President Trump’s decision this week to replace outgoing Veterans Affairs Secretary David Shulkin with White House physician Ronny Jackson has rankled groups that work closely with the VA and unleashed a powerful new critic of the Trump administration.

Veterans service organizations have expressed concern and confusion over the selection of Jackson, a doctor and Navy veteran, to lead an organization that employs more than 300,000 people. His predecessor had gone into the VA’s top job with far more experience — both at the agency itself and in the private sector — but still survived only a year before the president disposed of him via Twitter after weeks of allowing speculation about his future to fester.