After nearly nine months in office, President Obama has filled some 250 appointments to top government positions. That's about half the number of vacancies for Senate confirmed jobs.
The process has stalled for reasons including increased vetting by the administration, and Senate Republicans have put holds on more than a dozen top nominees.
The delays mean the president's policies at the Department of Health and Human Services, the Labor Department and other agencies are being carried out by temporary officials — or in some cases not at all.
The Labor Department's office of solicitor acts as the labor secretary's chief lawyer. The solicitor is in charge of carrying out enforcement actions, like going after employers who don't pay minimum wage or fail to compensate workers properly for overtime.
"During the Bush administration, the Labor Department's approach was to work closely with the employer community when it came to enforcing the labor laws," says Christine Owens of the National Employment Law project. "It's time to work with the worker community, and that's what Ms. Smith has been doing in New York and that's what we think is what the Labor Department ought to be doing."
Smith would be M. Patricia Smith, who was New York's labor commissioner, and who was nominated by Obama to be Labor Department solicitor.
Smith's nomination has been approved by a Senate committee, but in stepped Sen. Mike Enzi of Wyoming, the panel's ranking Republican.
Enzi said he was putting Smith's nomination on hold. His office turned down a request for an interview, but Republicans feel Smith gave inaccurate testimony during her confirmation hearing.
Smith's nomination is one of some three dozen that have been approved by relevant committees but not yet had a full Senate vote. Many are because of holds.
Holds are a tradition Sen. Lamar Alexander (R-TN) knows all too well.
Alexander remembers 1991 when the first President Bush nominated him to be education secretary: "[Democratic] Sen. [Howard] Metzenbaum put a hold on my nomination. In my hearing he said, 'Gov. Alexander, I've heard some bad things about you but I don't want to bring them up here.' I said, 'Well, senator, you've just brought them up.' He put a hold on me so I went to my office and sat quietly and wrote up my education plan. There's nothing new about it."
Democratic leaders in the Senate could overcome any hold by getting 60 votes in favor of the nominee.
As frustrating as they most likely are for the president, the Senate holds account for a fraction of the unfilled positions in his administration. Many of the openings can be traced back to the administration's vetting process.
"He is using Mother Teresa standards in a city where there are very few saints," says Darrell West of the Brookings Institution. "That is creating a huge barrier to getting his people approved."
Obama signed an executive order barring any federally registered lobbyists from serving in his administration. That, and the tax problems of some of his earlier nominees, have made the vetting process all the more difficult.
"President Obama is having to rely much more on the career bureaucracy to implement his ideas," West says, "as opposed to having his own individuals who are committed to his vision, want to pursue his agenda and who are willing to work very hard to make sure his ideas get implemented."
According to White House Transition Project, the departments of Treasury, Justice, Health and Labor have the most unfilled positions.
Obama can take one consolation: He has about the same number of positions filled as did his predecessor George W. Bush at this point in his administration.