The confirmation of wellness influencer Casey Means, Donald Trump’s pick to become the next U.S. surgeon general, is uncertain after her appearance before the Senate health committee last week.
The Senate’s health committee still must decide whether to advance her nomination. From there, it would go to a vote before the full Senate.
Unlike past Surgeon Generals, Means doesn’t have board certifications or an active medical license. While she completed her training as a medical doctor and holds an MD, she dropped out of residency and doesn’t have board qualifications or an active medical license. A strong proponent of the Make America Healthy Again (MAHA) movement, she has long criticized mainstream medicine and the power of the pharmaceutical industry. She’s criticized the use of pesticides and other environmental toxins, and also publicly voiced controversial views on vaccines and birth control, among other topics.
Here’s a closer look at Means and her background, as well as what a potential confirmation as America’s top doctor could mean for public health.
Who Is Casey Means?
Means is a medical doctor who received her degree from Stanford University in 2014. She did four years of head and neck surgical training in otolaryngology — a speciality commonly called an ear, nose, and throat doctor, or ENT.
In 2024, she published the book Good Energy: The Surprising Connection Between Metabolism and Limitless Health, which suggests that improving metabolic health can lower the risk of depression, infertility, insomnia, heart disease, and other chronic illnesses.
What Does the Surgeon General Do?
The surgeon general’s purpose is to communicate “the best scientific information available” on health and illness to the public, usually through advisories, reports, and calls to action, says Jeff Niederdeppe, PhD, a professor of communication and an associate director of the Cornell Health Policy Center in Ithaca, New York.
The surgeon general also oversees the U.S. Public Service Commissioned Corps, which Dr. Niederdeppe describes as “a public health rapid response team of sorts.” While the surgeon general doesn’t set policy, the person holding the title “advises policymaking bodies,” Niederdeppe says.
But the power of the surgeon general is somewhat limited, says Georges Benjamin, MD, an internal medicine doctor and CEO of the nonprofit American Public Health Association. “The surgeon general has no regulatory policy or authority directly,” he says. “Most of the surgeon general’s powers have been moved to the secretary of the Department of Health and Human Services,” currently Robert F. Kennedy Jr.
However, Means has an existing relationship with Kennedy, along with her own public following. If approved, “She will have enormous clout,” Dr. Benjamin says.
Casey Means’s Public Stances on Big Health Issues, Explained
Here’s what Means has said about major health issues.
Vaccines
Means took a more moderate approach during her confirmation hearing when asked if she would recommend that parents vaccinate their children against measles.
Autism
Means was measured in how she responded to questions about autism during her hearing.
“The reality is that we have an autism crisis that’s increasing and this is devastating to many families. We do not know as a medical community what causes autism,” she said.
Food and Pesticides
Hormonal Birth Control
Supplements
During the hearing, Means was asked about potential conflicts of interest from receiving at least $325,000 to promote supplements since 2024, along with the $1,500 annual membership fee required to use Levels.
“You’ve said that our healthcare system is broken, but it seems to me that you’ve spent your career making money off the flaws of the system,” said Senator Tammy Baldwin.