Looks Like Dr. Means is Dead on Arrival

Only in Trump world would a non-licensed physician be Surgeon General

The Surgeon General slot has now claimed three nominees in a single Trump administration. The latest casualty is Dr. Casey Means, the Stanford-educated wellness influencer and “functional medicine” practitioner, whose nomination quietly suffocated in Senate committee this week. Trump withdrew her name on Thursday and announced her replacement on Truth Social, in his customary style. The new pick is Dr. Nicole B. Saphier, a radiologist and director of breast imaging at MSK Monmouth, a satellite of Memorial Sloan Kettering Cancer Center. Trump praised her as “a STAR physician” and “an INCREDIBLE COMMUNICATOR.” (The capital letters are his.)

Means did not survive the Senate’s slow-motion strangulation. Senator Bill Cassidy of Louisiana, chairman of the health committee, never publicly said where he stood on her. He didn’t have to. Senators Susan Collins of Maine and Lisa Murkowski of Alaska refused to commit. That was enough. The math does not require a megaphone.

Trump nonetheless found his villain. In an earlier Thursday post he assailed Cassidy by name, accusing him of obstructing “Robert F. Kennedy Jr.’s Nominee.” Kennedy, the health secretary, does not nominate anyone. The president does. This detail did not seem to interest the president.

The grievance is older than the Means nomination. Cassidy voted to convict Trump on the “incitement of insurrection” charge in 2021. Trump has endorsed Cassidy’s primary opponent in next month’s Louisiana election. The Surgeon General fight was a useful occasion for an ongoing project.

Means herself was a curious figure for the role. A wellness influencer with a careful relationship to vaccination. At her confirmation hearings she said “vaccines save lives” but declined to recommend the measles or influenza vaccine, deferring those decisions to parents and pediatricians. The phrasing was lawyerly. It was also insufficient.

The Make America Healthy Again movement, whose leaders had recently met with Trump and his aides to press personally for her confirmation, will be disappointed. Means is the sister of Calley Means, a senior Kennedy adviser, who took to X to denounce Cassidy at length. He was proud of Casey, he wrote, and proud to work for an administration “driven by victories against dark forces personified by Bill Cassidy.” Restraint was not the goal.

Two senior administration officials, granted anonymity to speak candidly on Wednesday, would not say whether Trump had personally pressured any senator on Means’s behalf. They would not describe the strategy at all. This is usually informative.

Saphier is the third nominee. The first was Dr. Janette Nesheiwat, a former Fox News contributor, whose nomination collapsed in May 2025 after Laura Loomer, the right-wing influencer with a direct line to the president, decided against her. Loomer also opposed Means. She had given up the fight months ago, she said, when Means appeared likely to be confirmed. That assessment turned out to be premature.

Means was not immediately available for comment.

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