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A veteran deserves the very best health care anywhere. That means sometimes, they should go out into the private sector if something's being done better than the VA.

There will be far greater accountability, dramatically improved access, responsiveness, and expanded care options, but the Department of Veterans Affairs will not be privatized under my watch.

If there is evidence that an employee has broken the law, caused harm to veterans, or have violated the public trust, they should be terminated immediately. Instead, due to overly cumbersome and lengthy arbitrations as well as extensive bureaucratic red tape, VA has not been able to remove employees as quickly as we would have liked.

Accountability is a two way street. We can't just make it easier for us to fire people; we must make it easier for us to hire people. It takes VA an average of 240 days to complete the hiring process for executives joining VA from outside government. We are losing talented people because it simply takes too long.

What we know about American medicine is that our supply of health-care professionals is not equally distributed. In rural areas, we have severe shortages.

I do think that VA, as the largest employer of nurses and the largest health system in the country, often does become a place where we can demonstrate advances in medical practice.

Part of what any good health-care professional does, including an advanced-practice nurse, is know when it is time to seek help from more experienced professionals. I'm a primary care doctor. It doesn't mean I know everything. When something is beyond my competency or expertise, I seek consultation from my colleagues.

VA is a unique national resource that is worth saving, and I am committed to doing just that.

It was clear that VA was in need of reform, and when the president asked for help, I could not say no. First, I felt I could help, and my private sector experience was relevant. Second, that this was my chance to give back to those that had stepped up to serve our country.

I've always approached my job first as a physician. I'm here to help and take care of patients. I'm an administrator second.

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