UNIT II

Administrative Profi le

Montgomery Van Wart is professor

in the Department of Public Administration

at California State University, San

Bernardino. He has served as chair of his

department and dean of the College of

Business and Public Administration. He has

authored nine books, including Dynamics

of Leadership in Public Service,

Leadership in Public Organizations,

The Business of Leadership (with

Karen Dill Bowerman), Administrative

Leadership in the Public Sector

(with Lisa A. Dicke), and, most recently,

Leadership and Culture: Comparative Models of Top Civil Servant Training. E-mail: [email protected]

760 Public Administration Review • September | October 2015

Public Administration Review,

Vol. 75, Iss. 5, pp. 760–769. © 2015 by

The American Society for Public Administration.

DOI: 10.1111/puar.12393.

Abstract: Evaluating less than fully successful transformational leaders is difficult. One common method of assessing leadership is to focus on a single temporal narrative. A second approach uses a particular theory, such as transforma- tional leadership, to frame the analysis. The latter, less common strategy is used with the example of Eric Shinseki, who served as both chief of staff of the U.S. Army and as secretary of the U.S. Department of Veterans Affairs (VA). The analytic framework used here has six major elements that are specified by 22 factors. Using those factors to evaluate Shinseki’s tenure at the VA, he is found to be very poor in only 2 factors but poor in 11, adequate in 6, good in 1, and excellent in only 2. While using a list of factors does not eliminate subjectivity or the challenges of reaching a single assessment, it does clarify the elements of judgment and weighting.

Evaluating Transformational Leaders: Th e Challenging Case of Eric Shinseki and the U.S. Department of Veterans Aff airs

W. Henry Lambright, Editor

Montgomery Van Wart California State University, San Bernardino

Evaluating individual leaders using a biographi-cal approach can be done in many ways. One method that is common in the public admin- istration literature is to focus on a single temporal narrative. Done well, it provides examples of a leader’s successes and failures with a case-based, non-theory- driven presentation, focusing on special contributions, challenges, and values. The narrative method is useful for context-rich, heuristic, and/or celebratory exam- ples (Dodge, Ospina, and Foldy 2005). While this method is likely to enhance “the story,” it is less likely to produce generalizable and replicable analysis.

A second approach is to use a particular theory or recognized model, such as transformational leader- ship, to frame the evaluation; this superimposes a predefined framework on the chronology. A variety of scholars have urged the use of theory-driven analysis for administrative profiles (DiIulio 1990; Lambright and Quinn 2011; Van Wart 2011). For example, Van Wart noted the underutilization of this method in his leadership literature review: “There is great opportu- nity for comparative biography using a more rigorous standardized framework. This has . . . yet to occur with explicit leadership frameworks” (2013, 538). A more theory-driven biographical approach has the advantage of being an extended example of theoretical types and concepts, being more easily integrated into the literature, and being more likely to be relatable to other biographies. Attractive as these advantages are, challenges arise that must be dealt with, including access to sufficient data to flesh out the theory being used, space limitations when using an article format, and the adequacy of a single theoretical model.

This article demonstrates the latter, less common, analytic strategy. It uses the example of Eric Shinseki, who served as both chief of staff of the U.S. Army, where he was largely successful (Kolenda 2003), and as secretary of the U.S. Department of Veterans Affairs (VA), where he was largely unsuccessful and forced to resign after a scandal involving widespread falsified medical appointment wait lists. The article focuses primarily on his tenure as secretary of the Department of Veterans Affairs, where analysis and evaluation of his record as a transformational leader is most difficult.

How Do You Defi ne Transformational Leadership for Applied Settings? Perhaps the most widely known and best respected transformational leadership theory is the full-range leadership theory of Bernard Bass, which was first pro- posed in his book Leadership and Performance Beyond Expectations (1985). It has stood the test of time well as a high-level theoretical model that has been customized for various uses in the public administra- tion literature (Oberfield 2014). It asserts that while transactional leadership is critical for basic organi- zational performance, transformational leadership provides an important additive quality that is neces- sary for keeping organizations at the high-performing end of their production. Bass identifies two transac- tional and four transformational characteristics that contribute to high performance. However, the model as it is typically articulated tends to focus on internal organizational change (because it relies on employee perceptions) over external political forces and non- employee sources of data, neglects crisis management,

Evaluating Transformational Leaders: The Challenging Case of Eric Shinseki and the U.S. Department of Veterans Affairs 761

and poorly articulates transformation as a process rather than as a set of leader characteristics. The model can be adapted, however, by embedding the change management literature. In doing so, multiple sources of information, such as performance statistics, public opin- ion data, and event analysis, are more readily incorporated.

In order to use a theory-based approach in a biographical case study, indicators were chosen to reflect the six factors.

The first transactional characteristic is called management by excep- tion; this aspect of leadership occurs when management reacts to various problems or exceptions. Such problems include dealing with low-performing employees, avoiding future technical mistakes and blunders, addressing performance issues, and stabilizing the organization in a crisis. The second transactional element is called contingent reward; this aspect of leadership is based on the exchange and contractual relationship that exists between employers and employees. The foremost factor in this relationship is pay, but life– work balance is also important.

One of the four transformational factors is individualized considera- tion, which is supportiveness of employees. This can be demon- strated by coaching, delegation, and training opportunities, among other things. A second transformational factor is idealized influence, which is a result of trusting the leader as well as the persuasiveness of the leader. This is demonstrated by the leader modeling exem- plary behavior, avoiding personal scandal, and the use of charismatic communication through symbols, evocative language, and personal dynamism. A third factor is inspirational commitment, which results in employees bonding as a group and transcending self-interests. This is demonstrated by pride in the shared work, on one hand, and teamwork, on the other. The final factor is intellectual stimulation, or the vision, planning, and implementation of change. This critical role of transformational leaders is well articulated in the change man- agement literature. The basics of change management (Fernandez and Rainey 2006) include establishing the need for change, provid- ing a plan, building internal support, ensuring top management support, arranging external support, providing resources, and institu- tionalizing change. In sum, then, 22 items can be used to critique a leader and arrive at the basis for a holistic assessment. The expanded framework, based on Bass, is summarized in table 1.

How Transformational Does a Leader Need or Try to Be? Not all jobs are equally difficult, and this is critically true when trans- formational efforts are undertaken. If general management is hard (Van Wart and Berman 1999), transformational leadership is very hard. While transformational leaders may reap greater “glory,” they also increase the likeli- hood of failure. But not all transformations are equivalent. Therefore, when evaluating leaders, it is necessary to get a clear sense of (a) just how transformational they need or try to be and (b) in comparison to what? One factor is the breadth of task. A second element is the radi- calness of change. A third factor is the complexity of change. A fourth factor is demand on followers. Finally, there is the speed of change.

