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Dr. Casey Means appeared before a Senate committee for her confirmation hearing
to become the next Surgeon General of the United States, a role that carries
symbolic authority and national visibility in public health. Nominated by President
Donald Trump, Means would serve as the country’s leading public health
spokesperson if confirmed.
The hearing lasted more than two hours and covered a wide range of topics,
including chronic disease, vaccines, environmental health, abortion policy, medical
credentials, and potential conflicts of interest. While the surgeon general does not
create laws or directly enforce policy, the office has historically played an
influential role in shaping public understanding of major health issues.
Here is a detailed look at the most important moments and themes from the
hearing.
A Central Focus on Chronic Disease
From her opening remarks, Means made it clear that her top priority would be
addressing what she calls a national crisis of chronic disease. She described the
The United States is facing rising rates of obesity, diabetes, heart disease,
autoimmune disorders, dementia, and mental health challenges.
Means argued that the health care system has become too focused on managing
symptoms rather than preventing disease. She said the country needs to better
understand the “root causes” of illness, including nutrition, lifestyle habits,
environmental exposures, and metabolic health.
Her philosophy aligns closely with the “Make America Healthy Again” movement
promoted by Health and Human Services Secretary Robert F. Kennedy Jr.. Means
emphasized that improving food quality, reducing ultra-processed foods, and
Encouraging exercise and metabolic awareness could dramatically improve public
health outcomes.
She framed her mission as restoring “wholeness” to American health, both
physically and mentally.
Vaccine Policy Draws Close Attention
Vaccines were one of the most sensitive topics during the hearing. Some senators
questioned Means about past comments in which she appeared skeptical of
certain vaccines.
During the hearing, she stated clearly that vaccines save lives and that she
supports recommendations from the Centers for Disease Control and Prevention.
However, she was cautious in her wording when pressed on specific questions.
In a tense exchange, she was repeatedly asked whether flu vaccination reduces
hospitalization and death. After several attempts to redirect the conversation
toward broader themes, she acknowledged that at a population level, flu vaccines
can reduce risk.
She also emphasized parental autonomy in vaccine decision-making, especially
regarding childhood immunizations. While she described vaccines such as
hepatitis B as important and lifesaving, she said parents should be respected in
making decisions for their children.
Means reassured senators that vaccine policy would not be her primary focus if
confirmed. Instead, she said her attention would center on chronic disease
prevention.
Environmental Health and Pesticides
Another key issue discussed during the hearing was pesticide use, particularly
glyphosate. Means has previously raised concerns about environmental toxins and
their potential connection to chronic illness.
She told senators that chemical exposures should be studied carefully to
understand their long-term health impacts. At the same time, she acknowledged
the challenges faced by American farmers and said agricultural transitions must
be approached carefully.
Although the surgeon general does not regulate pesticide policy, the office can
commission reports that influence public debate. Means suggested that
environmental contributors to chronic illness deserve more scientific investigation.
Her position reflects a broader emphasis on prevention and environmental
awareness rather than direct regulatory authority.
Abortion Pill and Telehealth Prescribing
Senators also questioned Means about her views on mifepristone, the abortion pill.
Some Republicans have called for limiting prescriptions to in-person visits rather
than telehealth.
Means declined to take a firm position on whether prescribing should be restricted.
She stated that such decisions fall outside the surgeon general’s direct authority.
Instead, she emphasized that patients should have thorough discussions with their
doctors before taking any medication.
Her responses were careful and avoided strong partisan language, focusing instead
on the importance of informed consent and doctor-patient communication.
Contraception and Women’s Health
Democratic senators asked Means about previous comments suggesting that
hormonal birth control may carry long-term health risks.
During the hearing, she clarified that she believes contraception should be
accessible. However, she stressed that women should be fully informed about
potential risks and benefits through detailed conversations with their health care
providers.
Her overall approach again emphasized patient education and shared decision-
making rather than strict policy positions.
Medical Background and License Status
One of the most debated aspects of the hearing involved Means’ medical
credentials. She graduated from Stanford School of Medicine but did not complete
her residency training. She has explained in the past that she left residency
because she became disillusioned with aspects of the health care system.
Her medical license in Oregon is currently inactive, meaning she cannot prescribe
medication.
Critics argued that past Surgeons General typically had extensive clinical
experience and active medical licenses. Means responded that her education,
research background, and communication experience make her well suited for a
role that is largely focused on public health messaging.
She said she has no immediate plans to reactivate her medical license.
Business Ties and Ethics Questions
Means’ background as a wellness entrepreneur and influencer also drew attention.
She co-founded Levels, a health technology company that links glucose monitors
to an app that tracks metabolic health. She has also promoted various wellness-
related products and services.
Some senators questioned whether these ties could create conflicts of interest.
Means stated that she has worked with government ethics officials to address any
potential conflicts and has been transparent about past paid endorsements.
She said she would fully comply with federal ethics rules if confirmed.
Psychedelic Therapies and Mental Health
One senator raised questions about Means’ discussion of psilocybin in her book,
where she described using psychedelic mushrooms during her mother’s illness.
Means said that research into psychedelic therapies for conditions such as PTSD
and depression is ongoing and promising in some areas. However, she emphasized
that as surgeon general, she would rely on scientific evidence and established
research rather than personal experiences.
She distinguished between her views as a private citizen and her responsibilities as
a public health official.
The Role and Influence of the Surgeon General
Although the surgeon general cannot pass laws or directly regulate health care, the
office has historically played a powerful role in shaping public health narratives.
Past Surgeons General have influenced national conversations on smoking,
HIV/AIDS, mental health, and substance abuse.
If confirmed, Means would likely focus her messaging on metabolic health,
nutrition, prevention, and lifestyle changes. Her communication style, shaped by
years of writing and social media engagement, could significantly influence how
Americans think about chronic illness.
Supporters argue that her approach reflects growing frustration with rising health
care costs and worsening chronic disease rates. Critics worry that ambiguity on
vaccines and her limited clinical experience could affect public trust.
What Comes Next
The Senate is expected to vote on her nomination soon. While the confirmation
process revealed partisan disagreements, the outcome appears likely to favor
confirmation.
If approved, Casey Means would become one of the most unconventional surgeons
general in modern history — a physician-turned-wellness advocate stepping into
one of the nation’s most visible public health roles.
Her tenure would likely emphasize prevention, food reform, environmental
awareness, and metabolic health education. Whether that approach strengthens
public trust in health institutions or deepens divisions remains to be seen.
What is clear from the hearing is that the future direction of American public health
Messaging could shift significantly if she is confirmed.
