President selects new Surgeon General nominee

President Donald Trump has selected Casey Means, MD, to serve as the next US Surgeon General, following the withdrawal of his earlier surgeon general nominee, Janette Nesheiwat, MD.

The announcement of the new nomination came May 7.

Who is Casey Means?

Means, who grew up in Washington, D.C., is a 2014 graduate of Stanford University School of Medicine. After receiving her medical degree she started a five-year otolaryngology residency at Oregon Health and Science University (OHSU), training as an ear, nose and throat surgeon. (Like many specialty medical residencies, the program is extremely competitive; according to OHSU’s website, it only accepts three new residents per year.)

In 2018, six months before Means was scheduled to complete the program, she left, citing her frustration with the medical establishment, and pivoted to holistic health, launching a functional medicine practice in Portland.

Three years later in 2021, Means suffered the death of her mother, Gayle, who at 71 was diagnosed with stage IV pancreatic cancer and died less than two weeks after receiving the news, the New Yorker reported in a May 22 article. Gayle Means, it noted, had been vigilant about her health in terms of going to doctor’s appointments, getting preventive tests, eating healthy food and exercising; but she had been a smoker and was on prescription medications to control her blood sugar and cholesterol.

Metabolic health became and remains one of Means’ key issues; she later co-founded and now serves as CEO of Levels, a company that makes continuous glucose monitoring devices.

She also coauthored the 2024 book “Good Energy: The Surprising Connection Between Metabolism and Limitless Health” with her brother, Calley Means, a former food industry lobbyist who is now a close adviser to Robert F. Kennedy, Jr., Secretary of Health and Human Services.

“Good Energy” takes the US medical system to task for overprioritizing profit and overprescribing drugs, and encourages patients to be proactive with their own health by investing in fresh, organic food, giving up processed foods, drinking more water, avoiding chemicals, exercising often and taking charge of their progress by monitoring their status with devices, such as fitness trackers and glucose monitors.

Qualifications and beliefs

While supporters praise Means’ emphasis on wellness and prevention rather than only treating disease, critics question whether she meets the conventional criteria for the US’s top public health post.

The Surgeon General’s  daily duties focus on protecting public health, which typically includes overseeing public health policy and communication, providing scientific information to the public about potential health threats, offering guidance on reducing disease risk, working with other agencies to address public health challenges, promoting initiatives such as those encouraging people to quit smoking or take advantage of new vaccines, and overseeing the US Public Health Service Commissioned Corps.

The Surgeon General can also issue special health warnings, such as the ones that appeared on cigarette packs starting in 1965. One of the latest warnings, issued by Surgeon General Vivek Murthy, points out the connection between alcohol consumption and cancer risk.

The Trump administration has defended the choice of nominee, citing Means’ influence in the “Make America Healthy Again” initiative and her reach as a health educator. Administration officials say her approach aligns with a broader vision for proactive, lifestyle-focused healthcare.

“What Casey brings to the spotlight is this perspective that we should really be focusing on health and keeping people healthy,” David Perlmutter, MD, a board-certified neurologist and functional medicine advocate, told Time magazine in a May 8 article on Means’ health views. “Our healthcare system now has very little to do with health. It has to do with treating disease.”

Next steps

If confirmed by the Senate, Means would become only the fourth woman to hold the post of Surgeon General since it was created in 1871, preceded by Antonia Novello (1990-1993), Regina Benjamin (2009-2013) and Murthy, currently completing her service.

As of May 23, the Senate has not yet scheduled a date for Means’ confirmation hearing.

For more information, visit the US Senate Nominations page.

Chiropractic Economics will keep this story updated as new information about  confirmation becomes available.

Allison M. Payne is the associate editor of Chiropractic Economics.