Dr. Casey Means will appear before a Senate committee Wednesday to make her case to become the next surgeon general. The job would make her the face of the mainstream medical system — which Dr. Means, a wellness influencer and entrepreneur, has vehemently criticized.
Parts of Dr. Means’s résumé make her seem like a natural fit. She graduated from the Stanford School of Medicine and has worked as a biomedical researcher. She championed healthy eating and exercise as essential for good health, long before Make America Healthy Again became a political movement. And with hundreds of thousands of social media followers and a popular newsletter, Dr. Means is well-versed in communicating with the public about their health.
But Dr. Means has also repeatedly railed against the conventional medical system. She dropped out of her medical residency and does not have an active license to treat patients. She is skeptical of some vaccines and has repeated the debunked claim that they could be linked to autism. She has spoken out against bans on raw milk, which can contain dangerous bacteria. She has frequently told Americans not to trust the medical system, titling one chapter of her best-selling book: “Trust Yourself, Not Your Doctor.”
Dr. Means did not respond to multiple requests for comment.
“We actually have to figure out new approaches to medicine, and that’s the kind of leadership that she’s going to bring to our country,” Health Secretary Robert F. Kennedy Jr. told Fox News after President Trump nominated Dr. Means for surgeon general.
The Senate is expected to confirm Dr. Means for the role. While the surgeon general cannot shape or enforce health policy directly, the position carries sizable influence over how Americans think and talk about health. Past surgeons general have pushed to slash smoking rates in America, beat back the stigma around AIDS and change the way the public talks about loneliness and mental health.
For decades, people have listened to the surgeon general’s voice because it “was speaking for what we knew from the best available science,” said Kathleen Hall Jamieson, a science communication researcher and the director of the Annenberg Public Policy Center at the University of Pennsylvania. “And it wasn’t saying, ‘Don’t trust your doctor, trust yourself,’” she said. “It was saying, ‘I’m a doctor you can trust. I’m speaking for a kind of science that is grounded in our traditional understanding of how science works.’”
Dr. Jamieson added: “Now imagine that in this context, that voice was being used to say, ‘Drink raw milk.’”
The fact that Dr. Means is not a practicing physician and that she did not complete her medical training is also a sticking point. Critics say she is ill-equipped to take on the role, which involves issuing public health advisories and coordinating responses to public health threats, as well as leading the more than 6,000 health professionals who make up the U.S. Public Health Service Commissioned Corps.
To her supporters, Dr. Means’ focus on chronic disease, and her rejection of the medical establishment, is precisely what will allow her to improve Americans’ health.
“She’s not a career bureaucrat. She’s not a pharma spokesperson. She understands biomarkers, lifestyle drivers, environmental impacts, nutrition, how they all connect,” said Alex Clark, the host of the popular Turning Point USA wellness podcast “Culture Apothecary.”
Some of what Dr. Means calls for is uncontroversial. Nearly every doctor would say Americans should eat better and move more. Many would agree the medical establishment, which Dr. Means has called a “sick care” system that focuses more on treating disease than preventing it, is not adequately serving the public. Dr. Means has said she wants to see warning labels on most ultraprocessed foods, which have been linked to a range of health problems and which nutritionists widely recommend avoiding.
Dr. Means has said she dropped out of her surgical residency in 2018 because she was frustrated and alarmed that she was cutting people open instead of understanding why they were sick in the first place.
“The system is rigged against the American patient to create diseases and then profit off of them,” Dr. Means said on Tucker Carlson’s podcast.
In 2019, she started a small functional medicine practice in Portland, Ore., focused on what she calls the “root causes” of illness. (She has said she started “phasing out” that practice a year later and let her license become inactive in 2024, because she was no longer seeing patients.)
Dr. Means describes what she believes those root causes to be in her book “Good Energy,” which she wrote with her brother, Calley Means, a prominent adviser to Mr. Kennedy. In it, the siblings argue that cancer, infertility, diabetes, depression and many other chronic health issues can be blamed on diet, chemical exposures, prescription medications and Americans’ stressed-out and sedentary modern lifestyles.
While Dr. Means says that doctors can be helpful in an acute crisis, she has also suggested that getting more sleep, sunlight, time in nature, exercise and whole foods could help alleviate these health issues without the aid of traditional physicians. She has also said that the more prescription medicines Americans take, the sicker they get.
She regularly echoes these points on podcasts and in her newsletter, where she has also promoted supplements and other wellness products that are not always backed by rigorous science, including those sold by companies that paid to sponsor her newsletter. Dr. Means is also the co-founder of Levels, a company that offers wearable glucose monitors. (She has pledged to divest from her wellness interests.)
While Dr. Means positions herself as a truth-teller, critics say she sometimes uses her medical background to sell unscientific ideas.
“What Casey Means and MAHA do so well is take those little pieces of truth and really just turn them into something they’re not, turn them into a reason to find fault or to distrust scientific expertise and medical expertise,” said Matthew Motta, an associate professor of health law, policy and management at the Boston University School of Public Health. He said that her confirmation could sow further distrust at a time when the public’s confidence in government health authorities has already plummeted.
Dr. Richard Carmona, who served as the surgeon general under President George W. Bush, said that he thought Dr. Means lacked the credentials for the role. He had been a practicing physician for over 20 years when he stepped into the role, which involved spending time overseas to coordinate emergency plans with other countries.
“They saw me as bringing the best information from the United States forward and understanding it, so that we can make prudent decisions for the health, safety and security of the world,” he said.
Dr. Motta also worried that having Dr. Means in a role as prominent as surgeon general will add “an element of legitimacy” to her past statements that have strayed far from the established science, like her skepticism of the hepatitis B vaccine for newborns or her condemnation of birth control pills.
To Dr. Means, though, straying from the mainstream is a badge of honor.
Americans need to “start really being the CEO of our health,” she told Megyn Kelly in a 2024 interview, “and not just fully outsourcing our health data to ‘Daddy Doctor.’”
Dani Blum is a health reporter for The Times.
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