Committed to Showing Results at the VA

Carolyn M. Clancy, MD, was named Interim Under Secretary for Health for the VA on July 2, 2014, just as the wait time crisis seemed to be spinning out of control. Her appointment and the confirmation of Secretary Robert A. McDonald less than a month later proved essential to calming the furor but were admittedly just the first steps in a long-term process to increase veterans’ access to care and develop better systems and procedures across the agency.

Six months after her appointment, Federal Practitioner talked with Dr. Clancy about the pace of change and the role of health care providers in improving care for veterans. In the interview, Dr. Clancy clearly noted that many VA facilities already represent the best of U.S. health care and that the path forward requires sharing of best practices. Many other facilities, of course, will have to change, but Dr. Clancy insisted it is “an incredible opportunity” for the VA to learn as a system. Perhaps most heartening to VA practitioners, Dr. Clancy also recognized that “you can’t provide veteran-centered care without employees who are inspired to do their very, very best.”

To be sure, any successful change in VA procedures and culture will require buy-in not only from across the agency, but also from veterans and Congress. Dr. Clancy has already received 2 votes of confidence: The Paralyzed Veterans of America and the Vietnam Veterans of America jointly called on President Obama to make Dr. Clancy’s appointment permanent. The White House and congressional leaders, however, have yet to schedule hearings or comment publicly.

Below is an edited and condensed version of the interview. To hear the complete interview, including an in-depth discussion of the Blueprint for Excellence, visit http://www.fedprac.com/multimedia/multimedia-library.html.

Taking Measure of VA Strengths

Interim Under Secretary for Health Carolyn M. Clancy, MD. I came to this system in August of 2013 after more than 20 years at HHS, all working for an agency that had the lead charge for funding research to improve quality and safety in health care; and I had spent the last 10 years prior to coming here as the director of that agency. I came to VHA because I thought this system was unique among all systems, public and private, in this country and had the strongest foundation in place to deliver 21st century health care. And at least as important—probably more so—was the sense of mission among all of the employees I met. These were people I’ve known in academia, people I met on the interviews, people I’ve intersected with for a number of years in the research community. You can’t replicate it, and you can’t buy it; and I figured the combination of a strong foundation and mission meant that this was one of the best systems to work for.

I still think that. Some of our best facilities could compete head to head with any facilities in the private sector. There is no question about that. We have some systems, facilities, and clinics that are struggling as well, which is also very typical of the private sector.

What we have is an incredible opportunity, first, because we have a fabulous mission. We have highly committed and dedicated employees. We have an incredible opportunity to actually learn as a system. There has been a lot of discussion at a number of levels about how health care in the new century needs to be a learning health care system. We actually have the capability of delivering on that promise. So I’m very, very excited.