In a major change to his public health leadership team, former President Donald Trump has withdrawn his nomination of Dr. Janette Nesheiwat for U.S. Surgeon General and has instead tapped Dr. Casey Means-a wellness advocate, Stanford-trained physician, and co-founder of a health tech startup. The move signals a deeper commitment to the administration’s “Make America Healthy Again” (MAHA) initiative, spearheaded by Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.
A New Direction in Public Health Leadership
Dr. Casey Means, 37, is best known as the co-founder of Levels, a digital health company focused on metabolic wellness. She holds a medical degree from Stanford University and began her career in surgical residency before shifting her focus to lifestyle medicine and preventative care.
Dr. Means is also the co-author of Good Energy, a wellness-focused book written alongside her brother, Calley Means, a policy adviser at the HHS. Her work promotes nutrition, environmental health, and holistic approaches to chronic disease—aligning closely with the broader MAHA agenda.
Background on the Nomination Shift
Dr. Janette Nesheiwat, a family and emergency medicine physician, had originally been nominated by Trump in April 2025. However, her previous support for stringent COVID-19 policies and ties to former national security adviser Mike Waltz drew criticism from MAHA supporters and anti-vaccine activists. As a result, her nomination was pulled just one day before her scheduled Senate confirmation hearing.
While she is no longer in the running for Surgeon General, Dr. Nesheiwat is expected to be appointed to a separate position within the Department of Health and Human Services.
Responsibilities and Expectations
If confirmed, Dr. Means will lead the U.S. Public Health Service Commissioned Corps and serve as the country’s top public health spokesperson. Her duties would include:
- Issuing national public health advisories
- Promoting wellness and chronic disease prevention
- Overseeing campaigns on nutrition, mental health, and environmental safety
- Supporting MAHA initiatives, such as eliminating harmful food additives and improving transparency in federal health agencies
The Surgeon General plays a key role in shaping public awareness and delivering science-backed health recommendations across a range of pressing issues.
A Shift Toward Wellness and Prevention
Dr. Means has publicly criticized what she calls the “exploitative” nature of traditional healthcare systems and has long advocated for more personalized, tech-enabled, and food-based interventions to manage disease. Her medical license has been inactive since 2024, though her involvement in public discourse around health policy has only grown.
Her nomination is part of a larger pivot by the Trump-Kennedy health coalition toward lifestyle medicine, echoing initiatives that aim to curb chronic conditions like obesity, diabetes, and heart disease through prevention rather than pharmaceuticals.
Public and Professional Reaction
The response to Dr. Means’ nomination has been mixed.
Supporters praise her fresh perspective and alignment with a growing movement of patients seeking alternatives to traditional medicine. MAHA advocates in particular have applauded her stance against industrial food additives, her promotion of metabolic awareness, and her holistic view of health.
Critics, however, express concerns about her lack of clinical practice in recent years and her ties to wellness trends that lack peer-reviewed validation.
Next Steps
Dr. Means’ nomination now moves to the U.S. Senate Committee on Health, Education, Labor and Pensions for vetting and confirmation. The process is expected to include questioning about her medical credentials, wellness advocacy, and long-term plans for reshaping public health policy.
Conclusion
Dr. Casey Means’ nomination reflects a decisive shift in America’s public health trajectory-from reactive care to proactive wellness. As chronic illness continues to plague millions of Americans, the Trump-Kennedy administration is betting on a new kind of leadership-one that sees food, fitness, and environment not as side notes, but as frontline tools in the nation’s health defense.
Whether Dr. Means can balance science, skepticism, and the Senate remains to be seen-but her appointment could mark the beginning of a significant transformation in how the U.S. approaches public health.