President Donald Trump has officially pulled the surgeon general nomination of Dr. Casey Means and named radiologist Dr. Nicole Saphier as his replacement, marking the third time in his second term that he has attempted to fill the nation's top public health position.
Means' path to confirmation collapsed after a tense February Senate hearing laid bare deep divisions over her vaccine stances and raised persistent concerns about her professional credentials, including the fact that she does not currently hold an active medical license.
Nicole is a STAR physician who has spent her career guiding women facing breast cancer through their diagnosis and treatment. She is also an INCREDIBLE COMMUNICATOR.
Trump announced Saphier's nomination Thursday on Truth Social, calling her a star physician dedicated to guiding women through breast cancer diagnoses and treatment, while Health Secretary Robert F. Kennedy Jr. praised her as a longtime warrior for the MAHA movement.
Nicole Saphier Nominated as Surgeon General After Casey Means Exits
President Trump's decision to withdraw Casey Means' surgeon general nomination brings a definitive end to one of the most drawn-out and politically charged confirmation battles of his second term, leaving the nation's top public health seat open for a third nominee in less than two years.
Means' February confirmation hearing before the Senate Health, Education, Labor, and Pensions Committee turned deeply contentious, with senators from both parties pressing her on vaccine policy, her professional qualifications, and her decision to leave her surgical residency without completing it — a record that critics argued made her unfit to serve as the country's chief medical authority.
The hearing left serious doubts with key Republican senators, including Lisa Murkowski of Alaska and Susan Collins of Maine, both of whom signaled reservations that ultimately proved impossible to overcome as weeks turned into months with no committee vote ever scheduled by chairman Bill Cassidy of Louisiana. Means herself acknowledged that Murkowski was unlikely to vote for her, and that Collins had deep reservations about the nomination moving forward.
Despite an organized grassroots push from MAHA movement supporters who flooded Senate phone lines demanding Republicans back her confirmation, the campaign failed to shift enough votes to give Means any viable path through committee, effectively ending her bid before it ever reached a full Senate floor vote.
In an interview on Thursday, Means blamed what she described as a yearlong smear campaign aimed not just at her personally but at the broader MAHA movement's mission to fundamentally reshape American food systems and overhaul the country's approach to chronic disease and healthcare.
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Trump Blasts Cassidy as 'Very Disloyal' in Scathing Truth Social Post
Before announcing Saphier's nomination, Trump fired off a direct and unusually personal attack at Senator Bill Cassidy of Louisiana, the Republican chair of the Senate health committee, accusing him of standing in the way of Means' confirmation through what he called 'intransigence and political games.'
Trump went further, calling Cassidy 'a very disloyal person' — a label that carries particular weight given that Trump has already endorsed a primary challenger against the Louisiana senator, who faces a tough reelection race this year and has repeatedly clashed with the White House over health policy nominees.
Calley Means, Casey's brother and a health policy adviser inside the Trump administration, amplified the attack on social media by accusing Cassidy's 'constant delay tactics' of sinking the nomination, and Kennedy separately claimed Cassidy 'did the dirty work for entrenched interests seeking to stall the MAHA movement.' Cassidy's office did not respond to requests for comment from major news outlets on Thursday.
Who Is Nicole Saphier — Trump's New Pick for Surgeon General
Dr. Nicole Saphier is a board-certified radiologist and the director of breast imaging at Memorial Sloan Kettering Cancer Center Monmouth in New Jersey, one of the country's most respected oncology institutions — and unlike her predecessor nominee, she holds active medical licenses in New York, New Jersey, and Arizona.
Saphier served as a regular medical contributor on Fox News from 2018 until her nomination, and she has built a public health media presence through her 'Wellness Unmasked' podcast, where she covers evidence-based wellness topics, and through two books — her 2020 title 'Make America Healthy Again,' which criticized government overreach in healthcare, and her 2021 follow-up 'Panic Attack,' which condemned pandemic-era school closures and lockdowns.
She has also launched a wellness supplement company called DropRx, which sells botanical products marketed for focus and stress relief. The supplements, priced around $30 a bottle, are not reviewed by the FDA for effectiveness — a detail that is already drawing scrutiny given the role she is being nominated to fill as the nation's top doctor.
Interestingly, Saphier used the phrase 'Make America Healthy Again' years before Kennedy turned it into a movement — it was the title of her 2020 book, which tackled the opioid crisis, cancer, healthcare costs, and the government's handling of the COVID-19 pandemic, arguing that politics consistently overrode scientific data in public health decision-making.
She earned her medical degree from Ross University School of Medicine and completed fellowships at the prestigious Mayo Clinic, bringing a clinical training background that stands in direct contrast to Means, who graduated from Stanford medical school but never completed her residency program and whose license lapsed in 2024.
Where Saphier Stands on Vaccines and Health Policy
Like Means before her, Saphier has raised questions about the hepatitis B vaccine given at birth, saying on a podcast that if a mother recently tested negative and lives a low-risk lifestyle, the newborn may not necessarily need the shot immediately and that timing could be discussed later in life.
She has also criticized COVID-19 booster mandates, arguing on a radio program in September that requirements were not consistently grounded in solid clinical evidence and that public health messaging around boosters frequently outpaced the science behind them.
However, Saphier has shown a willingness to publicly break with Trump on health messaging — she pushed back on his advice to pregnant women to avoid Tylenol entirely, pointing out that untreated fever and severe pain also carry serious risks for mothers and babies, and she has generally indicated support for vaccines, saying on Fox News that the majority of research shows no causal link between the MMR vaccine and autism.
Three Nominees, One Vacant Post — What Comes Next
Saphier is now the third person Trump has attempted to install as surgeon general in his second term. His first nominee, Fox News medical contributor Dr. Janette Nesheiwat, had her nomination abruptly pulled in May 2025 — before her confirmation hearings even began — after questions surfaced about her academic credentials.
Means then became the second attempt, nominated with strong backing from Kennedy, only to see her bid unravel over nearly a year due to her lack of an active medical license, her incomplete residency, and her evasive answers on vaccines during the February hearing that alienated both Republican and Democratic senators.
Saphier's nomination now heads to the Senate HELP Committee for consideration, and if Cassidy advances it to the floor, a full Senate confirmation vote would follow — though the political tension between Trump and Cassidy, and the ongoing question of how many Republican senators will fall in line, means the path forward is far from straightforward for the administration's third choice to lead the Office of the Surgeon General.
Read more in our Politics section for similar stories and expert analysis.
Charlotte Reynolds
Political Journalist
Charlotte Reynolds is a political journalist with years of experience covering Congress, federal policies, elections, and political strategy. She provides in-depth analysis and commentary on national issues.
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