WASHINGTON — The embattled nomination of Ronny Jackson, President Trump’s pick to head the Department of Veterans Affairs, is the latest example one of the president’s most persistent problems: The people he trusts to run his administration are the very ones who have ground it to a controversy-plagued halt.

Trump’s reliance on his gut instinct over vetting, emphasis on personal rapport over experience and skill, and penchant for firing those who fall out of favor have rendered his administration organizationally feckless — unable to carry out his policies, or function effectively at all.

“It’s immensely disruptive,” said Max Stier of the nonpartisan Partnership for Public Service, who has served in all three branches of government.

At the VA, the stakes are especially high: It’s the federal government’s second largest agency, tasked with providing health care services to 9 million veterans, and which has been plagued with massive problems for decades.

No other agency is in more dire need of clear steady leadership. That’s not what’s happening — after Trump’s first pick to head the agency, David Shulkin, was ousted, Trump tapped his White House physician — who told reporters that with a few diet tweaks Trump could live to be 200 years old — to replace him.

No vetting was conducted, according to those familiar with the process. Such vetting would have uncovered an internal watchdog report finding that Jackson engaged in “unprofessional behaviors” in the White House medical unit, as well as accusations that he was drunk while on call as the president’s doctor and that he caused a hostile work environment.

Now even the president is questioning Jackson’s qualifications.

“I know there’s an experience problem because of lack of experience,” Trump told reporters yesterday, suggesting that no one would blame him for withdrawing, but also saying that he’ll stand by him if he doesn’t.

It’s not just harming the VA. The lack of a confirmed secretary keeps Acting Secretary Robert Wilkie in that role instead of the important one he was confirmed to fill, Defense Department undersecretary of personnel and readiness.

Jackson is far from alone in having questions of qualifications hamstring an agency at a crucial time. Mike Pompeo’s confirmation vote for secretary of state is poised to be the narrowest in history, EPA Administrator Scott Pruitt is the subject of multiple internal investigations and faces calls to resign, Education Secretary Betsy DeVos and HUD Secretary Ben Carson have repeatedly come under scrutiny for failing to express an understanding or command of policy.

“If you don’t do the vetting effectively at the front end, you pay the consequences on the back end,” Stier said.