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Dr. David Shulkin M.D.
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It Shouldn't Be This Hard to Serve Your Country: Our Broken Government and the Plight of Veterans Hardcover – Illustrated, October 22, 2019

by David Shulkin (Author)
4.6 out of 5 stars 194 ratings

The former VA secretary describes his fight to save veteran health care from partisan politics and how his efforts were ultimately derailed by a small group of unelected officials appointed by the Trump White House.




Known in health care circles for his ability to turn around ailing hospitals, Dr. David Shulkin was originally brought into government by President Obama to save the beleaguered Department of Veterans Affairs. When President Trump appointed him as secretary of the VA, Shulkin was as shocked as anyone.




Yet this surprise was trivial compared to what Shulkin encountered as secretary: a team of political appointees devoted to stopping anyone -- including the secretary himself -- who stood in the way of privatizing the agency and implementing their political agenda. In this uninhibited memoir, Shulkin opens up about why the government has long struggled to provide good medical care to military veterans and the plan he had to solve these problems. This is a book about the commitment we make to the men and women who risk their lives fighting for our country, how the VA was finally beginning to live up to it, and why the new administration may now be taking us in the wrong direction.
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  1. Print length
    384 pages
  2. Language
    English
  3. Publisher
    PublicAffairs
  4. Publication date
    October 22, 2019
  5. Dimensions
    6.35 x 1.55 x 9.5 inches
  6. ISBN-10
    1541762657
  7. ISBN-13
    978-1541762657
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Editorial Reviews

Review

"From the moment David Shulkin was appointed secretary of the VA, Trump's corporate henchmen put a target on his back to achieve their aim of shutting down the VA hospital system. Shulkin, the highest-ranking person to serve in both the Obama and Trump administrations, provides play-by-play detail of his tumultuous tenure and spells out the ongoing threats to the VA. A harrowing and important story."―Andy Slavitt, former acting administrator of the Centers for Medicare and Medicaid Services

"This is a very important book. I hope Americans who care about our veterans will take the time to read it. The title of the book says it all, but what's inside is a compelling story-a cautionary tale for all citizens who care about recruiting talented people to serve our government."―Bob Kerrey, former senator, former governor of Nebraska, and recipient of the Medal of Honor

"A painful-to-swallow story of a political environment gone toxic. And as Dr. Shulkin points out, the casualty isn't the loss of another government servant-it's our veterans."―General (ret.) Stanley McChrystal

"I have known Dr. David Shulkin for a decade and this book is an honest and emotional account of what he sacrificed to serve the public and how much he cares for our nation's veterans. For anyone considering public service, this book is a must-read."―Chris Christie, 55th governor of New Jersey

About the Author

The Honorable David Shulkin, M.D. joined the Department of Veterans Affairs in 2015, first as Under Secretary for Health and then as the ninth Secretary of Veterans Affairs. He was the only Obama holdover who served in the Cabinet within the Trump administration and the only one unanimously confirmed by the Senate. Prior to his government service, Shulkin worked in a number of health care administration roles, including as President and CEO of New York's Beth Israel Medical Center and President of Morristown Medical Center in New Jersey. He is the Distinguished Health Policy Fellow at the University of Pennsylvania, practices internal medicine in New York City, and still advocates on behalf of veterans.

Product details

  • Publisher ‏ : ‎ PublicAffairs; Illustrated edition (October 22, 2019)
  • Language ‏ : ‎ English
  • Hardcover ‏ : ‎ 384 pages
  • ISBN-10 ‏ : ‎ 1541762657
  • ISBN-13 ‏ : ‎ 978-1541762657
  • Item Weight ‏ : ‎ 1.36 pounds
  • Dimensions ‏ : ‎ 6.35 x 1.55 x 9.5 inches
  • Customer Reviews:
    4.6 out of 5 stars 194 ratings

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Dr. David Shulkin M.D.

Dr. David Shulkin M.D.

