While Casey Means awaits the start of a Senate confirmation process to take the role of U.S. surgeon general, there is widespread debate about her nomination.
Means, a functional medicine physician who does not have an active medical license, was announced as President Donald Trump’s nominee for surgeon general on May 7.
If confirmed by the Senate, Means will have one of the nation’s most visible public health roles. She is aligned with Health and Human Services Secretary Robert F. Kennedy Jr.’s Make America Healthy Again (MAHA) movement.
Generally considered America’s doctor, the surgeon general manages 6,000 Commissioned Corps of the U.S. Public Health Service members, but the Corps’ members are mostly managed through the agencies where they are posted.
Appointed by the president, with consent from the Senate, the surgeon general serves a four-year, renewable term.
The surgeon general can issue public health threat advisories and influence national conversations on health.
Trump said in a Truth Social post on May 7 that Means has “impeccable ‘MAHA’ credentials,” referencing the “Make America Healthy Again” platform introduced by Kennedy.
Means will work to eradicate chronic disease and improve the health and well-being of Americans, Trump added.
“Casey Means has the potential to be one of the finest Surgeon Generals in United States history,” Trump said.
Means graduated from Stanford University’s medical school, but she didn’t finish her surgical residency.
Her brother, Calley Means, is also a Kennedy ally who serves as a White House adviser and a special government employee at the Department of Health and Human Services (HHS).
Casey Means co-authored “Good Energy: The Surprising Connection Between Metabolism and Limitless Health” with her brother in 2024.
“There was something inside of me that was whispering and then speaking a little louder, and then finally was a deafening call to me that something is not right,” she told podcaster Joe Rogan last fall.
“When you pop up for just a second and look around at what is happening to American health, it’s a disaster. It’s literally a disaster,” Means added, while explaining her decision to discontinue her residency and start practicing functional medicine, which is a holistic approach to health care focused on addressing the root causes of disease.
Eventually, she qualified for a medical license in Oregon, but it is currently inactive.She co-founded Levels, a company that allows users to monitor their metabolic health, including diet, glucose levels, sleep, and exercise, through data.
Means has echoed Kennedy’s MAHA talking points.
She has advocated for ultra-processed foods in school lunches to be removed and replaced by organic, regenerative foods in school meals.
Means has said on her website that there should be more investigation into vaccine safety, and it should be easier for patients to sue pharmaceutical companies if they are harmed by vaccines.
She also mirrors Kennedy’s belief that vaccines are a potential cause of autism.
“I bet that one vaccine probably isn’t causing autism, but what about the 20 [vaccines] that [kids] are getting before 18?” Means said on Joe Rogan’s podcast.
Because Means is a holistic physician who does not have an active medical license, critics question whether a person with limited conventional medical experience should hold one of the country’s most visible health leadership roles.
“In every previous surgeon general, they’ve got the license, they’ve gotten the residency, they have at least some leadership ability that’s scalable,” Dr. Richard Carmona, who served as U.S. surgeon general under President George W. Bush, told NPR in early May.
“We don’t see any of that here. So I think that our nation deserves better.”
Nicole Shanahan, who was Kennedy’s running mate in the 2024 presidential election before he dropped out of the race and endorsed Trump, criticized the nomination of Means in an X post.
“Doesn’t make any sense. I was promised that if I supported RFK Jr. in his Senate confirmation that neither of these siblings would be working under HHS or in an appointment (and that people much more qualified would be),” she wrote.
Anna Matson, who served as a volunteer for Kennedy’s presidential campaign and is a podcaster and political researcher, said that Means is “almost as controversial as RFK Jr., but for entirely different reasons.”
“I knew her appointment would stir debate within the MAHA movement. And no, it’s not about her expired medical license,” Matson wrote on X. “Her company Levels was launched with heavy backing from Silicon Valley.
“There’s real concern that she, her brother ... could use their roles in government to gain access to our private health data,” Matson added, noting that “I would imagine she would have to divest from her companies since it would be a serious conflict of interest.”
Kennedy defended Means in a May 8 post on X.
“The absurd attacks on Casey Means reveal just how far off course our healthcare conversations have veered, and how badly entrenched interests—including Big Food and its industry-funded social media gurus—are terrified of change,” Kennedy wrote.
“Casey has excelled in every endeavor she has undertaken. She was president of her Stanford undergrad class, was a standout at Stanford Medical School, and was a top performer in surgical residency.
“She had the courage to leave traditional medicine because she realized her patients weren’t getting better,” he added.
Kennedy continued by writing that “the attacks that Casey is unqualified because she left the medical system completely miss the point of what we are trying to accomplish with MAHA.”
“Casey is the perfect choice for Surgeon General precisely because she left the traditional medical system, not in spite of it,” he said.
Lauren Lee, a strategist for American Values 2024, a PAC aligned with Kennedy, said, “It is peak hypocrisy to hate on [Means’] lack of credentials.”
“But now we appeal to authority? If Casey Means had every credential in the book, she would be labeled a ‘plant’ even more so.
“We would do ourselves well to see and recognize the immense progress here, joining forces to revolutionize science and medicine in this country.
“If I have learned anything this year, it’s that the establishment screams the loudest against those they fear the most. Clearly, they are terrified of Casey Means.”
The Senate confirmation hearing for Means has yet to be scheduled.
Initially, Trump nominated Dr. Janette Nesheiwat for the surgeon general post.
Nesheiwat, a medical doctor for an urgent care company, was originally scheduled to appear before the Senate Committee on Health, Education, Labor and Pensions for her confirmation hearing on May 8.
