Largest Government Agency and 350,000nt with over employees. What is your management style, what is your approach to this job . V. A. Sec. Shulkin my approaches is that we have a mandate from the president and from the country to get this organization back on track. Organization that has been working hard, but not necessarily accomplishing what we really need to accomplish. I have patients in my management style, but we really want to make sure the organization is successful and fulfilling its mission to take care of this countrys veterans. Host how did you get off track and when . This is. Shulkin decades and decades of problems that have not been dealt with for a long time that eventually the solutions were difficult and they got pushed off from administration to administration. There is a natural progression of these problems continuing to, essentially develop until we see them now so clearly. Hud sec. Carson you cant go back and change things host you cannot go back and change things, but if you could what would you . V. A. Sec. Shulkin it is a matter of not putting off hard decisions. When there are problems developing and when organizations outside of government are taking solutions and modernizing, government cant afford to fall behind and keep its head in the sand. These are issues that i think have been important to address, and now we will tackle this head on. Host do you consider yourself a doctor . V. A. Sec. Shulkin absolutely. I still see patients. That is who i am. I consider the way i approach the job as a physician, and secondly as a manager. Host why did you pursue being a doctor . V. A. Sec. Shulkin i think it is about helping people. I found that that is where my passion is. When you are an administrator or manager, you can begin to help fix the system issues and that helps many more people in a much broader way. I really consider my management career as an extension of what i am doing as a physician. Nonmilitary person first nonmilitary personnel hold this position. What do you bring to the job . V. A. Sec. Shulkin i bring my experience of the private sector and my passion to do Public Service. While i am not a veteran, i come from a long history of Family Commitment to Public Service. One of the things i regret is not being able to directly go in and help. This is my chance a little bit later in life to give back and do Public Service. Since i am not a veteran, it gives me extra region and emphasis to make sure that i am connected to those who are veterans and to work with those veteran organizations and to be out there and interacting on a daily basis with veterans to make sure i understand how to lead this organization in the right direction. Host your dad was in the army . What did he do . V. A. Sec. Shulkin he was a psychiatrist. Host what did he tell you about the experiences he had . V. A. Sec. Shulkin my grandfather served in the merit military. Hit my grandfathers v. A. Ather was in the i grew up listening to him talking about in serving veterans and how much it meant for him and how much he loved working at the v. A. Student i worked in the v. A. As a resident i worked in two other v. A. s. That is where i learned and trained in that had a big impact on me to rot my career. My father, being a psychiatrist, not only talked about his army experience, but all throughout growing up tucked about how he would deal with people that were people that were struggling with Mental Health issues and access to health care. That was one of the big issues we are dealing with today in the v. A. The issue of 20 veteran today taking their life through suicide. The issue of access to care and the issue of Mental Health treatment. All of these issues are things that have always been on my mind and i have thought a lot about. Host lets talk about suicide for a moment. When you talk to the family members of veterans who have taken their lives, what did they tell you . This is. Shulkin that a system that has let them and their family down. One of the first families i interacted with or the family of daniel summers. Howard and jeans howard and jean summers, they lost their son in a has been publisheds publicly. It is pretty clear that will family was let down by the system. Not intentionally, but a system that had too many gaps. From that experience, it taught manyfront that there are things we can do to make sure that this does not happen. We are seeing it happen 20 times a day is unacceptable. That is right is my top clinical priority to address that issue. V. A. Sec. Shulkin host based on your own dad expertise, what motivates somebody to take their life . V. A. Sec. Shulkin i think there is a sense that there are no other options. Isolation and being scared. Sometimes it is being in pain. Sometimes it is the illness itself, whether depression and the sense of hopelessness that lets people think that there is no better option. We have tot of what do. We have to make sure people are not alone, that they have the support that they need a dash around them and that they are connected to the right resources. Get carehen veterans and the v. A. That they do better. There are less likely to look at suicide is an option that we could save lives by connecting them with the right help. Host promise to care for veterans take deeds back to abraham lincoln. Dates backhulkin it before that. We give president lincoln that credit before because right before his second inaugural it is the said, countrys responsibility to bear the burden of those in battle. That is we put throughout this building and i usually start every public talk to talk about with president lincolns commitment to that. When you look back historically, it goes back to the pilgrims in that, when they were soldiers, their commanders felt the commitment to care for those who had left her lives in the battle and to protect what they believed in. Right back from the very beginnings of this country that there was a commitment and a need, and a responsibility to care for those who had