Robert Wilkie took the oath of office Monday to become the new Secretary of Veterans Affairs and take over a department riddled by poor morale among employees and political infighting at the top.
At a White House ceremony, President Donald Trump looked on as Vice President Mike Pence swore in Wilkie, 55, of North Carolina, who served as an intelligence officer in the Navy and holds the rank of colonel in the Air Force reserves.
Wilkie was taking on "a very, very tough and important position," Trump said. "Since day one, my administration has been focused on serving the men and women who make freedom possible, our great Veterans. These heroes deserve on the best and they will have it under Robert Wilkie."
Wilkie was coming to the VA from a post at the Pentagon, and Trump joked that Defense Secretary Jim Mattis was the only one upset by the move.
"General Mattis is here someplace? He's the only one unhappy about this because I took him away from General Mattis, right? And General Mattis, I'm sorry to have done that, we have no choice," Trump said. "The Vets are calling, right?"
Trump said Wilkie had the task of implementing key legislation passed in his administration -- the VA Mission Act expanding private health care options and the VA Accountability and Whistleblower Protection Act aimed at speeding up the process of firing poor performers.
Pence also swore in Wilkie's predecessor, Dr. David Shulkin, who was fired by Trump in March. Wilkie became the 10th VA Secretary since the department was made a Cabinet post in 1989.
As was the case with Shulkin, the only holdover from the Obama administration in Trump's Cabinet, Wilkie was not the president's first pick.
Trump nominated Rear Adm. Ronny Jackson, his personal physician and head of the White House medical unit to head the VA, but Jackson withdrew his name amid questions about his lack of experience in top management post and never-proven allegations of misconduct involving his job performance at the White House.
Wilkie, who had been serving as undersecretary of defense for personnel and readiness, was brought over to the VA in early April to serve on an interim basis as VA acting secretary.
Trump appeared to surprise him at an unrelated White House ceremony in May when he announced that Wilkie was his nominee for the permanent post.
As acting secretary, Wilkie indicated he was well aware of the poor morale at the VA and backbiting at the top over the expansion of private health care option for Veterans.
"If we don't listen to each other, we won't be able to listen to our Veterans and their families," said Wilkie, a Republican who previously served in a number of Capitol Hill and White House staff positions.
"We must have a bottom-up organization," he said when he was named to become acting secretary. "The energy must flow from you who are closest to those we are sworn to serve. It is from you that the ideas we carry to the Congress, the VSOs [Veterans service organizations], and to America's Veterans will come."
He stressed that he would listen to the rank-and-file. "Anyone who sits in this chair and tells you he has the answers is in the wrong business," he said.
In his Senate confirmation hearing, Wilkie, who grew up at Fort Bragg, North Carolina, said his concern for the military and Veterans comes from his late father, retired Army Lt. Col. Robert Leon Wilkie Sr., who died last year.
His father's awards included three Purple Hearts, four awards of the Bronze Star (one with Combat "V" device), four awards of the Air Medal, the Distinguished Flying Cross, the senior Parachutist Badge and the Ranger tab.
"At my Pentagon swearing in, I was proud when the officiating officer noted that I had been born in khaki diapers," Wilkie said.
"I have been privileged to see this military life from many angles, as a dependent, as the son of a gravely wounded combat soldier; as an officer in two services, the Navy and the Air Force; and as a senior leader in the Pentagon," he said.
The Washington Post reported Sunday that Wilkie would immediately set about reassigning several of the top-level Trump administration political appointees at the VA who have raised concerns among the VSOs and House and Senate Democrats.
Peter O'Rourke, the current acting secretary and former chief of staff at the VA, has clashed with the VA's Office of Inspector General over access to whistleblower complaint data. O'Rourke formerly worked on Trump's campaign staff.
Camilo Sandoval, another former Trump campaign staffer and current acting chief information officer at the VA, is expected to leave the VA in the coming months, The Washington Post reported.
VA Press Secretary Curt Cashour issued a statement Monday saying that the VA "has no personnel announcements at this time." Cashour also said that Sandoval was remaining at the VA and that he himself "has no plans to leave the department."
Wilkie will be taking over the nation's largest health care system, with 171 hospitals and more than 1,000 clinics and other facilities.
At his Senate confirmation hearing, he heard from both sides of the aisle on morale at the VA and the political infighting that has targeted long-serving civil service staff.
"Of all the challenges we have at VA, morale may be the biggest problem," Sen. Johnny Isakson, R-Georgia, chairman of the Senate Veterans Affairs Committee, told Wilkie. "You are getting an agency that has problems, that's in need of help."
Sen. Jon Tester, D-Montana, the ranking member of the committee, warned Wilkie that he would eventually come into conflict with Trump administration political appointees within the VA and at the White House who had pressed for a rapid expansion of private health care options.
"Sooner or later, you're going to come to a crossroads with these folks," Tester said of the political appointees. "My only advice to you is to take the cues from the Veterans and do what you think is right, even if political forces threaten your job because I want you to succeed. I really want you to succeed."
Wilkie said his main concern in taking the VA secretary's job is getting Veterans access to the treatment they have earned.
"Many of the issues I encountered as acting secretary were not with the quality of care but were getting Veterans through the door to get that care," he said at his confirmation hearing.
Isakson asked Wilkie what "customer service" means at the VA. Wilkie responded, "Customer service means before the Veteran walks through the door of the VA he's already been greeted by schedulers, by medical professionals.
"I have no doubt that VA provides some of the finest care in America, but I also understand that getting to that care is something that the leadership of the Veterans Affairs Department has to focus on like a laser beam," he added.
In addition to reassigning personnel, Wilkie will have several top jobs to fill. The VA currently lacks a permanent deputy secretary, the No. 2 post, and the jobs of undersecretary for health and deputy undersecretary for health are still unfilled.