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Director retires after nearly 30 years at VA in La Jolla

Dr. Robert Smith, newly retired director of the VA San Diego Healthcare System, packs his belongings June 30.
Dr. Robert Smith, newly retired director of the VA San Diego Healthcare System, packs his belongings June 30, his last day on the job.
(Hayne Palmour IV)

Dr. Robert Smith joined the health care system in 1993.

After nearly three decades with the VA San Diego Healthcare System in La Jolla, Dr. Robert Smith completed his final shift last week and retired from his role as director, a job he assumed in 2016 after spending many years caring for patients in pulmonology and critical care.

Smith’s experience working directly with local veterans began when he did a medical residency at the UC San Diego School of Medicine from 1979 through 1982, serving as chief resident of internal medicine his final year. The San Diego VA Medical Center, as it was known then, is a big part of clinical rotations for university residents.

He was hired by the San Diego VA in 1993, and though he ended his career as an administrator, the bulk of it was spent caring for patients and doing respiratory research.

As he gradually moved into leadership roles, culminating in his administration of the area Veterans Affairs health care system, Smith became known in medical circles for his willingness to collaborate with outside organizations and for his embrace of technology, especially electronic medical records.

Dr. Robert Smith retired June 30 as director of the VA San Diego Healthcare System.
(Hayne Palmour IV)

Dr. Eric McDonald, chief medical officer for San Diego County, said Smith helped create a digital information exchange, now called San Diego Health Connect, that enables medical providers throughout the region to securely and quickly share medical records when patients seek care outside their usual locations.

“He was never just wearing his VA hat, he was always interested in the entire community,” McDonald said.

That collaboration, he added, paid significant dividends during COVID-19 vaccination campaigns.

“We enjoy, I think, a uniquely strong relationship between the VA and the other health care partners here in San Diego compared to other parts of the country,” McDonald said. “I truly think it’s in major part to his strong leadership.”

About 120,000 people in San Diego County get their care from VA San Diego, which has the nation’s largest cohort of men and women who have served in uniform following the terrorist attacks on Sept. 11, 2001.

Though Smith said collaborative efforts — especially those that centered on the transformative use of new technology — provided some of his most satisfying professional moments, carrying the responsibility of providing comprehensive care to 120,000 people who served their country in uniform kept him grounded.

“You hear about all kinds of situations, and when you learn what they have done, what they have been through for their country, you need to make sure they get the services and benefits they have earned,” Smith said.

Three decades at the VA have not been without some rocky moments. The rockiest was likely the nationwide scandal surrounding falsified wait times at the Phoenix VA in 2014, which launched a series of audits at all similar installations around the country. Though a few outlying clinics suffered dings in audit reports, the San Diego VA came through the firestorm largely unscathed.

A subsequent care choice program that allowed local veterans to seek and receive care outside the VA system struggled at launch in 2016, though the situation appears to have smoothed out.

Smith said he tried to remain committed to choice during his tenure. “If we can’t do it better in the VA, then veterans should be able to seek their care somewhere else,” he said.

Though he plans to spend more time on hobbies in retirement and more time with his wife, Dr. Vivian Terkel, and the couple’s two grown children, Smith said he intends to return to the VA as a volunteer. ◆