Another question that must be raised in evaluating transforma- tional leaders has to do with their comparison groups. Still another

Table 1 Framework for the Analysis of Transformational Leaders

Management by exception • Deal with low-performing employees • Avoid technical mistakes and blunders • Deal with performance lapses • Stabilize organization if needed

Contingent reward • Pay • Life–work balance

Individualized consideration • Coaching • Delegation • Training opportunities

Idealized infl uence • Model exemplary behavior • Avoid personal scandal • Use of charismatic communication

Inspirational commitment • Gain commitment to the work and the profession • Teamwork

Intellectual stimulation • Ensure the need for change • Provide a plan • Build internal support • Ensure top management support • Ensure external support • Provide resources • Institutionalize changes • Pursue comprehensive change

contextual factor that should be noted, but that is beyond the bounds of this venue to fully explore, is the role of others, as even transformational leaders do not act alone. To what degree was President Barack Obama culpable in selecting a leader who may have been past his prime and out of his area of expertise? To what degree was the senior leadership in the VA to blame, a number of whom focused more on bonuses than on professionalism? Although the focus here is narrowly on Shinseki, a broader analysis would highlight the shortcomings of others more sharply.

The evaluation of Secretary Shinseki at the VA illustrates not only the importance of systematically analyzing and comparing a leader’s record but also the challenge of making final judgments when many obstacles are not overcome and when crises overshadow accomplish- ments or leave an agency in disarray.

Background on the Department of Veterans Affairs Today, the Department of Veterans Affairs is among the largest agencies in the federal government, with approximately 300,000 employees, a discretionary budget of $63.5 billion in 2014, and $87.5 billion in mandatory benefits. The department comprises 152 hospitals (124 of which are affiliated with medical schools), 800 community-based outpatient clinics, 126 nursing home care units, and 35 domiciliaries. The clinics and hospitals process 230,000 veterans a day and deliver 85 million appointments a year to 6.5 million patients. The Department of Veterans Affairs also provides

many nonmedical benefits, such as educa- tional grants, pensions based on service-related disability, and home loans. A total of 8.5 million veterans receive treatment or ben- efits annually, out of a veteran population of nearly 22 million. This population has been augmented by the post–September 11 con- flicts, but a voluntary military and multiple

deployments have meant that the numbers have not entirely offset the number of veterans dying who were in former conflicts (and peacetime service). While the veteran population has been decreas- ing slightly in recent years as a large share of World War II and Korean War vets have died, the needs of veterans have increased as a

While transformational leaders may reap greater “glory,” they

also increase the likelihood of failure.

762 Public Administration Review • September | October 2015

result of fewer battlefield fatalities but higher injury rates and official acknowledgment of a variety of conditions (labeled “presumptive” conditions by the VA) such as post-traumatic stress disorder.

Quality of care issues have had a roller-coaster history in the Department of Veterans Affairs and its predecessors (Moore 2014). In the twentieth century, while there have been a number of times when the agency allowed quality of care to disintegrate and mis- management was rife and sometimes appalling, there have also been substantial highlights, too. One important event was when the VA aligned itself with medical schools across the country after World War II, creating a highly synergistic effect for both veteran care and the medical training of the bulk of American doctors. Another great era for the VA was during the second half of the 1990s, when Kenneth Kizer, a medical doctor, was named to head the Veterans Health Administration. In his five years as medical director of the VA health system, Kizer introduced quality of care metrics, systemic feedback loops to reduce error rates, and computerized patient records, and he also rationalized service imbalances (Edmondson, Golden, and Young 2008; Kizer and Dudley 2009). The effects were dramatic, leading some to assert that VA health care was second to no other health maintenance organization (Longman 2007) by 2000 and that the effects have been relatively lasting (Glastris 2010; Pear 2014). While health care issues of significance have occasion- ally occurred in its more than 1,000 facilities, systematic health care lapses generally have been minor and oversight rigorous with a cur- rent well-staffed Inspector General’s office of more than 600, as well as a separate Office of the Medical Inspector that assesses quality of care problems or concerns.

Access to the VA system as a new enrollee (commonly known as “patient wait times”) and receipt of timely payments for benefits have long been issues. In 2001, the General Accounting Office issued a report about appointment time issues, and subsequent reports have confirmed the ongoing problem. Benefits payment problems seemed to start after the 1988 decision to allow federal court appeals of VA decisions, which, in turn, made the adjudica- tion of veterans’ claims far more litigious and extensive (veterans can appeal decisions numerous times without penalty); routine payments have lagged ever since, and complex cases frequently take years to resolve.

Eric Shinseki’s Background and Rise to Chief of Staff of the Army Eric Shinseki was born on November 28, 1942, in Hawaii, where he grew up. In high school, he was a Boy Scout and served as class presi- dent. He attended the U.S. Military Academy at West Point, graduat- ing in 1965. Among his early assignments, he served two combat tours in Vietnam. During that time, as a forward artillery observer, he stepped on a land mine, which blew off the front of one of his feet. Although it took him nearly a year to recover, he returned to active duty, which was unusual. He rotated among various commands, among which was a 10-year period in Europe. In 1997, he became a general after 32 years of ser- vice. In 1998, he assumed the important role of chief of staff of the U.S. Army, reporting directly to the secretary of defense. In 2003, he retired from military service.

As administrator in charge of the army, Shinseki largely designed its relatively radical reorganization (Moran 2007), and he was occasion- ally the subject of controversy. On the more successful side, he helped move the army from a conventional warfare army relying on large, heavily equipped divisions to one composed of “modular” brigades that could move independently, with some that could be lightly armored for strategic deployment as needed (Johnson et al. 2012). His most unpopular decision in terms of soldiers was his order to expand the use of the elite Rangers’ black beret for all army personnel.

