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story.lead_photo.caption Rear Adm. Ronny Jackson, President Donald Trump's choice to be secretary of the Department of Veterans Affairs, leaves a Senate office building after meeting individually with some members of the committee that would vet him for the post, on Capitol Hill in Washington, Tuesday, April 24, 2018.

WASHINGTON -- President Donald Trump said Tuesday that White House physician Ronny Jackson should consider withdrawing his nomination as Veterans Affairs secretary, while a Senate panel opened a review into allegations of improper behavior and management lapses.

Trump said at a news conference with French President Emmanuel Macron that he advised Jackson earlier in the day to withdraw.

"I said to Dr. Jackson, 'What do you need it for?'" Trump said. "I don't want to put a man through a process like this. It's too ugly and disgusting."

He later added, "I really don't think personally he should do it, but it's totally his, I would stand behind him, totally his decision."

Though Trump couched his comments as a defense of Jackson, his statement was a public signal to a nominee under fire. Trump repeated several times that he thought Jackson should withdraw.

Yet at a private meeting in the Oval Office later in the afternoon, Trump urged Jackson to keep fighting to win confirmation, according to a White House official briefed on the meeting.

Jackson used the meeting to deny allegations against him that were described earlier in the day by a pair of senators on the Veterans' Affairs Committee, said the official, who spoke on condition of anonymity to talk about internal discussions.

The committee chairman, Sen. Johnny Isakson, R-Ga., said he and the panel's ranking Democrat, Jon Tester of Montana, decided to delay a hearing on Jackson's nomination that had been scheduled for today, citing "serious allegations" detailed in materials provided to the committee. The two also sent a letter to Trump seeking more information.

Tester said in an interview with National Public Radio's All Things Considered that the allegations included that Jackson created a hostile work environment, overprescribed drugs and was "repeatedly drunk while on duty, while traveling" on presidential trips overseas.

Tester said the committee had received allegations from 20 people in the military.

Jackson was portrayed as "abusive toward staff" and as someone who "belittles" people, Tester said. "Basically creating an environment where the staff felt they needed to walk on eggshells around him."

A watchdog report reviewed Tuesday by The Associated Press appeared to corroborate some of those allegations.

The report, ordered by Jackson in 2012, found that he and a rival physician exhibited "unprofessional behaviors" as they engaged in a power struggle over the White House Medical Unit. The report suggested the White House consider replacing Jackson or Dr. Jeffrey Kuhlman -- or both.

Kuhlman was the physician to President Barack Obama at the time, and he had previously held the role occupied by Jackson: director of the White House Medical Unit.

The six-page report by the Navy's Medical Inspector General found a lack of trust in the leadership and low morale among staff members, who described the working environment as "being caught between parents going through a bitter divorce."

"There is a severe and pervasive lack of trust in the leadership that has deteriorated to the point that staff walk on 'eggshells,'" the report found.

Jackson was named physician to the president in 2013, after Kuhlman left the unit.

The inspector general report reviewed by the AP includes no references to improper prescribing or the use of alcohol.

The White House disputed that Jackson had improperly administered medication, saying the medical unit passed regular audits by the Controlled Substance Inventory Board.

At the Capitol on Tuesday, Jackson told reporters that he was eager to face the confirmation hearing, though he didn't respond directly to questions about the allegations.

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"I was looking forward the hearing tomorrow, kind of disappointed that it's been postponed, but I'm looking forward to getting it rescheduled and answering everybody's questions," he said in a video published by NBC News.


Trump at the news conference praised Jackson, a Navy rear admiral, as "a great leader" and brushed aside criticism from some lawmakers that he lacked sufficient management experience to run the federal government's second-largest department, after the Defense Department.

The veterans health system "is so big, you could run the biggest hospital system in the world and it's small-time compared to the Veterans Administration," Trump said. "So nobody has the experience."

Senate Majority Leader Mitch McConnell, R-Ky., told reporters that he would wait to hear from Trump and Isakson on "what they believe the way forward should be" on the nomination.

