The White House was thrown on the defensive on Thursday when President Trump led the Department of Veterans Affairs and forced officials to ward off growing skepticism that Ronny L. Jackson has the experience of leading the second largest government agency  Trump announced late Wednesday that the White House doctor would replace the ousted foreign minister David Shulkin, surprising veteran groups and lawmakers who were not previously informed and know the political views of someone whose positions are unknown to VA's chronic challenges ,
Jackson is a naval officer who worked as an ambulance in Iraq before spending the last 1
"It's great that he served in Iraq and he's our generation, but it does not seem that he had responsibilities that would suggest he could accept the extent of this job, and that makes Jackson a surprising one Election, "said Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America. The High Representative of the White House said he had been persuaded by anonymity to discuss internal consultations. After watching his interest in recent days, helpers hesitated to accept such a big job. But the president kept pushing and told his executive on Monday that the doctor was his first choice. A senior White House official described an informal interview process without the extensive review that typically takes place when a cabinet is selected.
"The President has full confidence in Dr. Jackson's ability to give our veterans the care they deserve," said spokesman Raj Say Shah.
The White House planned to announce Wednesday that Shulkin would leave the government and be provisionally replaced by Robert Wilkie, Undersecretary for Defense Personnel and Ministry of Defense, until a candidate was found.
But Trump Appeared The plan, as he tweeted that he intended to nominate Jackson, said government officials.
The active Rear Admiral had been behind the scenes while serving the last three governments as a White House doctor, but he created The Light of the World in January when he provided reporters with a beaming assessment of Trump's physical and mental health. which held him as an incentive for the president.
The White House on Thursday defended Trump's election of Jackson and said his hands-on experience as the doctor would serve him as secretary for veteran affairs.
"He knows what soldiers need on the battlefield and what they need when they come home as veterans." White House spokeswoman Lindsay Walters told reporters aboard Air Force One on their way to Cleveland, where Trump gave a speech about his infrastructure plan. "The president has every confidence in his choice and trusts that he can give veterans the care they deserve."
Major Republican Congressmen were cautious in the nomination.
"We're doing our homework with Dr Jackson," said Amanda Maddox, spokeswoman for Senator Johnny Isakson (R-Ga.), Chairman of the Senate Veterans Affairs Committee, which will hold Jackson's nomination hearing. Trump called Isakson after announcing that he had chosen the doctor to replace Shulkin
"His name was never thrown around," Maddox said, "so we're doing our due diligence."
Trump's decision to stand up VA leadership comes as Senate Republicans are already concerned about other potentially difficult nominations in the months leading up to the midterm elections, if they want to focus their message on the recently passed tax cuts rather than more To handle upheavals in administration.
"Any time Republicans fail to sell tax laws over the next seven months is a missed opportunity," said GOP strategist Brian Walsh, a former spokesman for the National Republican Senatorial Committee. "I'll say that the republican senators are a little bit more isolated by the kind of seats that are up there, but there is no question that these are not helpful distractions."
Nominees nominated by Trump include Gina Haspel, who was elected director of the CIA this month, and because of her connections, finds resistance from members of both parties to torture the agency's earlier use of brutal interrogation on terrorist suspects who say critics.
Senate Republicans have told the White House officials in recent days the procedure of ratifying CIA Director Mike Pompeo to replace Rex Tillerson as Foreign Minister. It will be a challenge, even though it is expected to be approved as Two people talk about the discussions. Democratic senators said privately, when Pompeo was chosen to replace Tillerson, that they expect far fewer Democrats to support him than the 14 who voted for him to lead the CIA.
Senate Republicans have privately commented on the personnel struggles that have raged since the start of the Trump presidency, and recently told the White House they did not want to consider a number of candidates this year, according to adjutants and officials  The decision to dismiss Shulkin – and the lack of communication about Jackson – has only fueled concerns on Capitol Hill that the government has not done enough to support the Congress or even respond to the onslaught of the President. 19659002] Jackson's political views are unknown, in particular to the most urgent problem faced by VA: how much access veterans should have to private physicians outside the system at government expense. Shulkin's mediocre views on this issue, which conflicted with many government officials, helped him end his term.
VA Secretary is one of Washington's most relentless jobs even for someone with extensive management experience. Shulkin, also a doctor, had run large hospital systems – including VA – before starting work. His predecessor Robert McDonald was managing director of Procter & Gamble. The secretary in front of him was a decorated retired army general, Eric K. Shinseki, who was pushed out after executives in the widely ramified healthcare system had manipulated veterinary doctor appointments.
Back in February, Jackson was a candidate for the VA Health Arm, the Veterans Health Administration, the country's largest healthcare system, with 1,200 hospitals and medical clinics. On the day of his interview, he told a jury that the president was unwilling to let him leave his job at the White House, two people who were familiar with the discussion.
The panel nevertheless interviewed him informally and asked him how he would make change in such a large organization, but not his views on politics. A person sitting on the panel and speaking on the condition of anonymity because their procedure is confidential said they did not think Jackson had the skills needed to hire a team of about 20 doctors, nurses and medical assistants in the area White House Medical Bureau to Oversee Health Administration
"I do not remember coming in to convince us he had the experience of getting the job done, he did not inflate his qualifications," he said this person. "The tone was," Maybe I do not have the same kind of experience as others who were in front of me in my job. "
Jackson 's former colleagues at the Obama White House, who have publicly praised him in the past, said he was surprised by his nomination when they exchanged text messages to ask how an extremely sympathetic but unlikely candidate can guide VA in the Trump administration.
"I've seen him lead a staff of a few dozen people," said Ned Price, a spokesman for the National Security Council under Obama, who recalled being treated by Jackson for a toe injury in the Philippines.
"But how would that affect the administration of the second largest department of the federal government, I have no idea," Price said. "He has competence and integrity – I do not think he's going to go world-wide or buy thousands of dollars in furniture – but can he let VA go? Everyone knows he's as good as me."
Colleagues described the plan of the White House doctor as grueling, with constant foreign and domestic travel, always on the side of the President.
Some Democrats warned that if Jackson privatized the idea of If he privatized more of VA's health insurance, his nomination would meet with strong opposition.
"I will scrutinize Dr. Jackson's qualifications to see if he has the best interests of our veterans in mind, or if he, like many in the Trump administration, wants to depress the dangerous path of privatization," said Senator Tammy Duckworth (D-Ill.), A wounded Iraq veteran, in a statement.
At the American Legion, the country's largest veterans organization, senior officials created ideas to help Jackson become familiar with the agency and its challenges.
"He will have a great learning curve," Executive Director Verna Jones said, "but we say I'm ready to support and educate him."
Robert Costa and Julie Tate have contributed to this report.