President Donald Trump on Thursday nominated Dr. Nicole B. Saphier to serve as the next surgeon general of the United States, moving within minutes of announcing he was withdrawing the stalled nomination of Dr. Casey Means, his second pick for the post and a favorite of Health and Human Services Secretary Robert F. Kennedy Jr.

Less than half an hour separated the two Truth Social posts. The first pulled Means. The second named Saphier. The speed of the pivot signaled that the White House had a replacement ready well before the public announcement, and that the administration had concluded Means could not clear the Senate.

Saphier, a radiologist and director of breast imaging at Memorial Sloan Kettering Cancer Center Monmouth, is Trump's third choice for the position. She is also a Fox News contributor and host of the program "Wellness Unmasked," as the Daily Caller reported. Trump praised her in his announcement post on Truth Social:

"She is also an incredible communicator who makes complicated health issues more easily understood by all Americans."

He called her a "star physician" who has spent her career guiding women through breast cancer diagnosis and treatment and who has championed early detection and prevention across multiple forms of the disease.

Why Casey Means failed to secure confirmation

Means was nominated last May as a replacement for Dr. Janette Nesheiwat, Trump's original surgeon general pick. Kennedy had championed Means as a standard-bearer for the Make America Healthy Again agenda, and Trump said at the time that she had "impeccable 'MAHA' credentials" and plans to work with Kennedy on chronic disease.

But the nomination ran into resistance almost immediately. Her confirmation hearing before the Senate Committee on Health, Education, Labor, and Pensions was postponed in late 2025, and when it finally took place earlier this year, she failed to gather enough votes. As Newsmax reported, Means faced tough questioning from senators of both parties about her vaccine views and other health positions, raising serious doubts about whether she could win confirmation.

The collapse of the Means nomination was months in the making. Her lack of bipartisan support, and the erosion of Republican support, left the White House with a nominee who could not move forward.

Trump placed blame squarely on Sen. Bill Cassidy, the Louisiana Republican who chairs the HELP Committee. In his Truth Social post withdrawing Means, Trump cited the "intransigence and political games" of Cassidy and called him a "very disloyal person." Trump noted that Cassidy had used Trump's endorsement to win election but later voted to impeach him.

The president did not leave Means empty-handed, at least rhetorically. He wrote that she would continue to promote the MAHA agenda outside the surgeon general's office:

"Casey will continue to fight for MAHA on the many important health issues facing our country, such as the rising childhood disease epidemic, increased autism rates, poor nutrition, over-medicalization, and researching the root causes of infertility, and many other difficult medical problems."

Who is Nicole Saphier?

Saphier brings a markedly different profile than Means. Where Means drew fire for her views on vaccines and her relatively unconventional medical background, Saphier is a practicing radiologist at one of the country's most prominent cancer centers. She has built a public career around cancer awareness, early screening, and health communication.

She has also staked out positions that align with the MAHA movement's skepticism of federal health bureaucracies. In 2022, she pushed back against the Centers for Disease Control and Prevention, claiming the agency would mandate coronavirus vaccines for schoolchildren. In 2025, she asked both the CDC and the American Academy of Pediatrics to allow parents to delay the MMR vaccine for their children.

Saphier framed that position as one of parental choice, saying parents should be able to "have that conversation and let them wait until their child's a little bit older."

She is also the author of a book titled "Make America Healthy Again: How Bad Behavior and Big Government Caused a Trillion-Dollar Crisis", a title that mirrors the administration's own health branding. The White House's rapid-response account on X highlighted her "impeccable 'MAHA' credentials" shortly after the announcement.

The nomination fits a broader pattern of Trump moving decisively when his personnel picks stall in the Senate. Other nominees have withdrawn after extended confirmation delays, and the administration has shown little patience for leaving key posts unfilled while the upper chamber dithers.

A third try at filling the post

Saphier is now the third woman Trump has tapped for surgeon general. Nesheiwat was first. Means followed. Each departure has carried its own complications, but the throughline is a Senate confirmation process that has repeatedly bogged down the administration's health agenda.

As Fox News reported, the announcement came after Trump accused Cassidy of obstructing the prior nomination. The president's willingness to name a specific Republican senator as the obstacle, and to do so in blunt, public terms, reflects both his frustration with the process and his calculation that the fight over Means was no longer worth waging.

For Kennedy and the MAHA movement, the withdrawal of Means represents a setback. Means was Kennedy's preferred choice, and her nomination was seen as a signal that the administration's health reform agenda would extend beyond rhetoric into personnel. Signs that Trump might pull the nomination had been building for weeks before Thursday's announcement.

The New York Post noted that Means' nomination had languished after her February Senate HELP Committee hearing and that Trump and her allies blamed Cassidy for standing in the way. Whether Saphier will face a smoother path remains an open question. The White House did not respond to the Daily Caller's request for comment on the nomination.

The administration has also been reshuffling leadership at other federal health agencies. Trump recently tapped former deputy surgeon general Erica Schwartz to lead the CDC, part of a broader effort to install aligned leaders across the public health bureaucracy.

What comes next

Whether the Senate has formally received Saphier's nomination is not yet clear, nor has she publicly commented on the announcement. Her confirmation process will test whether the HELP Committee, and Cassidy in particular, will treat this nominee differently than the last one.

Saphier's medical credentials are more conventional than Means', her public profile is well established, and her book title alone suggests she arrives speaking the administration's language. But the surgeon general's office has now been without a confirmed occupant through three nomination cycles, and the Senate has shown no urgency to change that.

At some point, the question stops being who the president picks and starts being whether the Senate intends to let anyone serve.