WASHINGTON — President Donald Trump's White House doctor reluctantly withdrew his nomination to be Veterans Affairs secretary Thursday in the face of accusations of misconduct, the latest embarrassing episode highlighting Trump's struggles to fill key jobs and the perils of his occasional spur-of-the-moment-decision-making.
The weeks-long saga surrounding the nomination of Navy Dr. Ronny Jackson leaves the government's second-largest agency without a permanent leader while it faces an immediate crisis with its private health care program. And it abruptly tarnished the reputation of a doctor beloved by two presidents and their staffs.
White House officials say they are taking a new look at the way nominees' backgrounds are checked — and they believe they will persuade Trump to take additional time to ensure that a replacement is sufficiently vetted.
The leading person now under consideration for the VA post is former Rep. Jeff Miller, who chaired the House Veterans Affairs Committee before retiring last year, according to White House officials. Miller is a strong proponent of expanding private care for veterans, a Trump priority.
Trump quickly selected Jackson, a rear admiral in the Navy, to head the VA last month after firing Obama appointee David Shulkin following accusations of ethical problems and a mounting rebellion within the agency. Jackson, a surprise choice who has worked as a White House physician since 2006, faced immediate questions from Republican and Democratic lawmakers as well as veterans groups about whether he had the experience to manage the massive department of 360,000 employees serving 9 million veterans.
Then this week's unconfirmed allegations by current and former colleagues about drunkenness and improper prescribing of controlled substances, compiled and released by Democrats, made the nomination all but unsalvageable.
"The allegations against me are completely false and fabricated," Jackson said in a statement announcing his withdrawal.
Press secretary Sarah Huckabee Sanders said Jackson was back at work at the White House on Thursday. But his future there remains uncertain. He had stepped aside from directing Trump's medical care and leading the medical unit while his nomination was being considered.
"I would hope the White House would closely consider whether he is the best person to provide medical care for the president," said Democratic Sen. Chris Coons of Delaware.
Trump himself praised Jackson, saying, "He's a great man, and he got treated very, very unfairly." Then the president went after Democratic Sen. Jon Tester of Montana, who released a list of allegations against Jackson that was compiled by the Democratic staff of the Senate Veterans Affairs Committee.
Trump aides said the president was furious with Tester, who faces a tough re-election fight this fall, and plans to aggressively campaign against him.
"I think Jon Tester has to have a big price to pay in Montana," Trump warned on "Fox & Friends" on TV.
Tester, meanwhile, called on Congress to continue its investigation of Jackson. "I want to thank the service members who bravely spoke out over the past week. It is my constitutional responsibility to make sure the veterans of this nation get a strong, thoroughly vetted leader who will fight for them," he said.
Elsewhere in the capital, Congress was questioning another Trump official whose job appears in jeopardy.
Scott Pruitt, head of the Environmental Protection Agency, was questioned closely by House Democrats about revelations of unusual security spending, first-class flights, an advantageous condo lease and more. Even Republicans who support Pruitt's deregulation efforts, said his conduct needed scrutiny.
Tom Price, Trump's first secretary of the Department of Health and Human Services, resigned last year after criticism of his use of private charter flights and military jets.
The turmoil at the VA comes as it faces a budget shortfall for its private-sector Veterans Choice program, a campaign priority of Trump's, with lawmakers deadlocked over a long-term fix due to disagreements over cost and how much access veterans should have to private doctors
Veterans are "exhausted by the unnecessary and seemingly never-ending drama," said Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America. "VA's reputation is damaged, staff is demoralized, momentum is stalled and the future is shockingly unclear."
The VA issued a statement late Wednesday that it would push to have Congress move on an expansion of Choice next month.
Sen. Johnny Isakson of Georgia, chairman of the Veterans Affairs Committee, said Thursday he would "work with the administration to see to it we get a VA secretary for our veterans and their families."
White House officials were visibly dismayed Wednesday and Thursday as they watched Jackson suffer the blows of the allegations. The doctor, who is well-liked by and has personal relationships with many White House staffers, cited the withering pressure for withdrawing from consideration for the post, but maintained he had done nothing wrong.
Trump said on Fox that he has an idea for a replacement nominee, adding it will be "someone with political capability."
Miller, the former congressman who was described as the leading candidate, is a strong proponent of expanding private care for veterans, Miller led the push to create Choice in 2014.
However, major veterans groups and Democrats stand opposed to an aggressive expansion of Choice, seeing the effort as a potential threat to VA medical centers.
Dan Caldwell, executive director of the conservative Concerned Veterans for America, urged the White House to take more time "to carefully select and vet a new nominee" who could head VA.
"The VA currently has a competent Acting Secretary in Robert Wilkie who can manage the VA along with the rest of his leadership team," he said. "Considering the tremendous challenges that the last three VA secretaries have faced, it is important that a capable individual with a high level of integrity is selected."
During the presidential campaign, Trump repeatedly pledged to fix the VA by bringing accountability and expanding access to private doctors, criticizing the department as "the most corrupt." At an Ohio event last July, Trump promised to triple the number of veterans "seeing the doctor of their choice."
Currently, more than 30 percent of VA appointments are made in the private sector.