Dr. Casey Means, President Trump's pick for U.S. Surgeon General.
The pharmaceutical industry may be facing a formidable new challenger at the highest level of U.S. public health leadership. On Wednesday, President Donald Trump announced the nomination of Dr. Casey Means as U.S. Surgeon General—an outspoken critic of what she calls a “profit-driven” healthcare system and a prominent voice within the “Make America Healthy Again” (MAHA) movement.
Means’s views on chronic illness, pharmaceutical overreach, and systemic reform have made her a champion to some and a lightning rod to others. Her nomination, which follows the abrupt withdrawal of former nominee Dr. Janette Nesheiwat, signals a sharp pivot in federal health priorities—and is already being described by some observers as “Big Pharma’s biggest nightmare.”
A Stanford Medical School graduate and former surgical resident, Means left clinical practice before completing her training at Oregon Health & Science University, citing disillusionment with conventional medicine. She has since redefined her career as a health tech entrepreneur, wellness advocate, and co-founder of Levels Health, a company focused on real-time blood glucose monitoring.
Means also co-authored the 2024 bestselling book Good Energy: The Surprising Connection Between Metabolism and Limitless Health with her brother, Calley Means, a former pharmaceutical consultant and current White House health adviser. Both siblings are closely aligned with Health and Human Services Secretary Robert F. Kennedy Jr., and were instrumental in securing his endorsement of Trump during the 2024 campaign.
Online, Means has built a sizable following—more than 766,000 followers on Instagram—amplifying critiques of processed food, synthetic chemicals, and overmedication. Her most viral appearances include an interview with Tucker Carlson where she accused the healthcare industry of profiting by keeping Americans sick.
If confirmed, Means would oversee the U.S. Public Health Service Commissioned Corps, a 6,000-member uniformed service, and act as the federal government’s top public health voice. Her platform would allow her to issue nationwide health advisories, calls to action, and reports that could influence medical practice, consumer behavior, and even legislation.
Key areas of concern for the pharmaceutical sector include:
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Increased Scrutiny: Means and Kennedy have called for greater transparency in clinical trial data and vaccine safety evaluations. If she uses the Surgeon General's office to echo these demands, it could lead to heightened regulatory oversight.
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Reduced Reliance on Medication: Means has described newborn vaccinations as early “pharmaceutical interventions” and criticized the routine prescription of medications for chronic conditions. Her advisories could challenge the necessity of widely used drugs, including statins and antidepressants.
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Food and Chemical Reform: She is likely to support Kennedy’s campaign to phase out certain food additives and synthetic dyes. Combined with public messaging from the Surgeon General’s office, this could pressure the food industry to reformulate products, affecting supply chains and costs.
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Cultural Shift: With her considerable media presence and alignment with wellness influencers like Vani Hari (“Food Babe”), Means could accelerate growing skepticism toward pharmaceuticals and drive consumers toward alternative therapies—further challenging traditional healthcare models.
Pharmaceutical lobbying groups, such as PhRMA (Pharmaceutical Research and Manufacturers of America), have already pushed back against policies they say threaten innovation and profitability. Means’s emphasis on prevention over treatment and skepticism of “Big Pharma” may escalate tensions between the administration and the industry.
Still, some analysts suggest her impact could be limited by institutional inertia. Ali Pashazadeh, CEO of Treehill Partners, noted that campaign rhetoric “often softens in office,” and emphasized that substantial reforms would require both Senate confirmation and agency cooperation.
Means’s appointment followed the withdrawal of Dr. Janette Nesheiwat, who had faced scrutiny over credential discrepancies and ideological misalignment with the MAHA agenda. Her medical degree, reportedly claimed from the University of Arkansas, was actually obtained from the American University of the Caribbean. Further backlash came from far-right figures like Laura Loomer, who criticized Nesheiwat’s pro-Covid-19 vaccine views.
Trump announced that Nesheiwat would serve elsewhere within the Department of Health and Human Services, but her exit cleared the way for Means—a figure who more clearly reflects the administration’s current health priorities.
President Trump praised Means’s “impeccable ‘MAHA’ credentials” and said he was confident she would be “one of the finest Surgeon Generals in United States History.”
Supporters see Means as a transformative figure. Dr. Robert Malone, a Kennedy ally, called her “qualified” with “ethical moorings,” and emphasized her communication skills. Social media advocates cheered the nomination as a blow to entrenched interests, pointing to CDC data showing a 40% rise in chronic disease since 1990.
Critics, however, highlight Means’s lack of an active medical license and limited clinical experience. Dr. Paul Offit, a leading infectious disease expert, said she “doesn’t know basic science” and described her rise as symptomatic of “wellness grifting.”
Means's confirmation will now go before the Senate. While the Republican-controlled chamber may offer a smoother path, her views, close ties to Kennedy, and lack of government experience could complicate the process.
