If you’re trying to figure out who’s actually running the show as the "Nation’s Doctor" right now, you aren't alone. It’s been a bit of a whirlwind lately. Honestly, the answer depends on whether you mean "who is the person nominated for the job" or "who is actually sitting in the office today."
As of mid-January 2026, the situation is basically this: Dr. Casey Means is the current nominee for U.S. Surgeon General. She was renominated by President Donald Trump on January 13, 2026, after her initial 2025 nomination technically expired due to Senate rules at the start of the new year.
But here is the kicker. She hasn't been officially confirmed by the Senate yet.
While the seat waits for a permanent occupant, the office is usually managed by an acting official or the Deputy Surgeon General. The previous long-term holder, Dr. Vivek Murthy, resigned at the start of the current administration in early 2025. So, if you’re looking for a name to put on a formal letter today, it’s Casey Means in the "Nominee" slot, while the gears of the U.S. Public Health Service Commissioned Corps keep turning under career leadership.
The Casey Means Era: Why This Pick Is Different
Dr. Casey Means isn't your typical government appointee. Not even close. If you’ve spent any time on health social media or listened to a wellness podcast in the last three years, you’ve probably heard her name. She’s a Stanford-trained physician, but she’s famous for walking away from a traditional surgical career.
💡 You might also like: Hair Thinning in Front Male: What Most People Get Wrong About a Receding hairline
Why? She felt like she was just "mopping up the floor" instead of "turning off the faucet."
Basically, she argued that surgery was treating the end-stage results of metabolic disease rather than fixing why people were getting sick in the first place. This led her to co-found Levels, a health-tech company that uses continuous glucose monitors (CGMs) to help people see how food affects their blood sugar in real-time.
She’s also the co-author of the massive bestseller Good Energy, which she wrote with her brother, Calley Means. Her whole platform is built on the idea of metabolic health. She believes—and she’s pretty vocal about it—that almost every chronic issue we face, from depression to diabetes, stems from how our cells process energy.
What happened with the first nomination?
You might remember her being nominated back in May 2025. Trump originally picked Dr. Janette Nesheiwat, but that shifted quickly. Means became the face of the "MAHA" (Make America Healthy Again) movement, closely aligned with HHS Secretary Robert F. Kennedy Jr.
Things got a little delayed, though. In a very human turn of events, her Senate confirmation hearing in late October 2025 had to be postponed because she went into labor. Because the Senate didn't vote before the session ended, her name had to be resubmitted this month.
What a Surgeon General Actually Does (It’s Not Just Giving Speeches)
Most people think the Surgeon General just puts warnings on cigarette cartons. While that's part of the legacy, the role is actually much bigger.
The Surgeon General is the head of the U.S. Public Health Service Commissioned Corps. This is one of the eight uniformed services of the United States. We’re talking about over 6,000 public health professionals who deploy during hurricanes, pandemics, and even the border crisis.
- Communication: They are the primary translator of science for the public.
- Policy Advising: They tell the Secretary of Health and Human Services (HHS) and the President what the "boots on the ground" data actually looks like.
- Uniformed Leadership: They hold the rank of Vice Admiral.
If Casey Means is confirmed, she’ll be trading her podcast microphone for a literal uniform and the responsibility of leading those 6,000 officers.
The Controversy and the Shift
You can't talk about who is current surgeon general without acknowledging the elephant in the room. Casey Means is a polarizing figure in traditional medical circles.
On one hand, her supporters see her as a visionary who wants to take on "Big Food" and "Big Pharma." They love her focus on soil health, seed oils, and getting processed junk out of school lunches. They think the "MAHA" approach is exactly the disruption the system needs.
On the other hand, some public health experts are nervous. They point to her lack of experience in large-scale government administration. There have also been debates about her stance on things like raw milk and vaccine liability. It’s a classic "outsider vs. establishment" showdown.
Previous Surgeons General to keep things in perspective:
- Dr. Vivek Murthy (2021–2025): Known for his focus on the "loneliness epidemic" and youth mental health.
- Dr. Jerome Adams (2017–2021): Led much of the early COVID-19 response and focused on the opioid crisis.
- Dr. C. Everett Koop (1982–1989): The guy who famously took on the tobacco industry and sent an AIDS pamphlet to every household in America.
What This Means for Your Health in 2026
If Casey Means takes the reins, expect the focus of the Office of the Surgeon General to shift dramatically.
Instead of just focusing on infectious diseases or specific lifestyle habits like smoking, the office will likely hammer home the idea of metabolic dysfunction. You might see new advisories on ultra-processed foods or a push for more transparency in how food is grown.
She’s been very clear that she wants to move the needle on chronic disease. Since about 88% of Americans are considered metabolically unhealthy according to some studies (like the one often cited from the University of North Carolina), her "agenda" is basically aimed at everyone.
Common Misconceptions About the Role
People get confused about the power the Surgeon General actually holds. They aren't a "Health Czar" who can pass laws. They can’t ban a chemical or change the price of insulin by themselves.
Their power is almost entirely the bully pulpit.
When a Surgeon General issues an "Advisory," it doesn't have the force of law, but it carries massive weight. It signals to doctors, insurance companies, and schools where the government’s focus is going to be. If Casey Means issues an advisory on, say, the metabolic impact of school lunches, it gives local activists the ammunition they need to demand change in their own districts.
Practical Next Steps for Staying Informed
So, what should you do now that you know who is current surgeon general (or at least, who is the top contender)?
- Watch the Confirmation Hearings: If you want to see how she’ll actually lead, watch her testimony. It’s usually streamed on the Senate HELP Committee website. This is where the real "meat" of her policy ideas will come out.
- Look for the "Advisories": Once someone is officially in the seat, keep an eye on the official HHS.gov "Surgeon General" page. These reports are actually quite readable and offer the best "state of the union" for American health.
- Check the "MAHA" Updates: Since the Surgeon General works under the HHS Secretary, keep an eye on what RFK Jr. is doing. Their agendas are deeply intertwined right now.
The role is currently in a state of transition, but the direction is clear: a move toward "root cause" medicine and a heavy focus on metabolic health. Whether you're a fan of the "MAHA" movement or a skeptic, the person in this seat is about to change the conversation around what it means to be a "healthy American."