The President’s nominee for U.S. Surgeon General, Casey Means, is facing a difficult confirmation process in the U.S. Senate. The concerns raised during her hearings are serious and are more than about politics.
It’s about whether she’s qualified and prepared to lead the 6,000 professionals who do the important work of the US Public Health Service.
The Surgeon General’s primary responsibility is to lead and manage the USPHS workforce and ensuring that their work fits with the most pressing public health and medical threats.
Every Surgeon General until now has been a physician who completed a medical residency and became board certified in a specialty. That background matters because medical training teaches physicians how to evaluate evidence, apply the scientific method, and make evidence-based decisions based on rigorous data.
Means doesn’t meet those basic expectations. She didn’t complete a residency and isn’t board certified in anything. Instead, she’s built her career as a wellness influencer, promoting health products and lifestyle advice through social media platforms – often with little or no evidence that what she’s selling is useful or even works.
What the Surgeon General Actually Does
The Surgeon General is one of the most visible public health figures in the country. The post can have a high public profile (depending on the SG’s personality), but the job isn’t primarily about developing public policy.
The Surgeon General’s central responsibility is different: leading the U.S. Public Health Service Commissioned Corps, a workforce of 6,000 public health professionals.
The Commissioned Corps is a uniformed, noncombatant service of about 6,000 health professionals. Officers include physicians, nurses, pharmacists, dentists, veterinarians, scientists, engineers, environmental health specialists, and public health administrators. These officers serve across the federal government. Roughly:
- About one-third work in the Indian Health Service providing clinical care in tribal and rural communities.
- Hundreds serve in the Federal Bureau of Prisons, delivering health care to incarcerated individuals.
- Others work at agencies such as the CDC, NIH, FDA and VA.
- Officers also support agencies outside traditional health programs, helping bring medical expertise into federal operations.
Their work includes:
- Preventing and responding to disease outbreaks
- Providing clinical care in underserved communities
- Conducting research and regulatory work
- Preparing for and responding to disasters and public health emergencies
For example, Commissioned Corps officers deployed during the 2014 Ebola crisis, working alongside CDC teams to contain the outbreak. They’re also regularly deployed during hurricanes, wildfires, and other national emergencies.
The Corps also includes the Ready Reserve, a surge workforce of trained health professionals who can deploy within days to support emergency responses.
In short, the Commissioned Corps is a mobile national public health workforce that helps protect the country during both routine operations and emergencies.
Leadership Requires Scientific Judgment
Managing a workforce of 6,000 highly trained health professionals needs strong leadership and administrative experience. It also requires something equally important: a clear understanding of evidence-based decision making.
The Surgeon General needs to ensure that officers are deployed effectively and focused on the nation’s most important health priorities. That requires someone who understands how to interpret scientific evidence and apply it in real-world public health settings.
A Job That Requires Preparation
The Office of the Surgeon General dates back more than two centuries, beginning with the Marine Hospital Service created in 1798 to care for sick seamen and prevent the spread of disease through U.S. ports. Over time, that system evolved into today’s U.S. Public Health Service and its Commissioned Corps.
Today the Surgeon General is responsible for helping lead that workforce and ensuring it is ready to respond to the nation’s (and sometimes global) health threats.
That role requires credibility, scientific judgment, and experience leading complex organizations.
The US has been fortunate that past Surgeons General brought those qualities to the job.
The Senate now has the responsibility to decide whether they think Means is qualified. We urge the Senate to decline to confirm Means and ask the administration to send them a qualified candidate.
Current Status: The nomination is still pending. She has had a senate committee hearing but is still awaiting a committee vote and then a full Senate vote.