In their letter to Trump, Isakson and Tester requested all communications between the Defense Department and the White House Military Office "regarding allegations or incidents involving Rear Admiral Jackson from 2006 to present."

They also are seeking any documents, "including those developed during the course of an investigation," held by any office in the executive office of the president "that were never communicated to the Department of Defense or Offices of Inspector General."

Several lawmakers said the allegations haven't been substantiated but that they must be addressed.

Isakson declined to say anything more at the Capitol. He said he isn't sure when, or whether, the hearing might be rescheduled. Tester said, "We're still working on the vetting."

Still, the Trump administration defended Jackson earlier Tuesday.

"Admiral Jackson has been on the front lines of deadly combat and saved the lives of many others in service to this country," White House spokesman Hogan Gidley said in a statement. "He's served as the physician to three presidents -- Republican and Democrat -- and been praised by them all."

Later, the White House released hand-written reports from Obama and Trump praising Jackson's leadership and medical care, and recommending him for promotion.

Before serving as a White House physician, Jackson had deployed as an emergency medicine physician to Taqaddum, Iraq, during the Iraq War.

Several lawmakers from both parties criticized the White House for not doing a thorough job of investigating its own nominees.

"I just think the White House does not vet their nominees, so it leaves us as members having to look at their personal and leadership and other qualities," said Sen. Patty Murray, D-Wash., a member of the Veterans' Affairs Committee. "And they didn't do a good job, and now we're doing it."

Jackson was nominated to replace Veterans Affairs Secretary David Shulkin, whom Trump fired March 28. Shulkin is a former hospital executive who was a holdover from Obama's administration and who initially won Trump's favor for his efforts to overhaul the long-troubled system for veterans health care.

He was ousted after questions about his official travel and during an internal administration fight over how much of the medical care delivered to veterans could be outsourced to private insurers.


Officials familiar with the allegations against Jackson declined to offer precise details but said that they suggest a pattern of behavior, not just one or two isolated incidents.

The officials declined to elaborate on the allegation that Jackson overprescribed drugs.

But White House physicians, including Jackson's predecessors, have for years distributed small amounts of Ambien, a prescription sleep aid, to White House staff and members of the press flying on long overseas trips. And several former officials said the doctors also distributed Provigil, a prescription drug for promoting wakefulness, to staff members upon landing.

On trips to Africa and other countries where malaria is rampant, White House doctors would also distribute Malarone, a prescription medicine that prevents the disease, former officials said.

Members of both parties pushed back on the alcohol allegation. Sen. Jerry Moran, R-Kan., said Jackson told him during a one-on-one meeting Tuesday that "he has never had a drink while on duty." Moran said Jackson did not specifically address other allegations against him but that he indicated he intended to move ahead as the nominee.

Brian McKeon, who served as chief of staff for the National Security Council under Obama, said he does not recall Jackson ever drinking to excess or being under the influence, even on long trips abroad.

"I am not even sure that I ever saw him in a hotel bar," McKeon wrote in an email Tuesday.

More than a half-dozen former White House officials who served with Jackson in Obama's administration also expressed support for him. None said they recalled him ever being drunk or loosely dispensing medications.

"He always seemed to be alert, responsive, responsible," said David Axelrod, who served as Obama's senior adviser. "My impressions were positive. My interactions were positive. I never heard any complaints."

Still, Republicans said the allegations are serious.

Sen. Thom Tillis, R-N.C., a member of the veterans committee, said that "if the allegations were based in fact, it would be concerning."

Information for this article was contributed by Erik Wasson, Laura Litvan, Justin Sink, Sahil Kapur, Toluse Olorunnipa, Ari Natter, Jennifer Epstein and Arit John of Bloomberg News; by Nicholas Fandos and Michael D. Shear of The New York Times; and by Zeke Miller, Ken Thomas, Hope Yen, Lisa Mascaro, Catherine Lucey, Alan Fram and Matthew Daly of The Associated Press.

A Section on 04/25/2018

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