gone to put their lives at risk for us. Host that promise today means what to veterans . s . V. A. Sec. Shulkin when we have a complete voluntary service. Less than 1 of citizens now serve in the military. Their hand andse volunteered to go off and put their life at risk, they have to understand that when they come back, their country will be there for them. Not just on the first 30 days after they are here, but when something happens, as a result of conflict and service, they have to understand that we are there for them to matter how long it takes. That responsibility is really connected to our National Security commitment. People ast see willing to volunteer as they do not believe the country will be there for them when they come back. We saw you in eastern texas with Vice President mike pence. When it comes to natural disasters, what is the role of the v. A. . V. A. Sec. Shulkin the v. A. Has four missions. The Health Care Mission as one people understand. We also have an Educational Mission where we train 70 of u. S. Trained doctors in this country. We have a Research Mission where we are the Largest Organization doing research. 1. 6 billion a year all dedicated to improving the lives of veterans. Our fourth mission, which even fewer people know about is emergency preparedness. In the case of natural disasters like hurricane harvey, or in the case of a military disaster, it really is the v. A. That is prepared to respond in conduct in conjunction with other federal agencies. We have the most doctors in the country, the most nurses in the country. The most Mental Health professionals. We of mobile units that can be prepared around the country and we train for this. To maket mission was sure that Veterans Health care and benefits continued. Our Medical Center in houston stayed open. We had staff there from friday evening all the way through now making sure that there are 400 in patients that were able to get the care that they needed. Our Emergency Rooms and operating room stayed open. We deployed mobile units throughout houston. I was down there with the Vice President , but i returned two days later with mrs. Trump. Having my personal commitment to be able to make sure that the veterans in the area hit in texas 530,000 of them knew that we were there for them and that we would be there no matter what their needs were, was very important to me. Host that goes back to your management style because you are only one person. How do you moment lies how do you mobilize and ensure it is done efficiently . V. A. Sec. Shulkin i do believe people look at their leaders and make sure they are walking the talk. It was important for me to be there and that is why i went there twice and i will continue to make sure that me and my team is visible there. It is one of the reasons why i still practiced medicine in the v. A. There is no better way to connect with your staff and Customer Base that you serve then to let them know that you are personally committed to it and that you understand the situation that they are going through. Host where did you grow up . In thec. Shulkin philadelphia area. I was born on a army base when my dad was serving in the chicago area. Soon after, he married my mother who is from philadelphia and we there. P i have an older sister who is a psychologist. You andat is she tell how do you apply it to your job . V. A. Sec. Shulkin i have a family who is very connected to the emotional needs of people and help people as they go through difficult times. Shared theirthe advice and wisdom to be able to stick at this issue as it relates to meeting the Mental Health needs of veterans and how important that is. I think that they think i am pushing in the right direction to make sure that we have Mental Health professionals integrated into the physical aspects of care, so these are not seen as separate systems. We treat the veteran as a whole person who can have physical and emotional needs that both need to be met and integrated together. Host how did you meet your wife . V. A. Sec. Shulkin in medical school. She was a classmate of mine. We had gone through our trainings in the v. A. s together and our residencies together. We get to still connect a lot on what it means to be a doctor. Host love at first sight . V. A. Sec. Shulkin for me, it yes. I think it took her longer. She wanted to make sure she was looking at all of her options. I need that she was the right person when i met her and it took a little convincing for her to recognize that back. Host two adult children, what did they do . V. A. Sec. Shulkin my son graduated from nyu and works in the new york area in the managed , helping to improve processes and the managed care industry, which they need a lot of assistance with. In her final year of law school at harvard. Host let me talk about your career. You are the ceo at work the halls at night to make sure things were done properly. How did that train you for this job . A newec. Shulkin running york City Hospital is a very complex task. Unusual or crazy happens, it can happen in new york city. When you run those institutions, you have to be prepared for everything. Very complex work relationships as well with very strong unions and other groups that work in managing and working in hospitals. Foras a good way to care the complexity and the troubles that organizations can have. After working through that, he gave me confidence and understanding that many of the problems that we see in the v. A. And across the country, the scale is much bigger, but really addressing the problems, it is a similar approach to the private sector. Host do you have it unique approach of health care and what we saw over Affordable Care what congress is dealing with today . Certainlyshulkin i understand the issues in the Affordable Care act and the broader issues in health care have to do with making sure that we have a way to provide access to health clear health care. If you run a Hospital Organization you understand that when people need health care