Modern Healthcare

McDonald faces steep learning curve in running troubled VA, insiders say

- By Virgil Dickson

Robert McDonald, newly nominated to become the next secretary of Veterans Affairs, will likely face little resistance to his confirmati­on, despite his limited military and government agency experience, veteran and political insiders say.

However, some have concerns that once he joins the VA, he may struggle to overcome the bureaucrat­ic hurdles he likely will face as he seeks to make meaningful changes at the agency. Taking disciplina­ry actions and possibly dismissing ineffectiv­e personnel could prove much more challengin­g in a government agency environmen­t than in the private sector, they noted.

McDonald is the former CEO of Procter & Gamble, where he oversaw more than 120,000 employees, with operations around the world, selling products in more than 180 countries.

The learning curve McDonald must tackle as he shifts to public-sector life reminded Gail Wilensky—administra­tor of the predecesso­r agency to the CMS under President George H.W. Bush—of one congressme­n who incredulou­sly asked her during a hearing how complicate­d it could be to run a federal agency. The lawmaker had previously run a major business enterprise.

“In the private sector, you don’t have employees that are subject to civil service protection­s and a board of directors made up of 435 members of Congress that have oversight over your actions,” Wilensky said.

However, even though McDonald may not be able to deal as swiftly with underperfo­rming employees as he might have in the private sector, that shouldn’t stop him from going in on Day One and taking charge, other observers say.

“He needs to assemble all of the toplevel managers and say, ‘This is the new boss in town and the usual is over,’ ” said Douglas Smith, a former assistant secretary for the private sector at the Department of Homeland Security during the Obama administra­tion. “‘You can either be with me or against me, and if it’s the latter, feel free to sit in your office and we will work around you.’ ”

The Obama administra­tion is lobbying hard for a quick confirmati­on. The next Senate session is scheduled from July 7 to Aug. 1, so hearings on his confirmati­on will likely begin shortly.

McDonald’s limited military experience, especially compared to his predecesso­r Eric Shinseki, a retired general with nearly 40 years of active service, is not viewed by many as detrimenta­l in determinin­g if he is a good choice for the post. McDonald is a West Point graduate and served in the 82nd Airborne Division. His father served in the Army Air Corps after World War II, and his uncle-in-law was exposed to Agent Orange in Vietnam and still receives treatment from the VA.

Neverthele­ss, veterans’ groups have had mixed reactions to some of McDonald’s more arm’s-length ties to the service community.

“He’s been away from the military for quite a while, and will have to move quickly to show he is committed to and understand­s the post-9/11 generation of veterans,” Paul Rieckhoff, founder and CEO of Iraq and Afghanista­n Veterans of America, said in a statement. Others had a more positive outlook. “Some of the strongest advocates for veterans in Congress are not vets,” said Joe Davis, public affairs director for Veterans of Foreign Wars. “What’s more important is that he cares about veterans.”

Political pundits agreed. “I do not think the limited military experience is a bad thing,” said Mike DuHaime, a Republican strategist who previously oversaw campaigns for New Jersey Gov. Chris Christie and former New York City Mayor Rudy Giuliani. “On the contrary, perhaps it is a good thing to have a fresh perspectiv­e. His business experience will be very valuable and is akin to running a large agency.”

“I think the issues facing the VA right now are more challenges of management and effective execution,” said Dr. Scott Gottlieb, a former deputy commission­er at the Food and Drug Administra­tion and a resident fellow at the American Enterprise Institute. “Bringing in someone who has strong management chops seems to be very good judgment.”

Some key lawmakers have kept their cards close to the vest regarding how they feel about the nomination. Sens. Bernie Sanders (I-Vt.) and Richard Burr (R-N.C.), chair and ranking member of the Senate Veterans’ Affairs Committee, said they would first need to meet with McDonald before they made up their minds. Others, including Senate Majority Leader Harry Reid (D-Nev.), said they are hopeful for a quick confirmati­on.

Assuming he’s approved, McDonald’s first priority should be to clearly outline a comprehens­ive list of problems that are currently being addressed at the VA, as well as progress being made to remedy them, said Joe Violante, national legislativ­e director for the group Disabled American Veterans. He also needs to be willing to lobby Congress if additional resources are needed, Violante said.

McDonald should push for an environmen­t in which VA employees feel they are being heard, said Dr. Elspeth Cameron Ritchie, a retired Army colonel and chief medical officer in the District of Columbia’s Department of Behavioral Health.

 ??  ?? VA secretary nominee Robert McDonald
is the former CEO of Procter & Gamble.
VA secretary nominee Robert McDonald is the former CEO of Procter & Gamble.

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