Trump Fires VA Secretary, Replacing Him with Navy Admiral

Descriptions of Robby Jackson as "Trump's personal physician" mischaracterize his qualifications for the job.

The rapid turnover in the Trump cabinet continues but I believe this one is being misframed.

The NYT headline, “Trump taps his doctor to replace Shulkin at VA, choosing personal chemistry over traditional qualifications,” is typical. But, like presumably most people, that conjured in my mind Trump appointing his personal physician from New York that he’d known for several decades. Not at all:

President Trump fired his embattled Veterans Affairs secretary Wednesday and tapped as his replacement atop the chronically mismanaged agency the president’s personal physician, who gained prominence with his effusive praise of the 71-year-old’s physical and mental health.

The ouster of Veterans Affairs Secretary David Shulkin, who has been mired in scandal over his charging taxpayers for luxury travel expenses and the infighting among his senior aides, had been widely expected and was made official at 5:31 p.m. by presidential tweet.

Trump said he would nominate Ronny L. Jackson, 50, an active-duty rear admiral in the Navy who has served for the past three administrations as a White House physician.

A biography released by the White House shows Jackson is credentialed and experienced in medicine but has no background in management. He nonetheless will be charged with delivering on one of Trump’s signature campaign promises: to fix the federal government’s second-largest bureaucracy.

VA, which employs 360,000 people and has a $186 billion annual budget, serves a growing population of veterans in need and is suffering from a shortage of doctors, nurses and mental health experts.

As a career military officer, Jackson has been apolitical, and his views on a range of hot-button issues affecting VA — including proposals to privatize care — are not publicly known.

Trump prizes relationships and loyalty over traditional qualifications, and he quickly developed personal chemistry with Jackson. The boss admires the man he calls “The Doc,” according to aides, and cheered Jackson’s on-camera performance in the press briefing room in January, where he delivered the results of Trump’s annual physical as “very, very good” and “excellent.”

“Some people have just great genes,” Jackson said. “I told the president that if he had a healthier diet over the last 20 years, he might live to be 200 years old. . . . He has incredibly good genes, and it’s just the way God made him.”

At a time when Trump’s critics questioned his mental fitness, based in part on accounts in the book “Fire and Fury,” Jackson effectively backed up Trump’s claims of being a “very stable genius,” telling reporters that he received a perfect score on a cognitive exam.

“He’s very sharp, and he’s very articulate when he speaks to me, and I’ve never known him to repeat himself around me,” Jackson said. “I’ve found no reason whatsoever to think the president has any issues whatsoever with his thought process.”

Trump praised Jackson in a statement Wednesday: “Admiral Jackson is highly trained and qualified and as a service member himself, he has seen firsthand the tremendous sacrifice our veterans make and has a deep appreciation for the debt our great country owes them.”

USA Today (“5 things to know about VA nominee Ronny Jackson“) adds:

Jackson went into active naval service in 1995 after getting his medical degree from University of Texas Medical Branch. He went on to become the honor graduate of the Navy’s Undersea Medical Officer Program in Groton, Conn., before getting more credentials in emergency medicine. During Operation Iraqi Freedom he served as a emergency doctor specializing in resuscitating troops in Iraq.

[…]

The Pentagon announced Friday that Jackson had been nominated to be promoted to rear admiral (upper half) from rear admiral (lower half). The nomination, which Secretary of Defense Jim Mattis announced, would give Jackson his second star and a bigger paycheck.

[…]

Jackson has served both Democrat and Republican administrations and draws praise from each side.

When Jackson got some criticism for appearing a bit too enthusiastic about Trump’s physical condition after his exam in January, Dan Pfeiffer, a former senior adviser to Obama, jumped to his defense via Twitter:

On Wednesday, Alyssas Mastromonaco, former Obama deputy chief of staff, tweeted “there is no one better than ronny.”

Jackson told reporters at a briefing after the president’s physical the same thing your doctor probably says to you. He said the 71-year-old, 239-pound president could use more exercise and a better diet that is lower in fat and carbohydrates. Trump, who is known to eat junk food and to avoid exercise beyond golf, is overweight and has set a “reasonable goal” of losing 10 to 15 pounds in the coming year and developing a regular fitness routine, Jackson said.

“He’s more enthusiastic about the diet part than the exercise part,” Jackson added.

So, Jackson isn’t a Trump crony. He’s a well-respected career Navy man who has served in a very high profile post through three administrations (an Obama holdover!). While his assessment of Trump’s mental health differs from my own, I have no reason to doubt his integrity; I’m sure Trump is passing the standard tests.

Is he traditionally qualified to run the VA? Maybe.

