Ronny Jackson is the doctor who gave President Donald Trump a glowing physical and mental health assessment in a televised briefing in January. | Al Drago/Bloomberg via Getty Images ‘My first reaction was OMG’: Trump’s VA pick is new to all this

Rear Adm. Ronny Jackson, the telegenic White House doctor named Wednesday as Donald Trump’s choice to run the VA, is a career Navy physician who served in Iraq. But he has never run anything approaching the sprawling Veterans Affairs bureaucracy or been caught in Washington’s crossfire.

Jackson is the doctor who gave Trump a glowing physical and mental health assessment in a televised briefing in January. He declared the overweight 71-year-old in excellent physical and mental health — and predicted he would remain that way throughout this term, and into the next one, should he get reelected.


“I’ve found no reason whatsoever to think that the president has any issues whatsoever with his thought process,” Jackson pronounced.

His cool handling of the hourlong grilling by White House reporters endeared him to his boss. But the VA is a lot bigger and more complicated than the White House physicians unit or, for that matter, a combat trauma team. It’s the second biggest federal department; only the Pentagon is larger. It runs 170 medical centers and 1,061 outpatient clinics serving more than 9 million veterans and it’s been caught up in political struggles over how much of its health system should be privatized. There’s also bitter controversy about its $10 billion Cerner contract for a new computerized health record system.

Trump’s firing-by-Twitter of embattled Secretary David Shulkin was no surprise. In Washington, it had become a “when, not if” the sole Obama administration Cabinet holdover would go, particularly after questions arose about blending personal and government-paid official travel. But Jackson’s name had not circulated as a potential successor, and it took Shulkin’s many allies at the VA and on the Hill by surprise.

"We have a lot of questions about the nominee," said Joseph Chenelly, national executive director of American Veterans, or AmVets, the fourth-largest veterans service organization. "We think the White House has a tall order ahead of it in showing that this doctor is qualified to lead a $200 billion agency."

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Chenelly said he also has concerns that Jackson is active duty and therefore answerable to the president as commander in chief. "There's a possibility that the doctor couldn't even say no to the president,” he said. “We're not a government that's run by our military.”

One former VA official said his “first reaction was OMG. That’s still my reaction.”

“The replacement has no experience,” the official added. “The VA is the hardest department to manage as it is so political."

No one questioned Jackson’s résumé — he has served in the White House since 2006, and it was former President Barack Obama who promoted him to the top medical position in 2013. He has multiple certifications and is both a diving specialist and a naval parachutist. But he’s never managed a large bureaucracy.

“Dr. Jackson is a good and honorable person, fine doctor and career military but you do get the sense that this has as much to do with his boffo press conference on the president’s physical as anything else,” tweeted David Axelrod, who was senior adviser to Obama.

Lawmakers on the Hill were full of praise for Shulkin and muted about Jackson, although many said they looked forward to meeting the president’s pick who has to be confirmed by the Senate.

“Dr. Shulkin has made a tremendous impact toward improving the lives of veterans during his time at the U.S. Department of Veterans Affairs. He has been instrumental in all that we have accomplished in the last year,” said Sen. Johnny Isakson (R-Ga.), the chairman of the Senate Committee on Veterans Affairs.

“I look forward to meeting Admiral Jackson and learning more about him,“ Isakson added in a statement. Jackson’s Senate confirmation would go through that panel.

Isakson’s counterpart on the House Veterans Affairs Committee, Rep. Phil Roe, (R-Tenn), also had kind words for Shulkin, though he also said he respected the president’s prerogative to choose someone else.

“At the end of the day, Cabinet secretaries serve at the pleasure of the president. I have enjoyed getting to know Secretary Shulkin, and I’m glad to call David a friend. I think he’s done a fantastic job and I hate to see him go,” Roe said in a statement.

But Roe added he would “work with anyone committed to doing the right thing on behalf of our nation’s veterans.“

Democrats were more skeptical. Sen. Jon Tester, the top Democrat on the VA committee, praised Shulkin for serving “honorably” and said he looked forward “to meeting Admiral Jackson soon and seeing if he is up to the job.”

Sen. Tammy Duckworth, a wounded Iraq veteran who also served as an Assistant VA Secretary, was more blunt. She said that by “choosing chaos over consistent leadership, Donald Trump is hurting veterans around the country.”

“Over the coming weeks, I will carefully review Dr. Jackson’s qualifications to determine whether he has the best interests of our veterans at heart or whether he, like many in the Trump administration, wants to push VA down the dangerous path of privatization. I will also review whether a currently-serving active duty military officer is eligible to serve as a politically appointed Cabinet Secretary.”

Sen. Bernie Sanders, who also serves on the VA panel, was also pointed in his criticism.

"Our job is to strengthen the VA in order to provide high-quality care to our veterans, not dismember it,” he said in a statement. "The Senate Committee on Veterans Affairs should not approve any nominee for secretary who supports the privatization of the VA.”

Jackson’s views on some of the most heated issues about the VA’s future are not publicly known. The raging debate over how much of the VA should be turned over to private health practitioners has split lawmakers and veterans organizations. The American Legion opposes privatization. The Koch brothers-backed Concerned Veterans of America wants a much larger private role.

But Jackson, who was nominated for a promotion under Trump just last week and who has treated three different presidents, has talked about how often he speaks to Trump around the White House.

His full-throated endorsement of the president’s health, including his mental acuity, dampened speculation after the book, “FIre and Fury: Inside the Trump White House” by Michael Wolff raised questions about the commander in chief’s mental stability. Trump tweeted that he was a "very stable genius" who was "like, really smart,” and a few days later, Jackson declared on national television that he had never seen the president falter cognitively or repeat himself. “He’s very sharp, and he’s very articulate,” Jackson said.

"Some people have just great genes,“ he added. “I told the president that if he had a healthier diet over the last 20 years he might live to be 200 years old."

Jackson’s enthusiasm got the “cold open” treatment on one of Trump’s most reliable foils, “Saturday Night Live.” Cast member Beck Bennett, portraying Jackson, praised Trump’s “rockin’ bod” and suggested Stormy Daniels, alleged to have had an affair with Trump, was a “lucky woman.”

“I’m telling you, this hunk is healthy enough to be president for at least another 10 to 20 years easy,” Bennett said.

Jennifer Haberkorn, Darius Tahir, Bryan Bender and Jason Millman contributed to this report.