they will come to you regardless of if they have insurance or not. Providing access is important in understanding a way to do it that is affordable is also important. I think that is the debate we are seeing at the national level. We are seeing the balance between access and affordability and the complexity on what is in the middle on how you administer a program like that. That was really a ability to after i finish my clinical training, to get expertise in finance and management skills. I was supported in the program by the johnson foundation, which allowed me to be able to develop some of the skills that a think a doctor may not necessarily have when they leave medical school, but to cut but to become the leader you need to round out those skills. I was fortunate to do that at the university of pennsylvania paired pennsylvania. Host what is your approach would transgender veterans . V. A. Sec. Shulkin when somebody becomes a veteran we will serve them and treat them with dignity and respect the matter what their issues are. If there is a change of policy at the department of defense, they will need to decide who is a veteran. Once they come out of the department of defense, my mission and responsibility is pretty clear. Anybody who is a veteran is someone we will take care of, as long as they want us to take care of them. Have you had any interesting or memorable conversations with veterans, whether world war ii, vietnam or recent conflicts . V. A. Sec. Shulkin i am thinking about yesterday were i had a chance at military Appreciation Day to spend time with world war ii veterans. These are just amazing people who have stories of such sacrifice and encourage that it really impacts me. I just love spending time with them. My Management Meeting this morning but my leaders and i said, after my experience yesterday, we have to do something more about capturing the stories of the incredible individuals. A think that young people today do not really understand what that generation went through, and what they did to be able to allow us to be here today. I think that is an important part of what v. A. Needs to do. It needs to expand its mission to include the ability to of servicehat people are doing and have done for the rest of the prop it up to the rest of the population. That why do you think generation did not want to talk about it . They never posted what they did in world war ii. They moved on with their lives and focused on family and careers . V. A. Sec. Shulkin i think that was part of the culture and what it meant to be a soldier at that time. I think what we have learned is is that when you do not have the ability to share and speak, that by internalizing that you can sometimes make issues more difficult. We try to do is allow people to understand that verbalizing, sharing, and about whatpeople they experienced is an important part of coming back and being successful into your transition to civilian life. It is also important to share with the 99 who have not experienced with people who have served have. They can understand and support those in service better. Are sec. Shulkin you dealing with whistleblowers in the v. A. How demings sure that those who want a point a finger can do so without repercussion . Host we have done a lot in that regard. The Office Reports directly to me so that people feel that they have a place where they can safely talk about things that are concerns to them as they see as employees and that there is not retaliation. One thing we have done is brought some was so blowers to work directly in the office of that they can tell us what they have experienced and they can be part of fixing the problems and solutions. We also have the law that allows us to expand additional protections for whistleblowers. Host you have worked for barack obama and donald trump, is it different one versus the other . V. A. Sec. Shulkin yes. First of all, i think anybody who has the privilege of working for the commanderinchief grows deep respect and affection for their commander and chief. I have a great deal of respect and affection for president obama, and cannot say nicer things about what the experience was like to work for him. Trump, theesident president is very clear about what he wants done. He puts that objective albert and sets High Expectations and then lets you do that job. My experience with President Trump is, he is really an ideal boss for me the cousin know any to do, i know what the expectations are, and he lets me do that job and i know i have his support. When i need his help he is very accessible to me. Feel it has been an extraordinary privilege to work for both of these president s. Id this president , now that am secretary, is really allowing me to accomplish the things that we are getting done. Host is he different privately . V. A. Sec. Shulkin President Trump is a guy who really feels deeply about issues. Veteran care, support of our active Service Members is something that he is very passionate about. When he speaks, he speaks from his heart on this issue. We have lots of candid conversations about this. He is very easy to deal with and very accessible. I dont know if everybody sees outside side of him. I am fortunate that i get to see that. Host are you the only cabinet member to be confirmed by the u. S. Senate by a vote of 100zero question like v. A. Sec. Shulkin 1000 . V. A. Sec. Shulkin that is her true. I think it shows how the country feels about veterans. This is not a partisan issue. Congress reflects that. It did not surprise me that this was an area that we were going to have unanimous support on. At the fivea look bills we have gone through congress so far, they have largely been done with almost unanimous support. Certainly strong bipartisan support on all cases. That is something that i think really speaks highly of congress and speaks highly of the president s leadership on these issues. Host how did you come about with this job, first with president obama . Was readingulkin i about the crisis in