Casey Means Faces Senate Scrutiny in Surgeon General Confirmation Hearing
Wellness influencer and entrepreneur Dr. Casey Means presented her vision for transforming American healthcare during a confirmation hearing before the Senate health committee on Wednesday. The 38-year-old physician, nominated to become the nation's next surgeon general, emphasized addressing root causes of chronic disease rather than what she termed "reactive sick care."
A Vision for Preventive Healthcare
"Our nation is angry, exhausted, and hurting from preventable diseases," Means declared before the committee. "If we're addressing shared root causes, we're going to be able to stop the whack-a-mole medicine that's not working for us and that is so costly."
Her message aligns closely with Health Secretary Robert F. Kennedy Jr.'s "Make America Healthy Again" movement, which has garnered bipartisan concern about rising chronic disease rates. Means stated her primary goal would be to "get more whole, healthy foods on American plates," reflecting her unconventional medical background.
Contentious Questioning on Vaccines and Birth Control
Despite some bipartisan agreement on chronic disease prevention, Means faced rigorous questioning from senators on more divisive topics. As surgeon general, she would be empowered to issue public health advisories and promote Kennedy's MAHA agenda, which includes removing additives from foods and improving school nutrition programs.
Senator Bill Cassidy, the Louisiana Republican chairing the committee, pressed Means on whether she would encourage vaccination during flu and measles outbreaks. She declined to make such commitments, instead emphasizing informed consent between patients and physicians.
When asked about vaccines potentially contributing to autism—a claim Kennedy has supported despite contrary evidence—Means responded, "I do accept that evidence. I also think that science is never settled." She expressed interest in federal studies examining environmental contributors to autism.
Democratic Senator Patty Murray questioned Means about past podcast comments where she described birth control pills being prescribed "like candy" and showing "disrespect of things that create life." Means clarified that she believes oral contraceptives should remain available but raised concerns about "horrifying side effects" in certain populations and inadequate informed consent conversations.
Qualifications and Conflicts of Interest Under Scrutiny
Means' unconventional path to this nomination drew significant scrutiny. After graduating from Stanford University's medical school, she abandoned her surgical residency at Oregon Health and Science University in 2018, citing a broken and exploitative healthcare system.
She subsequently obtained a medical license, opened a functional medicine practice that later closed, and co-founded Levels—a health-tracking app that provides insights from blood tests and glucose monitoring. Financial disclosures revealed she earned hundreds of thousands promoting various wellness products, including supplements, teas, probiotics, and meal delivery services.
An Associated Press investigation found she sometimes failed to disclose potential financial benefits when recommending these products. Senators questioned her about several specific incidents, though Means maintained such claims were incorrect and emphasized her commitment to addressing conflicts of interest.
Ethics Commitments and Professional Concerns
In ethics filings, Means pledged to resign from Levels and divest related stock options if confirmed. She also committed to stop working for Rupa, a specialty lab company, though she may continue receiving royalties from her book "Good Energy" without promoting it. Additionally, she agreed not to acquire financial interests in entities on the FDA's prohibited holdings list.
Her nomination has faced criticism from previous surgeons general. Dr. Rich Carmona, who served under President Bush, wrote that Means' qualifications "raise significant concerns," while Dr. Jerome Adams, Trump's first-term surgeon general, noted the role traditionally requires an active medical license—which Means currently lacks.
Means' brother, Calley Means, already works as a senior adviser at the Department of Health and Human Services, promoting the administration's message about ultraprocessed foods. The nomination follows the withdrawal of Trump's initial pick, former Fox News contributor Janette Nesheiwat, after criticism from presidential allies.
Vermont independent Senator Bernie Sanders expressed serious doubts about Means' suitability, stating, "I have very serious questions about the ability of Dr. Means to be the kind of surgeon general this country needs." The hearing, originally scheduled for October, was postponed when Means went into labor on the appointed day.