His interactions with his political superiors while he was chief of staff were equally important. Within a year after the September 11 terrorist attacks on the United States, the George W. Bush admin- istration was preparing for the possibility, and perhaps likelihood, of a war with Iraq based on allegations of ties to the terrorist group al-Qaeda and the belief that Iraq had weapons of mass destruc- tion (Hersh 2003). With significant tension between Shinseki and Secretary of Defense Donald Rumsfeld over philosophical differ- ences regarding the size of the military footprint necessary for army incursions, Shinseki announced his retirement nearly a year before it was to become effective, and Rumsfeld, with unusual haste, named his replacement soon thereafter. Later, when asked to testify before the Senate Armed Services Committee in February 2003, Shinseki stated that it would take “several hundred thousand soldiers” to secure Iraq after an invasion because of the size of the territory and ethnic tensions; this was strongly contradicted by Secretary Rumsfeld. Ultimately, Shinseki’s recommendation to plan on a larger ground force for longer-term peacekeeping was considered prescient (Ricks and Tyson 2006).

Shortly after Shinseki’s retirement as army chief of staff, he pub- lished a book (as second author) with Frances Hesselbein titled Be-Know-Do: Leadership the Army Way (2004), which was published in conjunction with the Leader to Leader Institute. In the book, Shinseki and Hesselbein assert that the “Army’s record for develop- ing leaders is superb” (xv) and that “all leaders can benefit” (xviii) from the way the army teaches leadership, and they provide lessons from the army for civilian organizations in all chapters. The book is consistent with the contemporary mainstream leadership litera- ture emphasizing leader character, empowerment, being a model, teamwork, focusing on change management, and providing the tools and support to be a learning organization. However, there are several ironies. First, Shinseki frequently was unable to live up to his own advice when he was given the chance at the VA, as quotes from the book will indicate. Second, his fundamental assump- tion that the leadership found in the army is easily transferred to civilian organizations with very different missions and cultures is highly suspect. Army leadership draws on extensive basic training, and thus inculcation, in a hierarchical setting that is not present in most civilian organizations outside public safety. Although the VA

may have former soldiers as its clientele (but who seek services as civilians), it is primarily a professional organization that tends to value professional over bureaucratic discipline.

Eric Shinseki as Secretary of the VA As a senator, Barack Obama served on the Senate Committee on Veterans’ Affairs and thus knew the veterans policy area well. As a

Army leadership draws on extensive basic training, and

thus inculcation, in a hierarchi- cal setting that is not present in most civilian organizations

outside public safety.

Evaluating Transformational Leaders: The Challenging Case of Eric Shinseki and the U.S. Department of Veterans Affairs 763

candidate for president, he spoke regularly about the importance of improving the Department of Veterans Affairs, stressing “compre- hensive reform” and the poor service and care at some facilities that was “totally unacceptable,” often calling the situation “a betrayal” and, even occasionally, “an outrage” (Obama 2008; see also Kaczynski 2014). Obama advocated expanding benefits, eliminat- ing means testing, and adding funding to help eliminate homeless- ness among veterans. He also asserted that his “Secretary of the Veterans Administration will be just as important as my Secretary of Defense” (Obama 2007). When President-Elect Obama announced his intention to nominate Shinseki on December 7, 2008, it was with the expectation that Shinseki would institute major reforms and get more attention from the president than is common. In mak- ing his selection, Obama chose a former military man rather than a health or other social service administrator.

During his nomination hearing on January 14, 2009, Shinseki was closely, but politely, interrogated about how he would deal with many issues, among them wait time problems in receiving benefits and initial appointments (U.S. Senate 2009). Shinseki’s Senate nomination was uncontroversial, and he was unanimously confirmed on January 20. Upon taking office, he acknowledged the challenges that he would face as he and the president committed to expanded service for veterans while having to deal with “budgetary pressures, given the state of the economy” (Shinseki 2009). In the Veterans Health Administration and elsewhere, Shinseki called for a culture of change. Under his leadership, the VA “adopted three guiding princi- ples to govern the changes under way, namely being people-centric, results driven, and forward-looking. These principles are reflected in the 16 major initiatives that serve as a platform from which transfor- mation is being executed,” according to the agency’s website.

By the end of his first year, Shinseki had done his initial outreach, put his senior executive team in place, and provided the goals for transformation to the agency. After this, his style was to rely on briefings from his direct reports; his contact with the field and even with his 22 regional directors was extremely limited. Despite the employee uptick in confidence when Shinseki initially took office, he began to decline in all categories except fairness, a trend that con- tinued throughout his tenure, as reported by agency employees in annual surveys (see table 2 for employee perceptions over time). His communication style was consistently formal and stiff. The culture

that was established was considered hierarchical and top-down and, over time, intolerant of dissent (Office of the Inspector General, U.S. Department of Veterans Affairs 2014) and “toxic” (Pear 2014). While he was involved in disciplining senior employees during his first year in response to a widespread scandal involving colonosco- pies inducing dangerous infections, he rarely was involved in disci- pline thereafter. Indeed, this was in contrast to the issue of executive bonuses, which frequently cropped up in critical news pieces (e.g., Shinn, Moore, and Rich 2013).

Over his tenure, Shinseki was very successful at getting higher levels of funding (in concert with the president and with Office of Management and Budget support). However, the vast bulk of the funding went to benefits expansion (mandatory expenditures) and new initiatives. The discretionary increases (administrative infra- structure) became largely focused on keeping up with the increased workload.

Administratively, the major goals of reductions of benefits wait times and patient wait times were challenging. The 125-day goal for benefits payments improved and deteriorated multiple times over his tenure as the new armies of benefits clerks were overwhelmed by the new demands placed on them. While there are many contribut- ing factors to the backlog, one aspect of conspicuous weakness was the delay in making veterans’ files electronic, as had been done suc- cessfully with medical records in the 1990s. This has been projected to be completed by 2016, and pilot programs have shown consider- able increased efficiencies.

A quietly momentous event was when Shinseki signed off on an order to decrease patient wait times from 30 to 14 days (to be implemented in 2011), tying performance bonuses to improve- ments in meeting this goal (Brunker 2014). In retrospect, this was widely perceived as an enormous management error that was unre- alistic, causing unsustainable pressure on the system (Kesling and Nissenbaum 2014). Sadly, the data used for this decision were woe- fully inaccurate, and Shinseki ignored recurring, successive reports about the continuing problem in this area (Philpott 2014).

