that patient relationship.