Dr. Casey Means will appear before the Senate on Wednesday in a long-awaited hearing to discuss her highly scrutinized nomination for surgeon general.

Means, a popular wellness influencer, was a campaign adviser during Robert F. Kennedy Jr.’s presidential bid and an architect of his “Make America Healthy Again” agenda. Her brother, Calley Means, is a Kennedy ally and senior adviser to the Health and Human Services Department.

If confirmed to the role, Means would be an outlier among surgeons general: She does not hold an active medical license (her license lapsed in January 2024) and she did not complete her medical residency (she graduated from Stanford University School of Medicine but left a surgical residency program at Oregon Health and Science University in 2018, just months before she was due to complete it).

As a result, many medical professionals have questioned whether Means is qualified to become America’s top doctor with the authority to issue health warnings and advisories for the entire country.

Means did not respond to a request for comment ahead of the hearing. Emily Hilliard, a spokesperson for HHS, said that Means’ “credentials, research background, and experience in public life give her the right insights to be the surgeon general who helps make sure America never again becomes the sickest nation on Earth.”

President Donald Trump nominated Means for surgeon general in May on Kennedy’s recommendation after withdrawing his previous choice, former Fox News medical contributor Dr. Janette Nesheiwat.

Means’ confirmation hearing — previously scheduled for October — was postponed after she went into labor with her first child. Her nomination subsequently expired, so Trump nominated her again Jan. 13.

In her new role, she would also oversee the Public Health Service Commissioned Corps, a federal branch whose officers include physicians, nurses, scientists and engineers. The branch requires its officers to maintain active licenses in their respective fields.

Means could face tough questions Wednesday from Democratic members of the Senate Health, Education, Labor and Pensions Committee about her alignment with Kennedy, a long-time anti-vaccine activist who is now the secretary of health and human services.

The confirmation hearing comes amid mounting scrutiny of Kennedy’s leadership from Democrats and some Republican lawmakers. In his first year in office, Kennedy has fired top health officials, overhauled the childhood vaccine schedule, downplayed the role of vaccinations during an unprecedented measles outbreak and slashed funding for critical research areas like mRNA shots.

Like Kennedy, Means has gained popularity in wellness circles because of her messages about outsized corporate influence in the food and pharmaceutical industries. She has often expressed skepticism of traditional medicine, writing on her website that hormonal birth control has “horrifying health risks” and that the “total burden” of the vaccine schedule — before Kennedy overhauled it — is “causing health declines in vulnerable children.” (Neither claim is substantiated by scientific evidence. Routine childhood shots are backed by decades of safety data, and serious complications from hormonal birth control are rare.)

Prior to her nomination, Means sold dietary supplements, teas and other wellness products on social media — a subject that has generated concern about potential conflicts of interest. A review from Public Citizen, a consumer advocacy group, determined that Means did not consistently disclose that she could profit or benefit from the sale of certain products.

The group has also raised questions about whether Means stands to profit from Kennedy’s endorsement of wearable devices, since she co-founded Levels, a company that helps people track their blood glucose via a wearable monitor and app.

Means signed an ethics agreement in September stating that she would resign from her advisory position at Levels and stop putting up monetized social media posts. She also agreed to stop producing her newsletter and promoting a 2024 book she co-wrote, “Good Energy.”

The book argues that people can “improve and extend their lives” through “simple principles doctors aren’t taught in medical school” — namely eating healthier, getting more sleep and physical activity, and understanding one’s underlying disease risk.