Although Shinseki was good at working with Congress in the tech- nical budget authorization process, he was unsuccessful at keeping the agency from becoming a political proxy leading up to President

Table 2 Employee Perceptions in the U.S. Department of Veteran Affairs, 2009 and 2014 (percentage of those rating the category satisfactory or highly satisfactory)

Category 2014 Rank among Largest Agencies* 2014 Score** 2009 Score

Employee satisfaction and commitment 18 of 19 54.6 66 Effective leadership and empowerment 18 of 19 39.2 46.4 Effective leadership and fairness 18 of 19 48.7 48.9 Effective leadership: Senior leaders 17 of 19 38.2 44.9 Employee skills–mission match 7 of 19 76.4 82 Pay 19 of 19 44.9 55.4 Strategic management 12 of 19 52.0 61.6 Teamwork 18 of 19 58.8 70.5 Training and development 11 of 19 56.1 63.9 Work-life balance 17 of 19 54.9 60.5 Performance-based rewards and advancement 18 of 19 38.2 44.3

*The responses of employees were being collected while the scandal was unfolding, thus likely affecting some categories such as senior leadership effectiveness and strategic management, in which larger drops were recorded. **The overall perceptions of federal employees declined in the 2009–14 period, but the VA has outstripped this trend. Source: Partnership for Public Service.

764 Public Administration Review • September | October 2015

Obama’s second midterm election in 2014. The Democrats, led by independent Senator Bernie Sanders, pushed for an enormous benefits expansion bill in February 2013, virtually blocking all Republican input. The Republicans, feeling forced to success- fully vote down a bill that they perceived to be “budget busting” (Ponder 2014), were soon able to use the revelation of hidden wait lists at VA medical facilities to get their revenge and improve their position for the upcoming election (Fram 2014). Shinseki’s insen- sitivity to political issues, previously seen in the 2003 surge debate, left him vulnerable when he would have needed nimble reflexes and public relations acumen.

The scandal began when a whistle-blower reported a patient wait time cover-up in the Phoenix VA facility in which 40 patients died while waiting for appointments. The story was immensely popular with the media, was proof to many Republican lawmakers of the bad management they had been alleging, and drew great public outrage. The president himself called for an investigation of the Phoenix medical care system and an assessment of the scope of the problem on April 28, 2014. The “scandal” ultimately was not simply about the wait times, which had been problematic for years, but, more importantly,

• The fact that the problem had been “covered up,” with false information provided to both the public and Congress

• The vast scope of the problem at facilities across the country • The apparent lack of concrete action by Shinseki and his

administration, even though official reports of “gaming” the system had been intermittently issued since 2001 (Office of the Inspector General, U.S. Department of Veterans Affairs 2014)

Shinseki took a series of disciplinary actions, including pressing the early retirement of the VA’s undersecretary of health, Robert Petzel, forcing some resignations, and putting the director of the Phoenix facility on leave because she refused to resign. While Obama initially stood by Shinseki, after the VA Inspector General issued its interim report, the president called him to the White House, and Shinseki resigned on May 30, 2014. In his last speech before resigning, Shinseki said, “I was too trusting of some, and I accepted, as accu- rate, reports that I now know to have been misleading with regard to patient wait times.” He apologized to veterans, their families, members of Congress, and veterans service organizations and took responsibility (Shinseki 2014).

Subsequent to Shinseki’s resignation, additional allegations were raised related to vacancy tracking gaps (Giblin 2014), loss of public and veteran support (Pew Research Center 2013), inattention to numerous management issues, and incompetence in change management and transformational leadership practices. Shinseki’s successor, Robert McDonald, a former private sector chief executive officer, was appointed to address the problems a few months after Shinseki’s resignation. McDonald’s “honeymoon” was short-lived, as his ability to fire senior VA executives under new legislation was found to be over- stated and insufficient by some members of Congress (Zoroya 2015), and the agency has yet to be able to provide documentation of improvement in management, as the agency

landed on the Government Accountability Office’s high-risk list for the first time in 2015.

Evaluating Shinseki’s Record as a Transformational Leader at the VA We can now apply the expanded Bass framework to Shinseki’s record to get a balanced picture of his success and failure as a trans- formational leader. Then we can use the contextual analysis to place his performance in a broader perspective.

The following is an assessment of Shinseki’s performance based on the six factors and 22 competencies identified earlier. Summative evaluations in each area use five qualitative standards: very poor, poor, adequate, good, and excellent. Adequate is equivalent to acceptable, and scores of very poor and excellent are meant to be unusually high or low praise.

Management by Exception (Maintain or Restore Organizational Operations) Deal with low-performing employees. Shinseki handled the colonoscopy scandal in 2009 with fi rmness, but thereafter he took a hands-off approach to disciplining unacceptable performance. The agency has never been good in this dimension; under Shinseki, it deteriorated dangerously, as performance-based rewards and advancement data from employees indicate. On average, he was very poor in dealing with low-performing employees.

Avoid technical mistakes and blunders. Shinseki had been good as a manager in organizing competent systems and arranging the elements of transformation when he was in the army, but by being out of his expertise in the VA and out of touch with frontline executives, his competence in this area plummeted. In particular, his decision to implement a 14-day wait time requirement for physician appointments was an enormous mistake. He had an opportunity to correct this important blunder but did not. Additionally, having no experience in the major systems of the Department of Veterans Affairs—medical and social services—he was unable to anticipate problems or personally know best practices. On average, he was very poor at avoiding technical errors.

Deal with performance lapses. Shinseki did a good job of expanding the use of performance metrics early in his tenure to drive improvements in quality and timeliness. However, by the end of his tenure, the use of performance metrics had become overwhelming and unfocused (Kizer and Jha 2014). Furthermore, he did only an adequate job of addressing the organizational defi ciency in benefi ts wait times because of how long it took him to fi x the problem. Surprisingly, he did a very poor job of addressing patient appointment wait times because of manipulated data. Intellectually, he knew better. Years before, Shinseki had warned

transformational leaders that “just because a leader sets a good ethical example doesn’t necessarily mean subordinates will follow it. Some of them may feel that circumstances justify unethical behavior. Therefore, leaders must constantly pay careful attention to the team’s current ethical climate and take prompt action to correct any discrepancies between it and the highest standards”

Leaders must constantly pay careful attention to the team’s

current ethical climate and take prompt action to correct any

discrepancies between it and the highest standards.

Evaluating Transformational Leaders: The Challenging Case of Eric Shinseki and the U.S. Department of Veterans Affairs 765

(Hesselbein and Shinseki 2004, 99). On average, he was poor at dealing with performance lapses and failed to follow his own advice.

Stabilize organization if needed (crisis leadership) and deal with crises that emerge. Although the VA that Shinseki inherited was underfunded and low performing in many categories, it was not in a state of crisis. It had largely recovered from the terrible reputation it had acquired in the 1970s as a result of the outstanding work of Kenneth Kizer in the quality of health care arena. Shinseki did a good job of dealing with modest crises initially. However, he completely failed in anticipating the emergence of the patient wait time crisis and was slow to respond, leaving the agency in turmoil. On average, he did a poor job of managing crises because he failed when it mattered most.

