After nearly three decades at VA San Diego, Dr. Robert M. Smith completed his final shift Thursday, retiring from his role as director and chief executive officer, a job he assumed in 2016 after spending many years caring for patients in pulmonology and critical care.

Hired by the San Diego VA in 1993, Smith’s experience working directly with local veterans began when he did a medical residency at UC San Diego School of Medicine from 1979 through 1982, serving as chief resident of internal medicine his final year. San Diego VA Medical Center, as it was known then, is a big part of clinical rotations for university residents.

Though he ended his career as an administrator, the bulk of Smith’s career was spent caring for patients and doing respiratory research.

As he gradually moved into leadership roles culminating in his administration of the VA healthcare system, the physician gradually 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's last day as director of San Diego VA Healthcare System was Thursday, June 30, 2022.

Dr. Robert Smith’s last day as director of San Diego VA Healthcare System was Thursday, June 30, 2022.

(Hayne Palmour IV/For The San Diego Union-Tribune)

Dr. Eric McDonald, chief medical officer for San Diego County, said that Smith was instrumental in helping to create a digital information exchange, now called San Diego Health Connect, that allows 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 the COVID-19 pandemic during vaccination campaigns.

Such close collaboration, he added, is not common everywhere that the VA operates.

“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.”

That leadership is responsible for one of the largest veteran populations in the United States with about 120,000 people in San Diego County getting 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 attack on Sept. 11, 2001.

While he said that collaborative efforts — especially those that centered around 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.

Hearing so many stories of service, from those on the front lines to those in logistics, he said, drives home the point that these are the people who stood in harm’s way for their nation.

“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 surely the nationwide scandal surrounding falsified wait times at the Phoenix VA in 2014 which launched a series of audits at all similar installations nationwide. Though a few outlying clinics suffered dings in audit reports, the San Diego VA came through the firestorm largely unscathed, though a subsequent care choice program, which allowed local veterans to seek and receive care outside the VA system, struggled at launch in 2016.

The situation appears to have smoothed out with Smith at the helm and he said he has 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 soon as a volunteer.

Dr. Kathleen Kim, VA San Diego Health System’s chief of staff, has assumed director duties on an interim basis.

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