As weeks stretch into months after the White House’s surgeon general nominee, Casey Means, MD, underwent a Senate committee hearing, she faces a diminishing probability of becoming the nation’s public health spokesperson.

President Donald Trump nominated Dr. Means, a wellness influencer, entrepreneur and author on metabolic health, in May 2025. Her original confirmation hearing was scheduled for October but postponed since she went into labor the day of the hearing. On Feb. 25, the Senate Health, Education, Labor and Pensions Committee questioned Dr. Means on her clinical background and stance on vaccines.

After the hearing, some Senate Republicans stalled her nomination, raising concerns related to her remarks on vaccines, according to Politico. During the hearing, Dr. Means said she believes vaccines save lives. She also promoted shared clinical decision-making and mentioned rising autism rates, which align with anti-vaccine rhetoric.

As of April 22, Senate HELP Committee Chair Bill Cassidy, R-La., has not scheduled for the full Senate to vote on whether to confirm Dr. Means as surgeon general.

Nearly two months after the hearing, here are four details to know:

1. Her confirmation is in stasis. Dr. Means does not hold an active medical license and did not fully complete her medical residency — which would make her an unprecedented pick for a role traditionally held by clinicians with extensive practice experience.

2. Anti-abortion activists are also lobbying against her nomination, according to an April 21 report from Politico. In the hearing, when asked about whether an in-person doctor’s visit should be required for an abortion pill prescription, she said the topic was “out of the purview of the surgeon general’s office.”

3. Dr. Means received her bachelor’s degree from Stanford (Calif.) University and her medical degree from Palo Alto, Calif.-based Stanford University School of Medicine, according to her professional website and LinkedIn profile.

After four years of residency training in otolaryngology–head and neck surgery, Dr. Means resigned from the residency in late 2018 “to focus on reforming the ‘sick care’ paradigm in American healthcare,” according to her website. Shortly afterward, she opened Means Health, a private practice in Portland, Ore., focused on holistic medicine.

Dr. Means also co-founded Levels, a company focused on preventing metabolic disease, and co-authored, “Good Energy: The Surprising Connection Between Metabolism and Limitless Health,” in May 2024 — a year before her nomination.

4. If Dr. Means is confirmed, she will oversee the U.S. Public Health Service Commissioned Corps, which includes more than 6,000 uniformed public health officers. The Surgeon General role is often referred to as the nation’s top doctor.

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