Contingent Reward Pay. Shinseki failed to acknowledge pay as a critical factor in the VA system. Because of low pay standards, reliance on bonus pay was critical to morale. Used properly, differential bonus pay can be a powerful tool for increasing performance standards and rewarding high-performing individuals. However, the employee opinion data indicate that base pay was consistently problematic relative to other federal agencies and that bonus pay was not used effectively to discriminate among employees. The disbursement of bonus pay was regularly pointed out when agency shortcomings were reported by the media. Of course, changing pay levels is exceptionally diffi cult in government systems, and even cost-of-living adjustments were reduced or eliminated in the aftermath of the recession of 2008, so his maneuverability in this regard was limited. Nonetheless, despite his own advice to “take care of your people” (Hesselbein and Shinseki 2004, 65), on average, Shinseki was poor in handling the pay issue because he refused to even acknowledge it.

Life–work balance for employees. Although Shinseki brought many resources to the agency, he expanded the scope of work even faster, and employees felt hard-pressed to keep up. Life–work perception data from employees declined signifi cantly during his tenure, and he did little to address the issue. On average, he was poor at handling the life– work balance because he stayed in “emergency mode” for too long.

Individualized Consideration (Supportiveness of Employees)

Coaching. Shinseki did set up opportunities for the executive team to learn about the transformational plan that he had created with the aid of the White House in the beginning of his tenure. After the fi rst year or so, however, there is little indication that an environ- ment of coaching existed at any level. On average, Shinseki did a poor job of coaching and providing a model that coaching was important.

Delegation. Although the VA has never been high in terms of employees feeling they have discretion or empowerment because of pressures for legal and organizational uniformity across the system and quality control in line with health care and insurance industry standards, this declined signifi cantly under Shinseki to very low

levels (Kizer and Jha 2014). Despite his own observation that “many organizations claim to have fl attened the hierarchy and empowered employees . . . but in our experience, there is a large amount of wishful thinking in these claims” (Hesselbein and Shinseki 2004, 21), he seems to have fallen into the trap he warned others about. On average, Shinseki did a poor job in terms of delegation at the VA over time.

Training opportunities. This had been one of the agency’s relative strong points, according to employee perceptions. Given the technical nature of the work of the agency the and amount of change in legal requirements and professional standards, a robust training environment is important. This dimension declined somewhat during Shinseki’s tenure; on average, he was poor in this dimension.

Idealized Infl uence (Trust and Charisma) Model exemplary behavior. While perceptions of fairness had not been a past strength of the agency, they increased during his tenure, only declining after the wait time scandal broke. Even so, he modeled the values of integrity that he asserted were critical in transformational leadership (Hesselbein and Shinseki 2004), and his integrity was relatively unchallenged, even in the depths of the scandal that pushed him out of offi ce. While overwhelmed by other factors, on average, Shinseki was excellent in modeling exemplary ethical behavior.

Avoid personal scandal. Although federal agency executives are less prone to personal scandal than their political cousins, they are

hardly immune. Alexander Hamilton stepped down from his powerful offi ce at the Treasury because of an extramarital affair, as did the highly popular former military man David Petraeus at the Central Intelligence Agency in 2012. Shinseki was never involved in any issues that impugned his propriety and, on average, was excellent at avoiding personal scandal.

Use of charismatic communication: Symbols, evocative language, dynamism. As Bennis and Nanus (1985) noted, charisma is not required to have idealized infl uence, but it is a contributing factor. Shinseki was never praised for his magnetism or motivational talks. Indeed, his speeches tended to be devoid of symbols, evocative language, and dynamism; he was thought to be aloof, stubborn, and haughty by many (but not all) people who observed him. On average, in terms of personal presence, he was poor.

Inspirational Commitment (Transcending Self-Interests) Commitment to the work and professionalism, even under adverse conditions. The strongest aspect of the agency from employees’ perspective is the employee skills–mission match, which remained at a high level even though it declined signifi cantly during Shinseki’s tenure. Belief in the quality of senior leadership is important in instilling inspirational commitment, but this declined from being poor/adequate to being very poor. Events themselves indicate an uneven commitment to the agency’s mission, despite professional and personal passion for the mission. On average, Shinseki did a poor job, despite his advice to leaders about

Although federal agency executives are less prone to personal scandal than their political cousins, they are

hardly immune.

766 Public Administration Review • September | October 2015

“building morale and determination to win” (Hesselbein and Shinseki 2004, 78), in enhancing the culture of the VA in this dimension.

Teamwork. When Shinseki came into the VA, he initially pushed teamwork in the agency to a high level. However, that sense of teamwork declined rapidly as a more top-down culture emerged. On average, Shinseki’s sustained contribution to a culture of teamwork was poor.

Intellectual Stimulation (Vision, Planning, and Implementation of Change; Change Management) Ensure the need. On one hand, Shinseki did a good job of addressing the need to expand veterans’ benefi ts, which had been fl atlined for too long. On the other hand, be overlooked the need to address basic administrative competence and organization issues fi rst so that greater demand could be met. On average, although the expanded benefi ts need was morally appropriate and the capacity to implement the change was plausible, Shinseki can only be evaluated as being adequate because his long implementation timeline put results at risk.

Provide a plan. Shinseki provided a 16-point plan within a year of becoming head of the VA; he considered this one of his great strengths. Initially, employees evaluated strategic management under his leadership favorably, although those perceptions declined over time as a loss of focus became problematic. A few goals in the plan were unrealistic or too long to complete. Despite his focus on this element, Shinseki can only be evaluated as adequate on average.

Build internal support. Parallel with related factors such as encouraging commitment and teamwork, Shinseki’s long-term ability to sustain internal support for transformational efforts waned. For example, when Shinseki fi rst took over as secretary, employee satisfaction was on par with that of other federal agencies. However, it continued to decline until the agency was rated as the second-worst place to work, only after the unpopular Department of Homeland Security. While Shinseki did not have internal opposition, most of his support was based on legitimate power and bonuses and lacked suffi cient internal motivation. Shinseki can only be evaluated as adequate in this regard.

