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Casey Means Confirmation
The Senate Committee on Health, Education, Labor, and Pensions (HELP) is tentatively scheduled to hold a confirmation hearing next week for Casey Means, President Donald Trump’s nominee for U.S. Surgeon General. Having thoughtful and evidence based questions prepared for the nominee would serve the public interest by helping to clarify her positions, challenge unsubstantiated claims, and contribute meaningfully to the broader dialogue on how best to make America healthy again.
Role of the U.S. Surgeon General
The Surgeon General is the nation’s chief public health spokesperson, often called “the doctor of the country.” The Surgeon General leads the U.S. Public Health Service Commissioned Corps (usphs.gov) that is a truly impressive organization of thousands of uniformed professionals who respond to health emergencies and crises. The office provides science based guidance to the public, advises on health policy, and communicates reliable medical information to help the nation make informed decisions about health.
Casey and Calley Means Business
Casey Means is a physician by training but not a licensed practitioner, best known as a wellness influencer who promotes the belief that diet, exercise, and lifestyle alone can prevent most chronic diseases. In partnership with her brother—an advisor to Robert F. Kennedy Jr.—she has advanced narratives that often conflate personal wellness ideology with medical authority. Although she earned her medical degree, Means left her surgical residency under disputed circumstances, later framing her departure as a rejection of what she describes as a medical system that “doesn’t cure patients.” While that message resonates with segments of the wellness community, it raises legitimate concerns about her readiness to lead a federal office charged with upholding evidence-based medicine and public trust in health institutions.
First Media Reactions May 2025
The initial kneejerk reactions to her appointment appeared in several outlets in May of this year.
Politico-politico.com/news/2025/…
The Hill -thehill.com/policy/heal…
Gathering the above reporting may be useful in generating evidence based questions for the nominee. But let's first gather and organize under two larger narratives: (1) Trust/Misinformation; and (2) Undermining Science/Alternative Medicine.
Erosion of Trust and Promotion of Misinformation
A central tactic of the anti-vaccine movement is spreading misinformation, falsely claiming that the growing childhood vaccine schedule harms vulnerable children or contributes to rising autism rates, with the argument that one vaccine may be safe, but the full series is not. This message is reinforced by extreme attacks on public health measures, including framing COVID-19 vaccine requirements for children as a "war crime." Amplified by prominent figures, such rhetoric fuels vaccine hesitancy, leading parents to delay or refuse routine immunizations, directly undermining herd immunity and increasing the risk of outbreaks of preventable diseases like measles and mumps. Efforts to reform the National Childhood Vaccine Injury Act of 1986, a goal championed by Robert Kennedy Jr., are presented as accountability but are closely tied to potential profit from litigation. Kennedy is connected to the law firm Wiser Baum, which is actively litigating claims related to HPV vaccines, and his son Connor is employed by the firm, creating immediate conflicts of interest that reinforce the narrative that vaccines are unsafe. Recent debates about vaccine components, including thimerosal, aluminum, and acetaminophen, further heighten fear, but the central public health question remains unchanged: do vaccines protect children and the community from serious disease?
Undermining Scientific Authority and Promoting Alternative Practices
The alternative medicine and wellness movements actively challenge the foundation of modern healthcare, urging individuals to trust "divine gifts of intuition" and "heart intelligence" over what they call "blindly trusting the science." Worth noting, not all wellness or complementary practices are inherently harmful; however, many challenge modern healthcare by questioning scientific consensus, emphasizing personal belief over evidence, promoting unproven therapies, eroding trust in institutions, and shaping health narratives that amplify messages contradicting conventional guidance, ultimately influencing patient decisions and public health outcomes. The elevation of “Traditional Medicine” and other alternative practices, including the promotion of raw milk despite clear warnings from health officials about its potential to cause serious illness is ongoing. While concerns about the influence of the pharmaceutical industry and the profitability of chronic disease management are legitimate, they are often interwoven with unscientific claims, such as prayer to inanimate objects or communication with spirit mediums. These are further compounded by the commercialization of wellness, where figures like Dr. Casey Means simultaneously market dozens of health and lifestyle products, raising questions of conflict of interest.
The resulting narrative blurs the line between skepticism and cynicism, transforming valid critiques into a broader rejection of scientific authority. The backlash between figures such as Shanahan and Loomer over accusations of “witch doctor” behavior underscores internal contradictions within this anti-establishment health movement, yet does little to mitigate the overall damage of its messaging. Collectively, these dynamics foster a fragmented health landscape in which evidence-based medicine competes with ideology and commerce for public trust. In such an environment, it becomes increasingly difficult for health authorities to contain outbreaks, promote vaccination, or maintain confidence in scientific institutions. It is difficult to ignore that some of the same voices vying for public health leadership now appear poised to further erode the credibility of federal health agencies—posing long-term risks to both the integrity of evidence-based medicine and the health of the nation.
Industry and Profit
I've written several times “profits over people” narrative that serves as a central justification for public distrust in science and medicine. There are legitimate concerns about industry influence, however sweeping condemnations of the entire healthcare system, proclaiming that chronic illnesses are deliberately kept profitable by malpractice or as a larger scheme, and portraying conventional medicine as a morally bankrupt enterprise designed to keep patients sick and dependent on pharmaceuticals is simply unacceptable.
Framing here is deliberate to create a moral vacuum to be filled with quackery by alternative practitioners who market themselves as authentic, intuitive, and free from corporate corruption. The companion charge of “corruption” further deepens this distrust by asserting that scientists, regulators, and academic institutions are financially compromised by industry. "Don't trust the experts!"
Ironically, those who invoke “profits over people” often replicate the very conflicts of interest they denounce—promoting their own costly wellness products and lifestyle brands. Figures such as Dr. Casey Means illustrate this paradox, where anti-industry rhetoric masks commercial self-interest. Ultimately, the slogan becomes a weapon not for reform, but for replacement—substituting one profit motive for another and leaving public health caught between mistrust of evidence-based care and exploitation by alternative markets. The Wellness Industry is very profitable.
Joint Condemnation from Six Former U.S. Surgeons General
Just recently (October 7, 2025 in the Washing Post), and in an unprecedented statement, six former U.S. Surgeons General: Jerome Adams, Richard Carmona, Joycelyn Elders, Vivek Murthy, Antonia Novello, and David Satcher, warned that Robert F. Kennedy Jr., in his role as Secretary of Health and Human Services, poses a serious threat to the nation’s public health. Representing both Republican and Democratic administrations, they explained that they felt “compelled to speak with one voice” because Kennedy’s actions are undermining science, eroding morale within federal health agencies, and compromising the integrity of evidence-based medicine.
The former Surgeons General highlighted Kennedy’s long history of spreading false claims linking vaccines to autism, misrepresenting the safety of mRNA vaccines, and promoting unproven therapies—even during outbreaks of serious diseases like measles. They also criticized his recent proposal to require warning labels on acetaminophen for pregnant women, noting that it is unsupported by credible science and widely rejected by medical experts.
Declaring that Kennedy is “entitled to his views but not to put people’s health at risk,” they warned that his leadership threatens to reverse decades of progress in disease prevention and public trust, replacing scientific rigor with ideology at a time when the nation can least afford it. The question now is clear for the nominee: will you join six former Surgeons General in this condemnation? (more: npr.org/2025/10/09/nx-s…
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