This week's guest on Off the Shelf is Anthony Principi, principal in the Principi Group, and former secretary of Veterans Affairs in the President George W. Bush Administration. His discussion with host Roger Waldron focuses on the evolving healthcare environment and the implications for the VA's mission. Principi highlighted the advances in medical technologies, treatments, and protocols that have reduced the need for hospital beds and resulted in a VA medical infrastructure that is a mismatch due to its surplus number of hospitals and facilities. He also talked about efforts over the last 20 years to address the VA’s healthcare infrastructure taking into consideration the evolving healthcare environment.Principi outlined the critical role the VA healthcare system plays in our nation, including medical research, training, and serving as the national healthcare backstop in times of emergency. The conversation also included Principi’s thoughts on leadership and management, often drawing on key experiences during his time in government. Finally, Principi highlights the noble mission of the VA in delivering critical healthcare to veterans.