“The only thing she practices is grift”: Meet Trump’s nominee for Surgeon General

Medical experts fear President Donald Trump’s nominee for surgeon general, Casey Means, could bring her “flaky” brand of wellness influencing to the nation. Means is best known as a wellness influencer, author and entrepreneur, as well as running a company that sells glucose monitoring systems. While Means did attend medical school, she dropped out during her surgical residency with just a few months left, claiming that she became disillusioned with traditional medicine. Trump in announcing the pick, said she had “impeccable ‘MAHA’ credentials,” referring to the “Make America Healthy Again” movement.

Means was nominated for the position in May, after Trump’s initial pick, Fox News contributor Dr. Janette Nesheiwat, faced backlash from Republicans over support for vaccination and masking during the COVID-19 pandemic, as well as scrutiny over her educational background. But Trump’s next choice is controversial with doctors and public health experts.

Dr. Ryan Marino is a board-certified physician and an associate professor at Case Western Reserve School of Medicine, cited a myriad of concerns he has about Means, from the fact that she dropped out of her residency, to her anti-vaccine sentiments, to her advocacy for using the sun to better “achieve optimal metabolic health.”

One of Marino’s biggest concerns, however, is that the consistent throughline of Means’ career is her advocacy for what she refers to as “functional medicine,” which Marino says “is a euphemism for unproven and disproven practices … and is, bluntly, nothing more than quackery.”

A few examples of this include her claim that people can naturally replicate the effects of GLP-1 drugs like Ozempic through modifying their diet, her advocacy for continuous glucose monitors for people who don’t need them and again, her criticism of vaccinations like the hepatitis B vaccine, which prevents the leading cause of liver cancer globally. It is typically given to infants and has been credited with saving lives. Hepatitis B contributes to an estimated 820,000 deaths every year, according to the Centers for Disease Control and Prevention.

“As we know, American health care has many problems and weaknesses. None of those are solved by purchasing a book about energy healing or buying milkshakes made from raw milk,” Marino said. “The only thing she practices is grift, and she has already used her nomination to further her self-promotion and sales.”

Other doctors are equally concerned about Means’ nomination and her financial relationships with a variety of supplement companies and medical device companies. She’s even invested in companies like Altria Group and Philip Morris International, two tobacco giants.

While Means has said that she would divest from investments that present a conflict of interest, Peter Lurie, a licensed physician and the president of the Center for Science in the Public Interest, told Salon that “what we need most is for her to divest herself of these flaky ideas.”

Lurie said that the surgeon general has essentially two formal functions in the government. The first, and probably most important, is to communicate to the public, and the second is to write reports, which have at times dramatically changed the national conversation about certain issues, such as the famous 1964 report on the hazards of tobacco use.

“The kind of thing that I would worry about is some kind of so-called comprehensive report on this or that aspect of the alternative medicine movement, which gets a whole bunch of attention in ways that could have an influence,” Lurie said.

Lurie said that usually the most powerful surgeon general reports are those that leave consumers with the ability to make changes themselves or that might spur policy change. Lurie said his concern with Means is that she could use the office to promote the sorts of products that she has plugged throughout her career. And typically, Americans don’t need to interact with a doctor or medical professional to go out and buy a supplement or medical device, which are regulated differently under the Food and Drug Administration. Means’ confirmation could be a massive windfall for supplement pushers like Alex Jones, the right-wing host of “Infowars.”

“I would worry about something like that, and I’d worry about a bunch of these theories that she has getting wider credence in society,” Lurie said.

Beyond potential influence over the public, the surgeon general would also be yet another post that the Secretary of Health and Human Services, Robert F. Kennedy Jr., could leverage to turn the screws on career doctors and bureaucrats at the department he heads. (Means’ brother Calley Means, with whom she co-authored a book called “Good Energy,” is a lobbyist that has closely advised Kennedy.) The secretary, Lurie explained, can’t attend every meeting, and so having another Kennedy loyalist in the HHS would represent an expansion of his influence over U.S. public health infrastructure.

“He can’t write every report. He can’t write every memo. He needs a phalanx of people who will be willing to do his bidding, and we’ve already seen what happens when you don’t promise to do his bidding,” Lurie said, referencing Kennedy’s firing of people who push back on his agenda.

Even in arenas where Means has received less scrutiny, her ideas present a serious risk to the American public, experts caution, without having the sort of clear-cut benefits that she promises. The best example of this is her advocacy for consuming organic produce.

Means has promoted organic agriculture and the consumption of organically grown foods over conventionally grown foods as a way to heal the environment and improve people’s health on a variety of issues, ranging from male infertility to cancer to ADHD.

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The issue isn’t so straightforward, however. Emily Bass is the director of Federal Policy, Food and Agriculture at the Breakthrough Institute, an organization that researches how to promote both environmental issues and agricultural abundance through policy.

Bass told Salon that the sort of wholesale conversion to organic foods that Means promotes is not only impractical from a food supply standpoint, with organic produce generally being more expensive and labor-intensive to grow, but isn’t necessarily beneficial to the environment.

For example, Bass pointed to genetically-modified corn and soybeans, which can yield larger harvests on smaller plots of land compared to their organic counterparts. At scale, this means tens of millions fewer acres of land need to be developed to grow GMO crops. There are other environmental tradeoffs to going organic as well. For instance, conventional agriculture has enabled no-till farming at scale, which helps preserve soil and reduce erosion.

There’s also the issue of the sorts of pesticides that are used in conventional versus organic farming. Bass said that, contrary to popular belief, some of the pesticides that are used in organic agriculture are sometimes more toxic than conventional pesticides.

“Copper sulfate is an example of a quote, unquote, natural pesticide. It’s not synthetically produced, but it has a much higher acute toxicity than glyphosate does, and it is used in the same way to control weeds,” Bass said. “There is a reason glyphosate and other modern synthetic pesticides have been produced with advanced technologies to have a hyper-specific mode of action to target the organisms they intend to.”

Notably, there is an ongoing debate around the safety of both copper sulfate and glyphosate, especially around the potential environmental impacts of the pesticides and their toxicity at the levels in which consumers are likely to encounter them. And, there have been recent developments in the debate, including the retraction of a 2000 glyphosate study over ethical concerns surrounding one of its authors.

Taken all together, Means’ vision of a dominant organic food system in the United States could mean higher prices for consumers and more environmental degradation, and without the straightforward benefits to health that people like Means promise.  As with the concerns over health and medicine, Bass noted that Means’ biggest influence in the agriculture space would be with the public.

“If she moves into this position and uses that platform to tell everyday Americans they should be scared of conventionally-grown food, there’s no reason to not expect that to have ripple effects into the market,” Bass said.

Means did not respond to a request for comment from Salon.