Longtime hospital administrator Dr. David Shulkin, the current undersecretary of health for the Department of Veterans Affairs, has been tapped for secretary of the department, President-elect Donald Trump announced on Wednesday.

Shulkin has a background in executive hospital leadership, at many hospitals across the country. He received his medical degree from the Medical College of Pennsylvania in 1986.

He has said his top priorities at the VA were increasing access to care and reducing wait times for veterans.

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The Trump transition team has floated the idea of privatizing elements of veterans’ health care, including letting veterans opt-out of government-managed care and apply their benefits in a private system. Shulkin has embraced some changes to the VA, but it’s not clear he would be on board with a wholesale privatization.

When Shulkin first took his position with the VA in 2015, he asked himself whether a department to manage veterans’ health was really necessary, and whether it could be replaced with a program that gave veterans vouchers to use in other health systems, according to the news site philly.com. But after 10 months in the position, he said he changed his mind, realizing that the VA serves a unique population with specific needs.

Shulkin has argued for reforming the bureaucracy, however. He penned a perspective piece in the New England Journal of Medicine in March 2016 on how to transform the VA into a high-performance health network. He argued that rather than serve as a direct care provider, the VA should shift to become an integrated payer and provider.

“It’s become apparent that the VA alone cannot meet all the health care needs of US veterans,” he wrote.

His proposed network would break providers down into those at VA-run hospitals and health centers and those working in private-sector systems. Those private providers would be responsible for submitting clinical data to VA health information exchanges.

Joe Chenelly, national executive director for AMVETS, a national veterans service organization, said that he “could not think of a better choice than Dr. Shulkin” to replace the current secretary, Robert McDonald. Chenelly praised Shulkin for continuing to see patients in the VA system while serving as the undersecretary.

A veterans issue advocacy organization whose current and former members have been involved with the Trump transition put out a more tepid statement: “We are hopeful he will take [the VA] in a new direction.” Executive Director Mark Lucas said that his group, Concerned Veterans for America, will work with Shulkin to enable veterans to seek care outside the VA “when the VA is failing them.”

Last June, Shulkin also proposed giving nurses more authority to treat patients without supervision by doctors as one way to decrease wait times. Nurses groups support the plan; doctors groups don’t, the Washington Post reports.

He has also rolled out a smartphone app for veterans that allows them to view, schedule, and track the status of their medical appointments. It is expected to be available to all veterans this year.

In 1999, he founded DoctorQuality.com, a pioneer in allowing hospital systems to track errors in patient care in real time. The company’s software was adopted by several health systems, including Baylor Health Care and Children’s Hospital of Omaha. The company, which was acquired in 2004 by a California-based competitor, Quantros, also created one of the first software solutions that allowed physicians to collect reviews from their patients.

 

And there’s still a lot to do: The nonpartisan Government Accountability Office is expected to place the department on its “high risk” list, the New York Times reported Wednesday, meaning that the office might be the source of significant wasteful spending.

Casey Ross contributed to this report.

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