President Donald Trump has nominated Dr. Casey Means, a wellness entrepreneur and physician-turned-influencer, to serve as the next U.S. Surgeon General, replacing his earlier nominee, Dr. Janette Nesheiwat.
The surprise announcement comes amid growing alignment between the Trump administration and leaders of the holistic health movement, including current Health and Human Services Secretary Robert F. Kennedy Jr., a longtime friend and ally of Dr. Means.
Who Is Dr. Casey Means?
Dr. Means is a Stanford-trained physician and co-founder of the metabolic health company Levels. 
Though she left traditional clinical practice years ago, she has since built a large following through books, podcasts, and health-tech platforms promoting lifestyle medicine and metabolic health as keys to national well-being.
She is also a vocal critic of the current healthcare model, which she often describes as “reactionary,” “profit-driven,” and overly dependent on pharmaceutical intervention.
“We need a health system that doesn’t just manage disease, it prevents it,” Means wrote in a 2023 op-ed that circulated widely among wellness circles. “America is sick, not just physically but systemically.”
A Controversial Pick
The nomination has sparked immediate debate, with supporters praising the selection as a bold pivot toward prevention-focused public health, and critics raising concerns about her lack of public health leadership experience and history of promoting alternative wellness approaches not always backed by peer-reviewed science.
“She has no background in public health administration or pandemic preparedness,” said Dr. Marcia Lang, a professor of health policy at Johns Hopkins University.
“The Surgeon General’s role is not just to inspire, it’s to respond, lead, and inform under pressure. This nomination is risky.”
Others say her alignment with Secretary Kennedy and shared skepticism of pharmaceutical industry influence is driving the pick.
Means has previously echoed Kennedy’s concerns about environmental toxins and over-medicalization, and in her public appearances has endorsed the “Make America Healthy Again” agenda, a wellness-forward health policy platform introduced earlier this year under the Department of Health and Human Services.
Reaction from the Medical Community
Reaction from within the medical and public health communities has been mixed.
While some practitioners and health-tech innovators applaud the move toward metabolic health awareness, many traditional public health leaders are urging caution.
“She is a talented communicator and has built a strong brand,” said Dr. Jamal Richards, president of the American Public Health Association. “But being a brand and being the country’s top doctor are two very different things.
This role demands clear science communication, rapid response capability, and credibility across political lines.”
Broader Political Implications
The nomination reflects the Trump administration’s broader embrace of the wellness movement’s anti-establishment sentiments and focus on lifestyle-based healthcare reform.
It also signals the administration’s continued distancing from traditional government health institutions in favor of more decentralized, often privately funded wellness strategies.
Dr. Means’ nomination will now go before the Senate for confirmation.
If confirmed, she would be the first Surgeon General in modern history without significant public health or military service background.
What Comes Next
With a Senate confirmation likely to become a partisan battleground, political analysts say the Means nomination is a test case for how far the federal government is willing to reshape its health leadership in response to rising distrust in institutions.
Supporters argue that a reset is overdue. Detractors warn that replacing public health expertise with influencer-driven wellness ideology could backfire.
As the nomination proceeds, the country will be watching closely, not just to see who leads America’s health communication efforts, but how the very definition of public health leadership is being rewritten.