Ensure top management support. In this case, it was the president and his staff, such as the Offi ce of Management and Budget, who would establish budget priorities. Shinseki always synchronized with the president, and his budget increases over time refl ected his high support from this quarter. Although he ultimately was pushed out by the president, Shinseki had been abandoned by all other major constituencies, leaving the president little choice as the scandal unfolded. As a change manager, he was good in this specifi c dimension.

Ensure external support. External support for Shinseki resided with Congress and the veterans service organizations that interact with the agency and Congress. Through most of his tenure, Shinseki had good relations with both groups. However, his skill at working in a dynamic, and exceedingly partisan, political environment was defi cient. Shinseki was unable to anticipate the ferocity of the assault on him and the agency despite numerous signals sent by

Republicans. Critically, he was unable to distance himself and his agency from the political “hot potato” legislation to greatly expand veteran benefi ts in 2014, and when the opportunity to strike back at Democrats and the president occurred with the Phoenix health care facility scandal, he only made the political opportunity more appealing to Republicans because of the mild distaste many had for him. He quickly transformed from an adequate head in charge of a frustrating agency to an out-of-touch head in charge of an out-of- control agency. Similarly, in terms of public opinion, the agency was well considered despite occasional issues reported by the press; however, because Shinseki did not have a connection with the public before the crisis, he was quickly demonized when it unfolded. He can only be evaluated as adequate in this category.

Provide resources. On one hand, Shinseki presided over enormous increases in resource gains for the agency. Mandatory increases (primarily for expanded benefi ts) grew by 86 percent from 2009 to 2014. However, the discretionary budget only grew by one-third, making it hard to catch up with increasing service demands over time. While he was excellent at securing new funds overall, he was poor at providing a good mix of resources. On average, he was adequate in providing resources.

Institutionalize changes. Most of Shinseki’s individual goals had a 2016 deadline. He was making good progress in benefi t wait times, seemed to have largely fi xed the patient wait time problem (but had not), and had made signifi cant progress in reducing homelessness but was far from eliminating it. Not only did the scandal reveal the inaccuracy of the patient wait time goal, but also it distracted the agency from its other goals and damaged to its reputation. Ironically, the publicness of his failure enabled the agency to get funding in the areas where it needed it (which would not have been the case had the February 2014 legislation passed), as well as to address some long-term issues that Shinseki had failed to adequately confront such as employee pay. It is diffi cult to assess how much credit he should receive, but in the short term, an evaluation of poor is the highest evaluation for transforming the organization that seems appropriate.

Pursue comprehensive change. The broader desire of the president and Shinseki was not only about coping with the demands placed on a system as defi ned in 2008, or about being more user friendly, but also about greatly expanding benefi ts provided. Here, there was a vast improvement in terms of including new benefi ts; this access to care was institutionalized in mandatory budget allocations. While this expansion of services may have made speedier service an elusive target, there is little doubt that VA funding will remain more comprehensive for years to come. However, this structural expansion of services is balanced by the strain put on other areas of the agency and the exceptional stress put on the VA by the scandal. On balance, his very mixed record in this area can be considered adequate.

Qualitatively, then, using this analysis of factors contributing to suc- cessful transformation, Shinseki was excellent in 2 of the 22 factors, good in 1, adequate in 6, poor in 11, and very poor in 2. If Shinseki were rated by his lowest scores, which often occurs when a widely reported but little-understood scandal occurs, then Shinseki was a very poor transformational leader worthy of the disgrace he suffered.

Evaluating Transformational Leaders: The Challenging Case of Eric Shinseki and the U.S. Department of Veterans Affairs 767

This is a harsh judgment for a man who successfully expanded services to veterans at a time when most Americans have retired. If Shinseki were evaluated more holistically by his median score, then he ranks as a poor leader because of the many challenges he failed to overcome. If one looks at the qualitative mean of his individual performance assessments, he is halfway between poor and adequate. This evaluation as somewhat subpar is certainly less than admirable, but also less of an indictment. If one focuses on the role he played in expanding services, the attempts he made to increase organizational effectiveness while demand grew, and his integrity throughout the process, then Shinseki could be rated a good but flawed transforma- tional leader who led his agency to the “promised land,” although he himself could not enter. The final assessment depends on one’s point of reference in interpreting the importance of his various efforts.

Evaluation of Shinseki’s Context The assessment of Shinseki is tempered by his context. Is he being compared with the administrative “greats” of federal administra- tive history, to the average secretary in his own agency over time, or to contemporary peers in the federal government? Five factors can be used to provide a basis for comparison.

1. Breadth of task: The breadth was quite broad because of major problems that Shinseki faced and the major initiative (homelessness) that the agency acquired during his tenure. Only the quality of medical care was in good condition when Shinseki took over, and years of underfunding had left the agency in a weakened state.

2. Radicalness of changes: Ironically, the radicalness of change was significantly less than the transformation of which he was a part in the army, where the entire structure was shifted for the first time since World War II.

3. Complexity of change: The complexity was relatively great because of the massiveness of the overlapping systems and the level of political intrusiveness of veterans service organi- zations, Congress, and the White House.

4. Demands on followers: The demand on followers was great because of underfunding, new programs, and the constant stress to increase productivity in numerous areas.

5. Speed of change: Although system transformation takes a long time, Shinseki had five years to accomplish the first round of changes. He had planned on having until 2015 to accomplish his goals, but a significant amount of his progress unraveled in the scandal, and it is unlikely that he would have fully achieved the goals he set for himself.

Overall, his challenges were substantial but not extraordinary. From the viewpoint of his own agency, none of his successors had striven for such a degree of transformation, and none had presided over such an increase in funding. Only one person in the agency, Undersecretary for Health Kizer, who served in the 1990s, can be said to have taken on such a transformational role, and was certainly one who was far more successful in his respective position.

Shinseki was not alone in the Obama cabinet regarding the level of challenges; in fact, it could be argued that many had greater challenges, such as in implementing the Affordable Care Act at the

Department of Health and Human Services. In this perspective, Shinseki’s challenges—more defined by the president than by the agency—were probably comparable but certainly not exceptional compared with his peers. Yet it also needs to be noted that being a transformational leader in a federal agency is a relatively rare feat, and the highly politicized environment in which the Obama presidency has operated has made transformation that much more difficult, as many agency secretaries and heads have learned.

Conclusion While the evaluation of great transformational leaders in senior administrative positions is rather easy, they are, in reality, scarce. In contextual terms, few administrative leaders have the circumstances or desire to be truly transformational, as Kaufman (1981) demon- strated. On the other hand, administrative leaders can be transfor-

mational under select circumstances and with sufficient will, skill, and some luck, as Doig and Hargrove (1987) also showed. Because being a transformational leader is hard, it is all the more important to evaluate without prejudice those who strive and fall short. To be fair, one should have a good yardstick— which is to say, a tested theory or framework in advance of the evaluation—and one should

be able to make comparative judgments across agencies and/or over time.

