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Could the USDOE Learn from Veterans Affairs? Some “What ifs…”

May 9, 2017

I just finished reading a NYTimes article by Dave Philips and Nicolaus Fandos profiling David Shulkin, the new secretary of veterans affairs. Dr. Shulkin took office in 2015, being appointed by President Obama after the Veterans Affairs department was scandalized because veterans experienced extraordinarily long wait times to get appointments. Since taking over, Dr. Shulkin has taken on this issue of inefficiency as well as many others to good effect. Indeed, he has done such a good job that President Trump ultimately decided to retain him in that cabinet position and he was confirmed by a 100-0 vote in the Senate. After reading the article I was struck by how his no nonsense approach might be beneficial to the US Department of Education. Here are some emphases Dr. Shulkin places on health care that might transfer to education:

  • Evidence-based decision making: In medicine, examining best-practices and putting them into place is often a life and death decision and the factors associated with poor practices are readily identifiable. As “a tireless student of efficiency” Dr. Shulkin spent his time poring over data to determine how and when post-operative infections occurred, when the most errors occurred during surgery, and when patients experienced the least satisfactory care. He then focussed his organization’s time, effort, and resources on fixing those areas of deficiency. As Philips and Fandos report, “By standardizing best practices, Dr. Shulkin believed, he could save money and patients… he pushed each system he worked in to train its focus on quality. Financial savings, he argued, would naturally follow.” What if USDOE focussed on quality using metrics other than standardized test scores? 
  • Patient-centered service: Throughout the article Philips and Fandos describe incidents where Dr. Shulkin, despite his leadership role, spent time in face-to-face contact with patients to determine the impact of the Veterans Affairs medical services on their lives. In this way he was able to identify how flaws in the system effected those receiving services. What if USDOE insisted that schools talk with parents and students to identify areas where there are gaps? 
  • An urgency to take action: One of the telling anecdotes involved Dr. Shulkin’s impatience with his department’s inability to take quick decisive action in developing a strategy to address suicide. When he was told it would take 10 months to schedule a “summit” of experts to address the issue of suicide among returning veterans, Dr. Shulkin took out a calculator and estimated that 6,000 veterans would die in that time interval. The summit was scheduled in a month. What if USDOE insisted that major issues like racial inequality, the effects of drug abuse on children, and the grinding effects of poverty on children be addressed with that kind of urgency? 
  • A willingness to tackle the toughest political issues: Another telling anecdote involved Dr. Shulkin’s willingness to immediately set up a mechanism to offer “...free mental health care to veterans long barred from its hospitals because of less-than-honorable discharges, including thousands with post-traumatic stress disorder”. There are countless examples of how this might play out in the USDOE. What if USDOE provided funds to schools to provide free mental health care to children who abused drugs? Teen parents? Parents of children who abused drugs? 
  • A refusal to see privatization as the solution: Dr. Shulkin rejects the notion of privatization of veteran’s  hospitals because he realizes that “many of the agency’s patients have a complex mix of physical and mental health issues”, issues that the private sector could not address. He does see the private sector as being able to address some of the routine issues, though. The provision of eyeglasses, hearing aids, and other “routine cases”. What if USDOE recognized that public school students ALL possess and complex mix of physical and mental health issues that do not lend themselves to routinized instruction? 

I have long believed there are parallels between the delivery of medical services and public education… which leads to one final “what if…” What if our society valued teachers as much as they valued medical professionals? 

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