  • Shulkin, who had served as a deputy at the Department under Obama before being elevated to Secretary by Trump, had been a career executive in the field, holding progressively higher positions in private and academic hospital management.
  • Bob McDonald, Obama’s second DVA Secretary, was a West Point graduate who left the Army after five years, somehow getting an MBA from the University of Utah along the way. He then spent a career at Proctor and Gamble, including some time in its pharmaceutical division, and rose to be its CEO. It was from that position from which Obama appointed him.
  • Eric Shinseki, Obama’s first DVA Secretary, was, of course, a retired four-star general who served as Army chief of staff. In retirement, he spent 5-1/2 years on various boards of directors before being plucked by Obama for the job.
  • James Peake, George W. Bush’s second DVA Secretary, had retired from the Army after a 42-year career that culminated as the 40th Surgeon General of the United States Army.
  • Jim Nicholson, Bush’s first DVA Secretary, was a West Point graduate who retired after 30 years of service as an Infantry colonel. He had a successful run in private business and became active in Republican politics, ultimately becoming chairman of the RNC. He also served as Ambassador to the Vatican.

Of those, only Peake is demonstrably better qualified to run the Department of Veterans Affairs. Shulkin, McDonald, Shinseki, and even Nicholson had better management credentials than Jackson but none of them are physicians.

A relatively young Navy admiral with a distinguished career in military medicine would have significant credibility with the veterans the agency serves. And having a rapport with the President is always extremely helpful for a cabinet secretary, especially on from a less visible department. That’s especially true with this President.

FILED UNDER: Government, Military Affairs
James Joyner
About James Joyner
James Joyner is a Security Studies professor at Marine Corps University's Command and Staff College and a nonresident senior fellow at the Scowcroft Center for Strategy and Security at the Atlantic Council. He's a former Army officer and Desert Storm vet. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. I have no doubt that Jackson is qualified as a physician, but it seems to me that what the DVA needs isn’t so much a medical expert, or even a veteran for that matter, as someone qualified in administrative matters. Perhaps Jackson fills that qualification, I don’t know enough about his career to speak to that, but that certainly seems like something the Senate ought to consider in confirmation hearings.

    One other question, does accepting this position mean that Jackson has to retire from the Navy?

  2. James Joyner says:

    @Doug Mataconis:

    I have no doubt that Jackson is qualified as a physician, but it seems to me that what the DVA needs isn’t so much a medical expert, or even a veteran for that matter, as someone qualified in administrative matters.

    While that’s my general sense of these things, the Department has had a troubled history with a rather diverse cast of characters at the helm. Jackson strikes me as perfectly qualified.

    One other question, does accepting this position mean that Jackson has to retire from the Navy?

    I don’t see why. Not unless it’s particularly written into the law. We’ve had sitting generals head up various intelligence posts and as National Security Advisor. I can’t think of any running civilian cabinet departments, though.

  3. OzarkHillbilly says:

    Adm Jackson appears to be eminently qualified for this position, but that also appears to be just a lucky happenstance as trump picked him for this position because he liked how Jackson looked and sounded on TV. Stopped clocks and all that.

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  4. @James Joyner:

    Yea I didn’t think so but the thought had occurred.

    At the same time, it does seem like the DVA’s problems are largely management/administrative and at least part of it seems to be routed in the fact that some of the people running things below the Secretary level just need to be replaced. It also seems to be a regional issue. I have a family member who works at a major VA facility in the Midwest and, at least according to what she tells me, they don’t have the same kind of problems that VA hospitals such as the one in San Diego have faced in recent years. That suggests that a big part of the issue could be that the Department needs a head who has the power and the willingness to let heads roll where needed and that those people need to be replaced with competent personnel.

  5. Mike Schilling says:

    When announcing the result of Trump’s physical. Jackson flattered the hell out of him. “Good genes”, ” “very sharp, and he’s very articulate “, “Hands down, there’s no question that he is in the excellent range. … I put out in the statement that the president’s health is excellent, because his overall health is excellent. … Overall, he has very, very good health. Excellent health.” I don’t doubt that the praise Jackson has gotten is sincere, but he’s also a bootlicker.

  6. MarkedMan says:

    With all due respect, James, I’ve seen nothing to indicate that Jackson is in any way qualified to lead an immense organization with huge budget. There is some allusion to supervising some other doctors in Iraq. Jackson may be a good man (although this appointment may explain the over the top obsequious flattery he had for Trump, and calls his character into question) and a good doctor, but that doesn’t qualify him to run an organization. The continual disrespect that Trump, the GOP and self describe conservatives in general have towards government is a disgrace. Such people generally despise government, hold those that have government jobs in contempt and therefore see nothing wrong with Trump appointing people because they fluff him on national television, or shout a lot on Fox News, or fly the president around in his personal airplane. People depend on these services and we as a country made a commitment to provide it.

  7. Mikey says:

    Shulkin was ostensibly fired for screw-ups with official travel, but an underlying reason is he opposed Koch-backed administration plans to privatize VA medical care.

    I hope Dr. Jackson can get up to speed on the policy side and will also oppose privatization. No doubt he’s smart enough for the former, but does he have the will to stand up to Trump on the latter?

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  8. Scott says:

    By all accounts the VA delivers decent healthcare to a mostly geriatric clientele. The controversial issues revolve around access and claims. I see the problem as one of processes and capacities which basically require resources. We don’t want to pay for our wars and we certainly don’t want to pay for their aftermaths.