The evaluation of Shinseki as secretary of the Department of Veterans Affairs has both its challenges and ironies. It is challeng- ing because he ranked well in some of the 22 indicators but poor in most of them. Do you “average out” his performance in making a global assessment, assert that a leader is only as good as his weakest link, or give the leader the benefit of the doubt for their efforts? Or do you simply leave the assessment as mixed and decline to general- ize? Whatever strategy is used from the holistic assessment, how- ever, the real work of assessment is in a systematic review of their performance as transformational leaders. Additionally, to put the accomplishment in perspective, how does the leader compare with predecessors and peers? Because of the scandal that ended Shinseki’s career at the VA, most would likely place him at the bottom of that list. Because of the lack of interest by his predecessors in being trans- formational (creating a very low bar), he ranks above them, given his extraordinary success in elevating permanent funding levels, despite the internal challenges he failed to address in an adequate or timely manner.

The greatest irony, perhaps, is comparing Shinseki to himself. As chief of staff of the army, he was the initial architect of the move- ment from a conventional divisional structure to the more highly articulated and rapidly mobile brigade structure in use today. He also accurately warned that the transformation of Iraq would not occur in its conquest but rather in being able to keep it subdued with sufficient military force while nation building was imple- mented. Because his departure from the army was earlier than he would have liked, and because he was publicly overruled on his forecast, Shinseki expressed eagerness for a second chance that he really did not need. When offered, he took on a challenge at the VA at age 66, one with which he had little experience. It was more complex than he anticipated, and it was harder for him to master

Administrative leaders can be transformational under select circumstances and

with suffi cient will, skill, and some luck.

768 Public Administration Review • September | October 2015

the details as instinctively as he had in the army. Indeed, the use of a typical military command style in a civilian agency dominated by a professional health focus was a major aspect of his downfall; he did not adapt his style. In the end, despite progress in policy goals (expansion of benefits and services), technical difficulties mounted and ultimately erupted. Nor did he change the internal culture; rather, the internal culture declined substantially during his tenure, with lower morale in general and strains of corruption that he did not detect until it was too late. To the degree that Shinseki can be considered a successful transformational leader, it is based on his admirable success in the army, and not his experience in the VA, which, sadly, ended in humiliation.

References Bass, Bernard M. 1985. Leadership and Performance Beyond Expectations. New York:

Free Press. Bennis, Warren, and Burt Nanus. 1985. Leaders: Strategies for Taking Charge. New

York: Harper & Row. Brunker, Mike. 2014. Performance Mismanagement: How an Unrealistic Goal

Fueled VA Scandal. NBC News, June 25. http://www.nbcnews.com/storyline/ va-hospital-scandal/performance-mismanagement-how-unrealistic-goal-fueled- va-scandal-n139906 [accessed April 20, 2015].

DiIulio, John J., Jr. 1990. Leadership and Innovation: A Biographical Perspective on Entrepreneurs in Government. Journal of Policy Analysis and Management 9(1): 116–26.

Dodge, Jennifer, Sonia M. Ospina, and Erica Gabrielle Foldy. 2005. Integrating Rigor and Relevance in Public Administration Scholarship: The Contribution of Narrative Inquiry. Public Administration Review 65(3): 286–300.

Doig, Jameson W., and Erwin C. Hargrove, eds. 1987. Leadership and Innovation: A Biographical Perspective on Entrepreneurs in Government. Baltimore: Johns Hopkins University Press.

Edmondson, Amy C., Brian R. Golden, and Gary J. Young. 2008. Turnaround at the Veterans Health Administration. Harvard Business School Case no. 608-061.

Fernandez, Sergio, and Hal G. Rainey. 2006. Managing Successful Organizational Change in the Public Sector. Public Administration Review 66(2): 168–76.

Fram, Alan. 2014. Republicans Block Senate Bill to Boost Veterans’ Benefits. Christian Science Monitor, February 27. http://www.csmonitor.com/USA/ Latest-News-Wires/2014/0227/Republicans-block-Senate-bill-to-boost-veterans- benefits [accessed April 20, 2015].

Giblin, Paul. 2014. VA Didn’t Track Vacant Medical Jobs until This Year. Arizona Republic, November 16. http://www.azcentral.com/story/news/arizona/investi- gations/2014/11/16/veterans-affairs-vacant-medical-jobs/19153069/ [accessed April 20, 2015].

Glastris, Paul. 2010. Phillip Longman Discusses His Book, Best Care Anywhere, with Paul Glastris. April 30. https://www.youtube.com/watch?v=kbI25J8C2Dc [accessed April 20, 2015].

Hersh, Seymour M. 2003. Selective Intelligence: Donald Rumsfeld Has His Own Special Sources: Are They Reliable? The New Yorker, May 12. http://www. newyorker.com/magazine/2003/05/12/selective-intelligence [accessed April 20, 2015].

Hesselbein, Frances, and Eric K. Shinseki. 2004. Be-Know-Do: Leadership the Army Way. San Francisco: Jossey-Bass.

Johnson, Stuart E., John E. Peters, Karin E. Kitchens, Aaron L. Martin, and Jordan R. Fischbach. 2012. A Review of the Army’s Modular Force Structure. Santa Monica, CA: RAND Corporation.

Kaczynski, Andrew. 2014. 7 Times Barack Obama Promised to Reform the VA. BuzzFeed News, June 2. http://www.buzzfeed.com/andrewkaczynski/ 7-times-barack-obama-promised-to-reform-the-va#.olDqzLaqkx [accessed April 20, 2015].

Kaufman, Herbert. 1981. The Administrative Behavior of Federal Bureau Chiefs. Washington, DC: Brookings Institution.

Kesling, Ben, and Dion Nissenbaum. 2014. VA Goal to Slash Wait Times Was “Unrealistic,” Aide Said. Wall Street Journal, May 23. http://www.wsj.com/ articles/SB10001424052702303749904579580473122138420 [accessed April 20, 2015].

Kizer, Kenneth W., and R. Adams Dudley. 2009. Extreme Makeover: Transformation of the Veterans Health Care System. Annual Review of Public Health 30: 313–39.

