The debacle over Donald Trump’s nomination of White House physician Rear Admiral Ronny Jackson to become head of the Veteran’s Administration has shed some light on this obscure position. During the period after his nomination, various allegations emerged that said that Jackson was not only lax in the way he ran the office but also frequently drank on the job and created a hostile work environment. After withdrawing his name from consideration for the VA position, Jackson had said that he would revert to his former position but now it appears that he will not do that either, and another navy doctor Sean Conley has taken over.
The odd thing about this whole episode is that if Jackson had not accepted the nomination to head the VA, his indiscretions (assuming the allegations are true) might never have seen the light of day because no one cares about the position of White House physician and he could have continued in what seems like a sinecure. So why did he take the risk of putting his work and life under the close scrutiny that comes with being nominated for a cabinet position? Either he is innocent of the charges and has been slandered or he honestly believed that his behavior was acceptable or he is utterly naïve about how politics and the media work in Washington.
I became curious about the position of White House physician. It is not that small an operation.
The White House physician has an office inside the White House. The location of his or her medical unit plays an important role in keeping the President of the United States healthy. He or she also oversees a staff which is typically composed of five military physicians, five nurses, five physician assistants, three medics, three administrators and one IT Manager.
The medical office of the White House doctor is a “mini urgent-care center” containing a physician’s office, private examination rooms, basic medications and medical supplies, and a crash cart for emergency resuscitation. Air Force One is equipped with emergency medical equipment, an operating table, and operating room lights installed at the center of the presidential plane for emergency use by the White House doctor, but does not have an X-ray machine or medical laboratory equipment.
All this seems a bit much for a single patient. It turns out that the physician also treats “the members of the president’s immediate family, the Vice President, and the Vice President’s family. He or she may also provide medical care and attention to the more than 1.5 million visitors who tour the White House each year, as well as to international dignitaries and other guests of the President.” But even allowing for that expanded range of patients, I cannot imagine that there is much actual doctoring going on. And surely if there is an emergency in Washington or other major US city, I would think that the emergency rooms of nearby hospitals with their trauma centers would be better equipped to deal with it than this staff.
I can see the need for there to be a doctor near the president at all times in case of emergencies, especially when he is traveling, but surely the job must be an excruciatingly boring one, and it is not surprising that Jackson was reportedly tempted to drink on the job. According to Wikipedia, the boredom got to a previous holder of the position.
Daniel Ruge, Ronald Reagan’s first physician in the White House, resigned after the president’s first term and called his job “vastly overrated, boring and not medically challenging.” Ruge could not attend most state dinners due to lack of space. He nonetheless had to be ready for emergencies, and usually waited alone in his office wearing a tuxedo.
Apart from the prestige of working in the White House, the job would have little attraction for any physician who wanted to develop their skills and practice their craft. The novelty of being in the vicinity of political dignitaries would quickly wear thin. Although the position does not require the person to be in the military, civilian doctors are understandably reluctant to give up their practices to take it on. Military doctors can shuffle in and out more easily which is why they are the usual occupants.