  9. KM says:

    @MarkedMan:

    a good doctor, but that doesn’t qualify him to run an organization

    Agreed. People think just because someone is competent in one field, they’ll do well in another. Back in my practicing days, one of my duties was making sure everyone in the depts was up to date on basic training and competency certs. Do you have any idea how many surgeons I’ve had to chase down because they’ve let their CPR qualifications lapse? How many brilliant doctors, nurses, researchers and practices can’t keep up with things like mandated reporter training and need to have a nanny on their ass about it? Just how many battlefield surgeons know what it costs to keep the OR going, where the supplies come from and how contracts work? Org work gets delegated out for a reason – it tends to get in the way of actual medicine.

    Jackson is good enough to care for the President – well done, a sign of an accomplished man. But don’t just hand over the reigns to *everything* to a guy we don’t even know can plan a household budget! He got the job because Trump knew him personally and kinda liked him, period.

  10. Daryl's other brother Darryl says:

    So, Jackson isn’t a Trump crony.

    C’mon…he all but called Dennison a hottie from the podium…and claimed that a 72 year old obese man on Crestor is in excellent health. Since when is heart disease a marker of excellent health?
    Neglecting all that…I don’t see how he is qualified to run a behemoth like the VA.
    But I don’t see how Dennison is qualified to run the US…so I guess it fits.

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  11. steve says:

    Good doctor does not mean good administrator. I currently chair a department and ran the business side of a decent sized group for years. Trust me, we have found out over and over that just because someone was a good doctor, that will not always translate into administrative skills. That said, he is an admiral. He must have had some admin experience along the way, so we can hope that someone looked at that. My assessment, not knowing his admin experience, is that he is probably the least qualified of the people you cite, except maybe Nicholson, depending upon his actual business experience. He will be very dependent upon his advisers.

    Steve

  12. Bob@Youngstown says:

    @James Joyner:

    Jackson strikes me as perfectly qualified

    Keep saying that to yourself.
    It would seem to me that the VA needs a qualified administrator more than a qualified physician.
    So far I’ve not seen anything that indicates Jackson’s administrative skills in managing a HUUGE organization.

  13. gVOR08 says:

    I worked for a company that had half a dozen VPs of Sales. This was because customers would say, “I don’t want to talk to a salesman, I want someone with some authority.” So all the sales guys got called “VP”. How do you get to be a Rear Admiral without ever having managed or commanded more than a couple dozen personnel?

  14. Mr. Prosser says:

    @Mikey: He may have the will but does he have the political skill to play with the big boys being coached by the Koch Bros? I’m sure there are intrigues and politics among flag rank officers but are they as cutthroat and hellbent on institutional destruction as the present administration? This guy just may be the season’s Paschal Lamb.

  15. Slugger says:

    The VA has a difficult job. Many of the problems that pop up in our veterans are covered or not covered because of political pressures. Agent Orange exposure, Gulf War syndrome, ALS in Iraq War vets are just some of these issues. Social problems related to PTSD are another. Equitable treatment for these disorders, managing a budget responsibly, and managing hundreds of sites and hundreds of thousand employees seems like a Herculean job to me. Somehow there ought to be a process of nurturing newer employees to grow into positions of responsibility and allow internal promotion to fill vacancies in a nonpartisan manner.

  16. SKI says:

    Of those, only Peake is demonstrably better qualified to run the Department of Veterans Affairs. Shulkin, McDonald, Shinseki, and even Nicholson had better management credentials than Jackson but none of them are physicians.

    I think you have that about 100% reversed, James. As steve noted above, it is the very, very rare doctor who is a good administrator for a medical group or hospital, let alone a federal agency. Bluntly, their training just doesn’t prepare them to be leaders of anything larger than a surgical team or small clinic.

  17. Scott says:

    BTW, apparently a good administrator can’t get things done because Trump has dumped a bunch of political appointees with their own agendas.

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  18. Franklin says:

    I also understand Ben Carson was an excellent neurosurgeon.

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  19. grumpy realist says:

    @Franklin: which means that Jackson will probably do as well running the VA as Carson has been at running HUD?

    I think Jackson’s too much of a boot-licker to be anything more than a small bump in the road against whatever crazy idea Trump has to do with the VA. If we’re lucky, Trump’s incessant chaos generation will mean that he’ll get in his own way and nothing will get done while Jackson keeps the place going on an even keel.

  20. Barry says:

    @Mike Schilling: “When announcing the result of Trump’s physical. Jackson flattered the hell out of him. “Good genes”, ” “very sharp, and he’s very articulate “, “Hands down, there’s no question that he is in the excellent range. … I put out in the statement that the president’s health is excellent, because his overall health is excellent. … Overall, he has very, very good health. Excellent health.” I don’t doubt that the praise Jackson has gotten is sincere, but he’s also a bootlicker.”

    What it means for a start is that the man is a liar, pure and simple. At that point, we can stop.