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David Shulkin, M.D. is a nationally recognized physician who has spent the past 30 years leading health care systems and creating innovations to improve them. That was until, President Obama tapped him to come fix the Veterans Affairs. In 2015, Dr. Shulkin was confirmed by the United States Senate as VA Under Secretary for Health. In 2017, President Trump nominated him to be a member of his cabinet as the Ninth Secretary of the Department of Veterans Affairs and he was again confirmed unanimously by the Senate.

Passionate about helping Veterans and reforming the VA, Secretary Shulkin worked tirelessly on behalf of our veterans and was making significant impact until he was fired by a Presidential tweet in March 2018, on the eve of one of the biggest bills to be passed.

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Customer reviews

4.6 out of 5 stars
194 global ratings

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Customers say

Customers find the book insightful and well-written, with one review noting it reads like a suspense novel. The story quality receives positive feedback, with customers describing it as believable and incredibly moving.

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18 customers mention "Insight"18 positive0 negative

Customers find the book insightful, describing it as fascinating and valuable, with one customer noting how it shines light on current and past challenges in the VA system.

"...Overall, this is one of the most fascinating books I've read this year, and have no qualms highly recommending it!" Read more

"This book is about a skilled leader and dedicated physician, who continued to see patients while Secretary of the Veterans Administration,...." Read more

"...The author, Dr. Shulkin, has focused his career on improving doctor quality and reducing medical errors...." Read more

"...from an individual who has viewed problems and laid out a strategy to create meaningful change in the largest healthcare organization n in the world." Read more

13 customers mention "Readability"13 positive0 negative

Customers find the book engaging, with one mentioning it reads like a suspense novel.

"This reads like a suspense novel, but its riveting narrative is all too real...." Read more

"This book reads like a story while providing a great education about the VA...." Read more

"...But, indeed it is a good read...." Read more

"...state of VA policies related to health care or benefits, this is a must read." Read more

8 customers mention "Story quality"8 positive0 negative

Customers praise the book's story quality, finding it believable and uncompromising in its detail, with one customer describing it as a riveting narrative that jumps off the page.

"This reads like a suspense novel, but its riveting narrative is all too real...." Read more

"...and polarized political ideologies, it is refreshing to read a very believable and unbiased detail of the innerworkings of the US Executive Branch...." Read more

"This is a compelling personal story of the best intentions of Dr. Shulkin to improve the VA, only to be stonewalled and betrayed by shadowy..." Read more

"...You can feel his heart and soul jump off the page and you can tell he cares deeply for Veterans and VA employees...." Read more

Top reviews from the United States

  • Christopher Duff
    5.0 out of 5 stars Exceptional Page-Turner For Those With An Interest in Healthcare and Government Affairs
    Reviewed in the United States on December 31, 2019
    Verified Purchase
    First, I want to thank Dr. Shulkin for taking the time and effort to write this book when the easy path would've been to move on past his time as a high-ranking U.S. government official, given his depth of service and what he experienced in Washington.

    His book is almost stunningly thorough and well-organized, and is exceptionally informative from multiple vantages. It balances the realities of managing a (very) large healthcare organization with countless moving parts, the myriad issues (e.g. suicide rates) continuing to affect millions of U.S. veterans, as well as the unfortunate difficulties of working within the tumultuous environment that tends to define Washington D.C.

    I'm glad he took the time to point out the nuances involved with each major 'news item' that defined his time as Secretary, such as Cerner's implementation within the VA, giving us an insider's look into the U.S. government at the highest level.

    I also appreciate that he attempted to understand and convey his political adversaries' viewpoints and actions, without noticeable bitterness, presenting them in a more generous and charitable manner than they almost certainly deserved. That lent credence to Dr. Shulkin's account of his time in Washington, in my opinion demonstrating as much objectivity as possible within the framework of a memoir.

