More changes in the Trump administration


But his tenure took a sour turn on February 14 when the VA inspector-general reported that Shulkin and his wife had improperly accepted Wimbledon tickets and used staff to arrange site-seeing visits during a business trip to Denmark and England last summer.

After releasing the results from Trump's physical, Jackson said "he has incredible genes and that's the way God made him".

"At the end of the day, cabinet secretaries serve at the pleasure of the president", he said. The Times reported that the White House was angry about how the report played in the media.

The president announced the move on Twitter, calling Jackson "highly respected" and thanking Shulkin, a physician and former hospital executive who was the sole Obama-era holdover in Trump's Cabinet.

Jackson has served since 2013 as the Physician to the President, and gained a national profile earlier this year for holding a sweeping press conference on the president's health. Robert Wilke, who serves as an undersecretary at the Defense Department, will serve as acting secretary. "That's for sure", Trump said in June.

A White House official said Trump warmed to Jackson and had been aware that Shulkin had sought to make Jackson the VA undersecretary past year. The Veterans Affairs Committee should not approve any nominee for secretary who supports the privatization of the VA.

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Will Fischer, director of government relations for the VoteVets lobby group, said his group hopes Jackson will oppose any attempt to privatize the VA or its health services, a concept that Republicans talk about occasionally.

The report fueled Shulkin's critics, both within his own agency and outside it, and brought into the open the power struggle over how to best care for the nation's veterans.

"If Dr. Jackson can do that, immediately, he will do a lot to help his chances at confirmation", Fischer said.

Though Trump and Shulkin got along well for many months, the mood inside the White House began to change as Shulkin clashed with conservative appointees over how to expand veterans access to private medical care, a program known as Choice that started in 2014 after revelations VA managers were manipulating patient wait lists. The Veterans Health Administration, the largest integrated healthcare system in the United States, provides care at more than 1,200 facilities, including 170 VA Medical Centers, to more than 9 million veterans.

At the time, he called for the head of the VA to "clean house".

"He's like central casting - like a Hollywood star", Trump told donors during a fundraiser at Mar-a-Lago last month, according to audio of his remarks obtained by CNN. It led to embarrassing headlines that irritated top White House officials and the president, who began to search for a replacement. The department announced two days after the report was issued that Shulkin's chief of staff, Vivieca Wright Simpson, would retire.