Kizer, Kenneth W., and Ashish K. Jha. 2014. Restoring Trust in VA Health Care. New England Journal of Medicine 371(4): 295–97.

Kolenda, Christopher D. 2003. Courageous Leader in Rocky Times. U.S. Naval Institute Proceedings 129(8). http://www.military.com/NewContent/0,13190,NI_ Leader_0803,00.html [accessed April 20, 2015].

Lambright, W. Henry, and Madison M. Quinn. 2011. Understanding Leadership in Public Administration: The Biographical Approach. Public Administration Review 71(5): 782–90.

Longman, Phillip. 2007. Best Care Anywhere: Why the VA Health Care Is Better than Yours. San Francisco: Berrett-Koehler.

Moore, Colin. 2014. How VA Scandals Have Made the VA Better. Monkey Cage (Washington Post blog), May 22. http://www.washingtonpost.com/blogs/mon- key-cage/wp/2014/05/22/how-va-scandals-have-made-the-va-better/ [accessed April 20, 2015].

Moran, Michael. 2007. U.S. Army Force Restructuring, “Modularity,” and Iraq. Council on Foreign Relations, October 26. http://www.cfr.org/iraq/us-army-force- restructuring-modularity-iraq/p14212 [accessed April 22, 2015].

Obama, Barack. 2007. Senator Obama Speech at the 2007 Veterans of Foreign Wars Convention, May 12. https://www.youtube.com/watch?v=H4atLxLkqjc [accessed April 21, 2015].

———. 2008. Presidential Candidate Obama on Veteran Affairs Department 5-12-08. https://www.youtube.com/watch?v=aoGm_SmLYDs [accessed April 21, 2015].

Oberfield, Zachary W. 2014. Public Management in Time: A Longitudinal Examination of the Full Range of Leadership Theory. Journal of Public Administration Research and Theory 24(2): 407–29.

Office of the Inspector General, U.S. Department of Veterans Affairs. 2014. Veterans Health Administration: Review of Alleged Patient Deaths, Patient Wait Times, and Scheduling Practices at the Phoenix VA Health Care System. http://www. va.gov/oig/pubs/VAOIG-14-02603-267.pdf [accessed April 20, 2015].

Partnership for Public Service. 2014. Agency Report: Department of Veteran Affairs. Best Places to Work in the Federal Government. http://bestplacestowork.org/ BPTW/rankings/detail/VA00 [accessed April 20, 2015].

Pear, Robert. 2014. History and Context of an Embattled Department of Veterans Affairs. New York Times, posted May 21. http://www.nytimes.com/2014/05/22/ us/politics/history-and-context-of-an-embattled-department-of-veterans-affairs. html?_r=0 [accessed April 20, 2015]

Pew Research Center. 2013. Trust in Government Nears Record Low, But Most Federal Agencies Are Viewed Favorably. October 13. http://www.people-press. org/2013/10/18/trust-in-government-nears-record-low-but-most-federal- agencies-are-viewed-favorably/ [accessed April 20, 2015].

Philpott, Tom. 2014. Did Leadership by Bold Goals Spark Wait-Time Crisis? Stars and Stripes, April 7. http://www.stripes.com/news/veterans/did-leadership-by- bold-goals-spark-va-wait-time-crisis-1.297139 [accessed April 20, 2015].

Ponder, Jon. 2014. Should U.S. Senators Who Voted against Additional Funding for VA Hospitals in February 2014 Also Resign? Pensito Review, May 29. http://www.pensitoreview.com/2014/05/29/should-u-s-senators-who-voted- against-additional-funding-for-va-hospitals-in-february-2014-also-resign/ [accessed April 20, 2015].

Ricks, Thomas E., and Ann Scott Tyson. 2006. Abizaid Says Withdrawal Would Mean More Unrest. Washington Post, November 16.

Evaluating Transformational Leaders: The Challenging Case of Eric Shinseki and the U.S. Department of Veterans Affairs 769

http://www.washingtonpost.com/wp-dyn/content/article/2006/11/15/ AR2006111500800.html [accessed April 20, 2015].

Shinn, Mary, Daniel Moore, and Steven Rich. 2013. Despite Backlogs, VA Disability Claims Processors Get Bonuses. Washington Post, August 25. http://www.washingtonpost.com/world/national-security/despite-backlogs- va-disability-claims-processors-get-bonuses/2013/08/25/1be00a28–0cea- 11e3-9941-6711ed662e71_story.html [accessed April 20, 2015].

Shinseki, Eric K. 2009. Remarks at the Veterans of Foreign Wars Mid- Winter Conference, Louisville, KY, February 20. http://va.gov/opa/ speeches/2009/09_0220.asp [accessed April 20, 2015].

Shinseki, Eric K. 2014. Remarks at the National Coalition for Homeless Veterans Annual Meeting, Washington, DC, May 30. http://www.va.gov/opa/ speeches/2014/05_30_2014.asp [accessed April 20, 2015].

U.S. Senate Committee on Veterans’ Affairs. 2009. Nomination of General Eric Shinseki to Be Secretary of Veterans Affairs. 111th Cong., 1st sess., January 14. http://www.veterans.senate.gov/hearings/

nomination-of-general-eric-shinseki-to-be-secretary-of-veterans-affairs [accessed April 21, 2015].

Van Wart, Montgomery. 2011. Changing Dynamics of Administrative Leadership. In The State of Public Administration: Issues, Challenges, and Opportunities, edited by Donald C. Menzel and Harvey L. White, 89–107. Armonk, NY: M. E. Sharpe.

———. 2013. Administrative Leadership Theory: A Reassessment after 10 Years. Public Administration 91(3): 521–43.

Van Wart, Montgomery, and Evan Berman. 1999. Contemporary Public Sector Productivity Values: Narrower Scope, Tougher Standards, and New Rules of the Game. Public Productivity and Management Review 22(3): 326–47.

White House. 2014. Historical Tables, Table 4.2—Percentage Distribution of Outlays by Agency. http://www.whitehouse.gov/omb/budget/Historicals [accessed April 20, 2015].

Zoroya, Gregg. 2015. Congressional Auditors: VA Health Care Is High Risk. USA Today, February 10.

The PAR Book Review section aims to engage our audience in a critical discussion of the work

of contemporary authors representing the diverse field of public administration.

We invite readers to participate in this exploration by submitting book reviews and suggestions

of books to review. If you have any suggestions or questions,

please contact Danny L. Balfour ([email protected]) or Stephanie P. Newbold

([email protected]).

Copyright of Public Administration Review is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.