    Overall, this is one of the most fascinating books I've read this year, and have no qualms highly recommending it!
    4 people found this helpful
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  • joseph fennelly
    5.0 out of 5 stars A dedicated physician/leader/administrator goes outside to save the VA health system
    Reviewed in the United States on November 21, 2019
    Verified Purchase
    This book is about a skilled leader and dedicated physician, who continued to see patients while Secretary of the Veterans Administration,. One challenge amongst many was to create a vital balance between the medical role of the VA and allowing veterans to have care in the private sector. .
    The fight was against forces that wanted complete privatization. There were vital services that VA hospitals could best handle, e.g. Post-Traumatic Stress Disorder, physical brain trauma, reconstructive surgery from amputations and rehabilitation.
    The title has a double meaning: applying to both those who serve as civilians as well as the veterans who fail to get the care they need.
    Dr. Shulkin was the only remaining secretary from the Obama administration . He was confirmed by the Senate 100-0, the only member of Trump's Cabinet to win unanimous confirmation. "Maybe bipartisanship wasn't totally dead," he writes.
    While perhaps naïve about the politics of Washington – perhaps a virtue- this was balanced by his professionalism, his communication skills, his capacity for collaboration and his passionate dedication to care of the veterans.
    The distorted issues surrounding who paid for his European travel turned out to be the tip of the iceberg; it was raised to create a reason for removing him his high position. Respected media outlets noted for accuracy and truthfulness at times failed to check the veracity of leaked lies that added to the defamations .
    The book is structured efficiently and effectively into 55 short chapters and is an easy read.
    Throughout the book Dr. Shulkin discussed the lack of organization, the breakdown of communication in the White House and the fact that the WH chief of staff did not have control of who was getting to the president. However, Dr. Shulkin approached these issues with grace and absence of vindictiveness. At no time did he overtly criticize his opponents including the Oval office.
    While continuously praised by President Trump this was not enough, to neutralize the powerful forces tending toward complete privatization of VA services, particularly driven by the Koch brothers.
    I would have liked to have seen some discussion about bioethics of end-of-life care. The VA has a long history of improving of end-of- life care, care that is critical to quality of life and to making care more efficient, by excluding inappropriate but expensive death-prolonging interventions.
    The objectivity of the book reflects a model in which Secretary Shulkin viewed obstructionism as a necessary process and challenge to resolve in the service of a larger and more noble cause; better care of our veterans.
    During his tenure he oversaw many significant improvements in the delivery of care.
    I would rate it with 5 stars
    Joseph F Fennelly, M.D..
    3 people found this helpful
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  • Midwestern Still Water
    5.0 out of 5 stars Not Just For Veterans or VA Employees
    Reviewed in the United States on December 3, 2019
    Verified Purchase
    This reads like a suspense novel, but its riveting narrative is all too real. There are elements in every administration who want to privatize VA and are ruthless in their mission. But they are getting better at it.
    Of course - unless you are a veteran or VA Employee - why would this matter to you? As Dr. Shulkin notes, private sector health care (in which he spent the majority of his distinguished career) is ill prepared to address the special needs - let alone the sheer volume - of the 9+ million veterans currently served by the VA.
    By the way, VA trains the majority of health care providers in this country. VA is a leading researcher in global health care (inventing the nicotine patch, shingles vaccination, numerous prosthetics, electronic health record and the list goes on). You will live longer if you receive your treatment through a VA - statistics prove it. You are 10 times LESS likely to experience a medication error at a VA hospital than at a private hospital.
    Other reviewers have commented on his extensive discussion on travel - who paid what. Remember how they ushered him out of office - not for their real reasons (privatization), but for travel expense allegations of which he was later exonerated. It was a coup d’état in a cabinet level agency of the US Government - the truth matters.
    The death of the VA means private sector will provide more costly, less proficient, even shoddy health care - for everyone.
    And the country will completely abandon its promise to those who protect us - "to care for him who shall have borne the battle, his widow and his orphan".
    5 people found this helpful
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  • Robert C. Richardson
    4.0 out of 5 stars Very insightful
    Reviewed in the United States on April 29, 2020
    Verified Purchase
    I was working for our not-for-profit as we helped the VA during his tenure. W saw a bunch of similar and worse directors of the VA during the period I worked for the VA in 2010. It was very insightful the stresses that Shulkin had to go through to be a decent man despite the efforts of others to turn him to the dark side.
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